Wednesday, 27 September 2006
Office of Tobacco Control Annual Report 2005: Statements
I apologise for being late which was due to questions in the other House taking longer than anticipated. I thank Senators for this opportunity to address the House on the 2005 Annual Report of the Office of Tobacco Control.
Last year saw the first anniversary of the introduction of the smoke free at work initiative introduced by the then Minister for Health and Children, Deputy Martin, and the year also saw the sad death of Tom Power, the first chief executive of the office whose commitment and dedication to the cause of tobacco control impressed all who met him. It is only fitting that we should record his untimely passing and pay tribute to his record of achievement. Tom worked tirelessly in developing and advancing policy in the area of tobacco and health and his drive and determination contributed to the introduction of the smoke free workplaces legislation.
The office was established under the Public Health (Tobacco) Act 2002. It is the body established to progress the Government's tobacco control strategy as outlined in the 2000 document, Towards a Tobacco Free Society. I will briefly summarise the work of the office during 2005. During that year much of the office's work was directed towards ensuring compliance with the smoke free at work legislation. This was achieved in co-operation with the Health Service Executive and the Health and Safety Authority. The office also played an important role in co-ordinating the national tobacco control inspection programme.
Over 35,000 inspections were carried out by environmental health officers and compliance continues to be high — 95% of premises inspected were compliant. This indicates that the vast majority of enclosed workplaces are smoke free and confirms that the measure enjoys widespread public support. Where necessary, prosecutions are initiated and 38 prosecutions were taken during the year. Of these, 32 related to licensed premises, four to taxi companies, one to a retail shop and one private individual was also prosecuted. Some 37 of these prosecutions were successful.
The office is also involved with the continued operation of the smoke free compliance line, although call volumes have dropped considerably. A total of 1,353 calls were received during the year and the office also dealt with over 700 calls from members of the public.
The office's role in regard to compliance was underlined and reinforced by a national radio and television campaign which was run during the year with the theme, "smoke free is working, let's keep it that way". The campaign reinforced the message that smoke free workplaces promote employees' health and well being and it also reminded people that the compliance line was still in operation.
The office continued its involvement in research into tobacco control programmes during the year. In conjunction with the Research Institute for a Tobacco Free Society, it funded the all-Ireland bar workers study conducted by Dr. Shane Allwright of TCD. This study monitored the effects of working in bars North and South and compared and contrasted the effects of working in a smoke free environment as against one where smoking is permitted.
This showed that among non-smokers, cotinine concentrations in the saliva declined by 80% in the South and by only 20% in the North. Cotinine is a breakdown product of nicotine. Work-related exposure to tobacco smoke dropped very significantly in the South but only slightly in the North. Exposure outside work decreased significantly in the South but increased in the North. This is a potentially significant finding and may indicate that the underlying public health message is getting through to people generally. Also, in the South, there was a significant drop in the number of bar staff reporting respiratory symptoms.
In regard to smoking prevalence, the office continues to monitor this important indicator. In recent years, smoking prevalence has fallen significantly — from 31% in 1998 to 24% in 2005. Unfortunately, there was a slight reversal of the downward trend in 2005 as against 2004 and the office believes that this indicates a need for a sustained anti-smoking campaign.
On a more encouraging note, a public opinion survey commissioned by the office showed that there is widespread support for the smoke free at work initiative. Some 93% of people think the measure was a good idea, including 80% of smokers; 96% of people think the measure is successful, including 89% of smokers; and 98% of people think that workplaces are now healthier, including 94% of smokers.
This widespread support is very encouraging and it shows that public opinion is likely to be supportive of other measures intended to reduce the harm caused by tobacco because, make no mistake about it, despite recent progress, smoking continues to be the number one avoidable cause of mortality and morbidity and there is a compelling case to be made for the re-intensification of our efforts to respond effectively to the challenge.
On this point, Senators may wish to note that my Department is currently heavily involved in defending a challenge to the Public Health (Tobacco) Acts which has been initiated by the tobacco industry. The case is currently in the High Court and is likely to go to a hearing towards the end of the year. In addition, my Department has recently concluded a consultation process on prohibiting the sale of cigarettes in packs of fewer than 20 and I expect to be in a position to announce a date for the implementation of this measure shortly.
During the summer I had the pleasure of attending a major conference in Washington on the tobacco issue. I had the honour of accepting an award on behalf of the Government, although I felt a little guilty since I was not that directly involved in——
Over 130 countries were represented at the conference. From listening to some of the contributions during the conference and from chatting to people on the sidelines, it was very encouraging to hear people talking about the miracle that had taken place in Ireland, how a small country in which many had pictured people with the pint in one hand and the cigarette in the other could be so courageous in taking this move and the inspiration it had given them to follow suit. Indeed, many countries have followed the same pattern, although perhaps not in the same fashion. There is an awareness that this is one area in which we can take action that will have immediate benefits to the people. It is all about trying to improve the health of our people and it is encouraging to see such a positive response from other countries.
The Department of Health and Children is involved in an EU process to introduce pictorial warnings which are significantly more striking than the current text-based warnings.
I welcome the Minister of State to the House and thank him for his contribution. I join him in his tributes to the former chief executive of the Office of Tobacco Control, Mr. Tom Power, and extend our sympathies to his family. Through his work, Mr. Power left an outstanding legacy which we must complete.
The Minister of State said there are many challenges to face and the figures to which I will refer highlight the extent of those challenges. We have, however, come a long way. During the late 1990s I was a member of the Oireachtas Joint Committee on Health and Children and, under the chairmanship of Deputy Batt O'Keeffe, the major project undertaken was to tackle smoking. It seemed a task that could result only in limited success but, fortunately, the committee's work was taken on board by then Minister for Health and Children, Deputy Martin, and its recommendations led to the smoking ban in the workplace. We have reached a positive stage and we can map the progress made but we should not underestimate the challenges which still face us.
One fact that jumps off the page at the reader is the trend in cigarette smoking. TNS/MRBI carries out a monthly tracker survey on behalf of the Office of Tobacco Control and it presents a picture that causes some concern. More females than males aged 15 and up smoke, 24.1% compared to 23.7%. There is a significant number smoking between 15 and 18 years of age, 17.6%. The age group with the highest rate of smoking prevalence is the 19 to 35 year age bracket, with 32.4% smoking. The real challenge is not simply maintaining the ban on smoking in the workplace but tackling those statistics. We must aim to eliminate smoking almost entirely because of the destruction, death and resultant costs to this country of tobacco smoking. The report notes that smoking kills almost 6,000 people in Ireland every year. We have public debates on a monthly basis on the rate of road traffic fatalities, tragic deaths that affect hundreds of families every year. Along with that we have this statistic of 6,000 people dying every year as a result of smoke-related illness. The challenge is very significant.
Medical analysis shows that there is an immediate improvement in health once a person stops smoking. We still, however, have huge numbers dying as a result of tobacco smoke and we must continue to highlight that. The statistics on young people, particularly women, who smoke prove that the fact of tobacco causing 6,000 deaths per year does not get through.
We must campaign aggressively in advertising to dissuade young people from taking up or continuing with the habit. The Minister of State's closing comments on the introduction of a ban on the sale of cigarettes in packs of less than 20 will be supported by Fine Gael, as it will be by everyone committed to ending smoking. This commitment was made some time ago, however, during the 2004 legislation, when we were told there would be a ban on the sale of packs of ten cigarettes. That has not happened so there should not be any further delay and I hope to hear an announcement on this soon.
At this time of year, we look forward to the budget. In recent budgets there have been only modest increases in cigarette prices. Experts tell us that price is the main disincentive to cigarette smoking among young people. The Minister for Finance must listen to the Minister for Health and Children and ensure there will be a substantial increase in the price of cigarettes in the next budget because it is a way to reduce consumption and, thus, to reduce the 6,000 deaths per annum.
We must continue to remind ourselves of this figure because when we read these reports and congratulate ourselves on being European and world leaders in our efforts to rid society of tobacco smoke, we can think the job has been done when 6,000 people are still dying every year and 30% of young people are smoking. Huge challenges remain. If price can play a part in the reduction of cigarette consumption among young people, the obligation on the Ministers for Health and Children and Finance is to act.
The workplace ban has been a success. Complaints by third parties are acted upon quickly and prosecutions follow. Such action is necessary and effective. Walking into a pub is almost entirely different from just four years ago. At the time the Minister for Health and Children took a lot of abuse but showed a commendable degree of courage and acted in a proper fashion, showing genuine leadership. We are all now benefitting from that decision but more leadership is required on pricing and advertising because the mountain remains to be climbed and the public perception changed.
Huge numbers are under greater stress than ever, with young people facing challenges in life in a broad range of areas. The lure of cigarette smoking as an antidote to all their problems presents itself to thousands of young people every year in an attractive fashion. That is why, from a political perspective, we need to continue our campaign against smoking from a legislative and advertising viewpoint to change the mindset because the perceived short-term benefits of tobacco result in major long-term costs.
I compliment the new chief executive and staff of the Office of Tobacco Control on their work. Much more needs to be done but it is moving in the right direction. It is one of the few issues that has been tackled over the past nine or ten years with all-party support about which we can report genuine progress. We must not count our chickens too soon, however. We note from the statistics that major challenges remain, so we need to redouble our efforts concerning legislation, advertising and consultation. The figure of 6,000 people dying annually in this country from tobacco-related illnesses is scandalous. It is in everybody's interest to ameliorate the situation as soon as possible.
Cuirim fáilte roimh an Aire Stáit go dtí an Teach. We have rarely had a victory such as that represented by the Public Health (Tobacco) Act. Both Houses should be complimented on having brought forward this legislation unanimously and with the support of trade unions that were conscious of the safety of their members in the workplace. It is hardly any wonder that the Public Health (Tobacco) Act is being challenged by the tobacco industry. Is that the same industry that from time to time increased addictive substances contained in tobacco products? That ensured that smokers would continue to be addicted, thus sustaining their habit. Dick Turpin may have worn a mask but he was a decent man. This is an outrageous insult to the public's intelligence.
I join with others in expressing sympathy to the family of the late Tom Power. As a member of the Oireachtas Joint Committee on Health and Children, I came to know him well. In the embryonic stages of this legislation, I had much contact with Mr. Power whom I found to be a committed and dedicated person in pursuit of the objectives now contained in the Public Health (Tobacco) Act. Since its enactment, the legislation has represented a victory for Members of the Oireachtas, trade unions and society in general. Unfortunately, it was one of the rare proactive measures taken over the years to deal with the scourge of smoking.
As a former smoker, I had great difficulty in kicking the habit. I worked in the psychiatric services where the cigarette or pipe was an integral part of the habits of residents of such hospitals. It does not happen as much as it used to but it was probably associated with their condition. We all welcome this proactive measure because the reactive measures can be seen in our hospitals when people reach the respiratory clinics and may need a lung transplant.
The general function of the Office of Tobacco Control is to promote a tobacco-free society in accordance with the Government policy document Towards a Tobacco-Free Society. In tandem with the experience of the Minister of State, Deputy Sean Power, I was pleased to attend a seminar in Luxembourg entitled "Towards a Smoke-Free Europe". On that occasion, this little dot on the edge of western Europe called Ireland, received resounding tributes for the proactive measures it adopted in the Public Health (Tobacco) Act 2002. It was pleasant to listen to highly-placed and well-qualified people paying tribute to the former Minister for Health and Children, Deputy Martin, as well as to the Oireachtas generally. I was pleased to have taken part in that seminar.
Now that the Act has been enforced, it is time to carry out an audit on its success or failure rate. When I entered the psychiatric nurses' training school in Mullingar, most of my colleagues smoked. By the time I had given up smoking, however, of the ten other student nurses only one smoked. That shows that many people had kicked the habit.
Research shows that the number of smokers in Ireland has declined to 23.6% in August 2005, which is less than one in four of the population. That represents a decrease from 31% in 1998, which was almost one in three people. Over the last two years, there has also been a significant drop in the number of cigarettes being smoked, particularly among heavy smokers. However, there is no room for complacency. Almost one fifth of 15 to 18 year olds continue to smoke even though it is illegal for tobacco products to be sold to them. Retailers have to obey the law and we must now turn our attention to more vigorous enforcement of the law in this regard. In particular, leadership within the retail sector must offer more creative solutions to this problem. In addition, we need to acknowledge the reality that cigarettes are affordable, particularly for young people. This issue needs to be addressed as a priority. I agree with my Opposition colleagues that there should be a significant increase in the price of cigarettes.
The problem with tobacco is that it is a legal drug and to some extent it is socially acceptable. In the fullness of time, however, the process whereby people who must now vacate licensed premises to smoke outdoors will bear fruit. They must make a conscious decision to get up from their comfortable seat indoors to got outside in mid-winter to a cold area to smoke a cigarette. Surely some of them will realise that what they are doing is not in their best interests.
This summer, the Department of Health and Children invited submissions regarding the banning of the sale of cigarettes in packs of less than 20. It is my hope that once packets of ten cigarettes are prohibited this worrying trend will decline. Surveys for the Office of Tobacco Control have also found that 92% of under 18s who bought cigarettes were not asked for ID. So much for the laws that this House and the other House pass. We can only enact laws, we cannot enforce them. I ask those whose responsibility it is to enforce the law to do so vigorously in the case of tobacco consumption.
In July, the British Government announced that it plans to raise the legal age for tobacco consumption to 18 and to introduce tougher penalties for retailers who sell tobacco to under age smokers. For retailers who sell tobacco to under age smokers the one simple remedy is to take away their licence. We have to get tough. Perhaps there is something we could think about in implementing the British proposal here. The British Minister for Public Health, Carolyn Flynn, pointed out that the younger people start smoking the more likely they are to become lifelong smokers. Someone who starts to smoke at 15 is three times more likely to die of cancer, due to smoking, than a person who starts in his or her late twenties. That is not a pleasant statistic.
Another measure demanded by anti-smoking groups, which has proved effective in combatting teenage smoking in Canada, is the use of graphic images showing the damage caused by tobacco on cigarette boxes. Belgium is about to become the first EU country to introduce this measure this year. We must continue to target cessation programmes to support smokers to quit.
In March 2003 a Harvard study found that Irish pubs under smoke-free law in Ireland show a 91% lower indoor air pollution level than Irish pubs in cities around the world. A study of air pollution levels in traditional Irish pubs around the world has found that indoor air pollution from secondhand smoking in authentic Irish pubs in Ireland is 91% lower than in Irish pubs located in other countries and cities where smoke-free legislation does not exist. The study conducted by researchers from Harvard School of Public Health and Roswell Park Cancer Institute in conjunction with the Office of Tobacco Control, the Research Institute for a Tobacco Free Society and the environmental health department in the HSE, western area, assessed air samples from 128 Irish pubs in 15 countries in North America, Europe, Australia and Asia. It is ironic that virtually every major city in the world has an Irish pub but only those in Ireland and a handful other cities, primarily in North America, have clean healthy air. That is convincing evidence of the dangers of environmental tobacco smoke.
The Irish law has also brought health benefits to the public as early research indicators have highlighted. Its successful implementation and enforcement is encouraging to other countries which intend to follow suit, including our closest neighbours in England, Scotland, Wales and Northern Ireland. We encourage other countries to do likewise.
Environmental tobacco smoke and the practice of smoking tobacco has been proven to be a known and established carcinogen. One has only to speak with the experts and visit our hospitals for that proof. The challenge by the tobacco industry of this law is grossly irresponsible. I am deeply disappointed but not surprised.
I welcome the Minister of State. Like all those in Washington who congratulated him, I applaud the marvellous effort by the Department of Health and Children, the then Minister for Health and Children, all those involved from ASH, the Irish Heart Foundation, Irish Cancer Society and all the institutions which pushed to get the legislation brought forward. I am utterly disgusted to hear it is being challenged by the tobacco industry in the courts. That has to be expected because it is what is being done internationally.
While the report is encouraging there are some serious issues that need to be addressed. That the rate of smoking is down to 24% from 31% in 1998 is encouraging. However, it is worrying that the number of women who smoke is the same as the number of men. Some years ago I was amazed to see in some parts of England, particularly east London, that the incidence of death from breast cancer in women was superseded by the incidence of death from lung cancer. Unfortunately the incidence of lung cancer in women is increasing here. It is probable that we will have to address the issue from a gender point of view. This is an area we have to deal with because we constantly hear about women drinking more and emulating men by drinking one for one with them. It appears we have reached a situation where women are achieving in smoking what men are trying to get rid of. Men start to smoke earlier than women and smoke more but they manage to give up more easily and earlier. That three quarters of smokers want to quit means we have a receptive audience. Therefore, it is important to see how we can address this issue.
Other Senators have raised the issue of affordability. Internationally that is an important consideration in getting people to stop smoking. I regret that in the 2006 budget there was no increase in tax on tobacco products and I hope this is remedied in the 2007 budget. It is a good idea that the Minister is bringing forward legislation on the sale of cigarettes in packets of fewer than 20. Behind the checkouts in many supermarkets are rows and rows of packets of cigarettes. Access is very important and it is all too easy. I see people asking for a packet of cigarettes as well as whatever they have put into the shopping basket. Perhaps the Minister of State would consider access and the position of cigarette products in supermarkets. This is extremely important in trying to reduce consumption.
While we have not addressed the issue of advertising here it is important. It is interesting to note that 60% of those who smoke Marlboro Light are female, as pointed out in the report, that nearly 70% of those who smoke Silk Cut Blue are female and 64% of those who smoke Silk Cut Purple are female while John Player and Benson and Hedges are favoured by male smokers. How are these products being projected at those who are smoking them? There must be a subtle difference in the advertising. The word "light" was included to appeal to women to give the impression that it was not as harmful as ordinary cigarettes. There is a class action in the United States where a judge has said it was a misleading form of advertising to call any brand "light" as so-called light brands were just as harmful as the regular brands.
The Minister pointed out that Dr. Shane Allwright's report showed huge changes in those who work in bars in particular. The improvement was astonishing. It also shows the dangers of passive smoking. A good leaflet has been produced on passive smoking entitled Let's Clear the Air and Create a Healthier Environment for Everyone, but I wonder whether it is getting enough circulation.
I re-read the 1996 report by the Economic and Social Research Institute, Women and Health Care in Ireland by Miriam Wiley and Barry Merriman, on tobacco and substance abuse. We will probably find that the trends are much the same, only better, because the incidence of smoking has reduced. Rural women smoke less than urban women. This report points out that Connacht-Ulster has the lowest level of smoking with only 20% of the target population smoking whereas in the Dublin area, the figure is 25%. It is interesting to note how particular factors affected whether a woman smoked in the various categories of women by occupation, education and social class.
We must not just base our help on gender but must break down the figures and help particular groups. For example, half of women in non-manual jobs but only 40% of women in manual jobs never smoked. The people least likely to smoke are women in higher professional class jobs, only 16% of whom smoke. As these figures are somewhat out of date, the numbers should have improved. However, there is a significant difference between the groups. Improved figures depend on education. Only 40% of women with primary education only never smoked whereas almost 70% of women with university education never smoked. Some 38% of women with medical cards smoke and these are the people who are most likely to have financial troubles.
I found the United States study very interesting. It showed that a woman in the lower socio-economic class was 3.7 times more likely to smoke during pregnancy. We have a serious problem with women smoking during pregnancy despite the fact it is well known and publicised that smoking seriously affects the foetus. Women who smoke have a higher incidence of miscarriage, stillbirth and of low birth weight children and when their children are born they are more at risk of sudden death. Cot death is tragic for any family.
It is important to remember that it is not just the woman's smoking that has an effect, but also that of the man or any other people in the house. Having a child in a smoky atmosphere is bad because children's defence mechanisms are much less developed than at a later date. Even when children pass the babyhood stage and the risk of sudden infant death, smoking can precipitate respiratory infections like bronchitis and pneumonia. Children of smokers are also much more likely to get chronic middle ear disease which is the commonest cause of deafness in children. Lung growth is also slower and these children will have less healthy lungs. Children with asthma are much more likely to suffer severe attacks if they are exposed to passive smoking. They will also have frequent coughs and sore throats and miss time from school. Smoking is, therefore, a serious issue for children.
It is extraordinary that studies in both Spain and Sweden show that far more pregnant than non-pregnant women gave up smoking. Unfortunately, we have not managed to get this message through to women. Large numbers of women here who smoke do not give up smoking during pregnancy as anyone who passes by our maternity hospitals will see by the numbers of women in late pregnancy standing outside dragging on their fags. We had to close down the little smoking rooms when the legislation was introduced. Those rooms used to be thick with smoke from the cigarettes of women smoking during late pregnancy, sometimes encouraged by visitors.
Senator Glynn mentioned the situation in psychiatric hospitals where significant smoking takes place. I remember a time when patients were given cigarettes more or less as a reward for good behaviour. It is good there has been such an improvement in that area.
Has the Minister of State reconsidered the situation in prisons? We must remember that all those who do not smoke, whether prison officers or other prisoners, are subject to passive smoke while prisoners are smoking. Attempts have been made to segregate smokers from non-smokers within cells, but do we need to reconsider the situation? I understand the prison is the person's home while he or she is there. On the other hand, if three-quarters of those who smoke want to give up smoking, it might be worthwhile addressing the issue again.
I congratulate the Minister of State on this report. It is great there has been support from all sides of the House for bringing it forward. We cannot forget the debate on the ban where it was implied that human life as we knew it would never be the same after the introduction of the ban. That has been proved totally wrong. The ban has done nothing except improve the situation for everyone in the country.
I welcome the Minister of State to the House and am pleased to have the opportunity to debate this comprehensive report from the Office of Tobacco Control. Other speakers have outlined the fact that the main objective of the report and the office is to inform public opinion and build support for tobacco control measures.
The Minister of State spoke about the thrill of being in the United States during the summer and receiving Ireland's deserved reward for the implementation of this measure. I spent a week in France where I noticed the difference between our non-smoking environment and the French smoking environment. As soon as I entered my hotel I wondered what was the terrible smell until it dawned on me that everybody in the lobby was smoking cigars or cigarettes. People were also smoking on the beach around young children. The weather is so sunny abroad that people eat outdoors, but when we went to eat out at night we were bombarded with smoke again. Not only is the smell bad, the smoke also affects one's eyes and throat and leaves a horrible lingering smell on clothes. It is terrible.
This experience brought home to me how lucky we are in Ireland to enjoy such a smoke free environment, particularly in our workplace and social outlets like pubs and restaurants. Whenever we sit on a plane or attend the cinema, we wonder how we ever allowed people smoke in these areas. I hope future generations will continue to ask the same question.
The report outlined stark statistics. I am delighted to hear the compliance rate is 95%. When looking at the nice charts dotted throughout the report, I was surprised to see that fewer than 24% of our population smoke. I thought the figure would have been lower because that is almost a quarter of the population. We should be aiming for a figure less than 24%. Some 93% of people think smoke-free workplaces are a good idea. What happened the other 7%? Perhaps they were not awake on the day of the survey. Everybody in his or her right mind, whether a smoker or not, would like a smoke-free environment. It is great that of the number of premises inspected, 95% were found compliant. I was interested in the Minister of State's report that 35,000 premises were inspected by control officers.
One fifth of teenagers from 15 to 18 years of age continue to smoke. This is alarming and it is sad that many of these young people are probably female. The male-female divide on smoking is 50-50 and as many young women as men smoke. Six thousand people die per year from tobacco related illness and lifetime smokers have a 50% greater chance of developing tobacco related illnesses. These are terrible figures.
Some time ago the Oireachtas Joint Committee on Health and Children heard a presentation from thoracic and lung surgeons. They pointed out how important it was for young women, particularly those with a persistent cough, to ensure they had lung and chest X-rays. By 2020, lung cancer will be a predominantly female disease in this country. This is most worrying, particularly when other health risks to which young women are exposed, including excessive drinking, are considered. Earlier today I heard what might have been an advertisement during the Pat Kenny show which referred to a debate running for a number of weeks in conjunction with an open week for the Rutland Centre. Reference was made to a public talk with questions and answers entitled "Wine, Women and Wasted Lives". Today's young women are all bright and well educated. I do not think they even know what is coming down the road at them.
I was delighted to see that the Minister of State's Department will introduce measures to ban the sale of cigarettes in any amount smaller than a 20 pack. Price is a major consideration in the fight against tobacco smoking. If the price is high enough, young people will be deterred from buying cigarettes. I suggest we lobby the Minister for Finance to make substantial increases in the tax on cigarettes in the upcoming budget.
I was also delighted to hear the Minister of State refer to the introduction of pictorial warnings on billboards rather than the digital message. If a message can be set out in picture form, it will have an effect, as has been seen in other instances.
I wish Dr. Michael Boland and his ten member board well. I compliment them on a fine report and on work well done which they should aim to keep up. Their work and the effects of their work will lead to a win-win situation; there are no losers in this one.
Cuirim fáilte roimh an Aire Stáit, ó mo chontae dhúchais féin, fear a bhfuil an-mheas agam air. I join with those who expressed sympathy and regret at the loss of Mr. Power, whom I did not know but who obviously had made a considerable impression. I wish to pay an unqualified tribute to my constituency colleague and fellow resident of Cork, on a very brave decision which pitted him against forces that were up until then regarded as invincible in Ireland. The vintners' lobby was one of the lobbies with which most politicians and parties were profoundly reluctant to engage in a head to head contest. It was taken to be a fact of political life that if one took on the publicans head on, one would lose. The former Minister for Health and Children, Deputy Martin, did not lose and the country benefited enormously from the measure. It was a world-leading decision and one which will spread across the whole planet. In my view, within 20 or 25 years, countries in which it is permitted to smoke in public places such as bars and restaurants and public buildings, will be the extraordinary exception.
I fully share my colleague's view about the cultural and aesthetic shock of going into premises outside of Ireland — particularly in our neighbouring island — and suddenly facing the odour of smoke. One of the pleasant side-effects of the smoking ban in our licensed premises has been a spectacular improvement in the general hygiene of the places because smells that were once covered up by the smell of smoke are no longer covered up and therefore have had to be dealt with properly. This is a commendable improvement.
I am concerned that the extraordinary success of the Irish smoking ban has provoked multinationals into watching this country much more closely. I refer to the extraordinary image of the ambassador of the United States lobbying against a levy on chewing gum, presumably the fear of further good example being the issue. I note the collapse of the Government's attempt to prohibit alcohol advertising which I believe was also the result of extraordinary lobbying. What has been achieved is wonderful but the forces that lobby for the status quo in many areas where public health is concerned have now decided that Ireland is a country to be watched very carefully. I regard this as a form of backhanded compliment.
It is always difficult for people who do not smoke, including myself, to understand the appeal of smoking. I can find most of the vices in life enormously appealing. I am naturally disposed towards vice and I do not think it is original sin; it is rather nice to have sex and——
I will not go into too much detail. Smoking has never been a vice that I could see the point of. I can see the point of every other vice. If smoking was not addictive, people would give it up very quickly because I do not believe it gives any great long-term satisfaction. It is something people start and they then become addicted and cannot give up. By the time they realise it is doing them health damage, they find it extraordinarily difficult and begin to rationalise it. If it was not addictive, most people would not stick at it for very long. This is a very serious issue even though I am making the point in a good-humoured way.
I have a few suggestions for the Minister of State. I fully support the idea of a minimum amount of 20 cigarettes per packet, which I would prefer to be a minimum of 200 but that is a separate issue. I do not believe in prohibition in most cases for substances that are currently prohibited but that is not to say I would legalise them because that would not be possible. Prohibition does not work very well. However, one can take constructive, concerted action to reduce accessibility. It may be worth considering whether cigarettes should be available only in premises which are to a degree restricted to persons over 18 years, such as licensed premises, where people under 18 should not really be present other than accompanied by an adult. The purchase of cigarettes or tobacco products should be restricted to places where only people over 18 have routine and regular access. There is a case to be made that all third level education centres and all training centres should prohibit the sale of cigarettes in any shops in those premises or anywhere there are people in the most vulnerable age group. We should seriously consider whether shops within a half mile radius of a second level school are appropriate places to sell cigarettes. I suggest a town like my own home town, Athy, or Newbridge, towns of 10,000 population, should have one or two places selling cigarettes. These could be identified as the places where one could buy cigarettes. Cigarettes should not be part of the normal range of products on sale in normal shops. I fully support some of my colleagues in the view that where retailers sell cigarettes to people under age, the same succession of penalties that arise in the case of pubs that sell to people under age should apply. These include various warnings followed by a closedown for a week. I believe many retailers would give up selling cigarettes because of the nuisance value involved if such penalties were in existence. I am informed the margin of profit is minuscule and that cigarettes are only sold to encourage people to purchase other products. There is a case for a steady succession of measures to reduce the number of places in which cigarettes can be bought. Cigarettes should not be sold in any place where large numbers of young people congregate, such as outside cinemas. None of these will end the effects of smoking, but it should be made more difficult for people under 18 to be anywhere they can get their hands on cigarettes.
There is a genuine case to be made about the price of cigarettes. I do not know if much can be done about it as I appreciate the argument that if the price is increased a huge incentive is provided for smuggling. I accept that, but I believe the issue is worth reconsidering.
I will mention some issues that I know to be true because I have been told about them, rather than witnessing them myself. Apparently there is a practice in many rural areas of a certain flexibility in pub closing times, and ashtrays may appear when the doors close at 11.30 p.m. An old-fashioned environment is then reinstated. Another example was reported to me by a publican in a part of Munster during the European elections. I was told that every Saturday afternoon people come in to see the Premiership matches. The doors are locked and the ashtrays are put out for the duration of the match, as these people will not come in to see a football match if they have to go outside to smoke.
It is time we spoke in a language that makes sense. The tobacco industry is made up of a form of drug baron. It has no more moral justification than Colombian drug barons for its existence. It serves no useful social or human purpose. Therefore I suggest to the Minister of State that as a fundamental principle of public policy, the National Treasury Management Agency and the National Pensions Reserve Fund should not invest in any industry which forms part of the tobacco industry. I would go as far as to state that our whole pensions industry, a major investor, should have a disincentive attached to investment in tobacco products.
There is no redeeming quality in tobacco, and it is an evil and dangerous product that has done enormous harm to people. It would not be continued in use if it was not inherently addictive. The idea of my and other people's pension funds being invested in an industry which will shorten people's lives seems to be a contradiction. I welcome the progress that has been made but I recognise more must be done.
I welcome the Minister of State, Deputy Seán Power, to the House. I congratulate the former Minister for Health and Children, Deputy Martin, on implementing the ban on smoking in workplaces. At the time of implementation I did not agree with him and if I had a free vote at the time I would have voted against the measure, as I used to be a smoker. I know what the addiction entails. I used to smoke 50 cigarettes a day up until 2 January this year. I am glad to have an opportunity to speak on the subject.
I know it is very difficult to give up cigarettes. If smoking in bars was still permitted, I would not still be off cigarettes. Usually if a person goes out for a drink and people are smoking, that person would smoke. I now find that when a person goes out for a drink to a local bar, for example, nobody is smoking and one does not have the urge to smoke. A person can have a drink in comfort. I find this to be the case.
There were many anti-smoking advertisements on television and on billboards. Two advertisements affected me. On television a 34-year-old man's lungs were shown. I will not describe what was in them as it was revolting. A billboard advertisement showed the brain of somebody who had suffered a stroke. The brain was dissected and clots of blood, etc., were visible. These advertisements affected and helped me. They undoubtedly make a difference.
In my home town there are two secondary schools, with approximately 1,000 children attending. When school finishes at a 3.45 p.m. or 3.50 p.m., I see the children coming from school. These young people range from 15 years to 17 years. The number smoking is frightening. The Office of Tobacco Control states that less than 24% of the Irish population are smokers. I honestly would not accept those figures as I believe many more people than that are smoking, particularly young people.
Senator Feeney mentioned the frightening statistic that by 2020, the biggest fatal disease in females will be lung cancer. It is important that we always keep vigilant. It has been proven beyond all doubt that smoking is very bad for us, but we must persist in getting that message out. The message is not getting to young people. It did for a time but recently, judging from what I see, young people are again smoking in greater numbers.
I am unsure as to whether it is a question of price or money. I was in a shop on a recent Saturday morning where a young girl was buying some bits and pieces. She got her cards and other bits, although she was not buying cigarettes. I would estimate she had €100 in her purse, although she was a young girl of perhaps 13 years old. It is not a question of money, as children undoubtedly have money. Although increasing the price of cigarettes is a deterrent, it is not the answer.
As a member of the North Western Health Board, I was aware of the practice of inspectors going into shops, particularly small corner shops. People running those shops usually employ young people to help out during the summer. In a number of cases, an inspector would have a 15-year-old girl with him or her dressed up to look older than 18, and these people would be used to catch out a young person behind the counter in the selling of cigarettes. That is not the way to go forward.
There have been 38 prosecutions in the country since the regulation was introduced. One prosecution was unsuccessful because the small shop owner fought the case and won it in court. It is wrong to carry out such a practice with small shop owners, as the fine is €3,000. Most business people are compliant and do not sell cigarettes to people under 18. I honestly believe this. It may occur if a young person is behind the counter. I know these fines must be in place but it is wrong to try to trick somebody.
It has been an interesting debate. One facet of it is the big problem of the number of people hooked on cigarettes and who cannot give them up. I have the Dominicans at Newbridge College to thank, as they created in me such an interest in getting on the football team that I was afraid to smoke in case I did not get on the team. I know the Minister of State, Deputy Seán Power, comes from that part of the world as well, although I am unsure as to whether he supports the Newbridge team to the same extent.
I know of a person hooked on cigarettes who is in hospital at the moment. She is in her 70s, and she has huge difficulties. It seems to be one of the big challenges we are facing. The success of the ban on smoking in the workplace proves that we can successfully change deeply rooted behaviour if we put our minds to it in the right way. Our task now is to ensure that we do not sit back following the implementation of the ban, that we move on the other areas of concern spoken about today.
The evidence shows that although the overall level of smoking remains static, there is a worrying increase, particularly in the numbers of young people and women smoking. How are we going to face up to this? Despite the success of the workplace ban, we should not be tempted into thinking that prohibition is an acceptable strategy in coping with the more general problem, as it is not. Down through the centuries and across the world, states have proved to be very unsuccessful in changing behaviour that is disapproved of. Generally speaking, when people are determined to act, they will find a way to do so whether inside or outside the law. We must persuade people not to smoke.
Research has conclusively proved that education, or propaganda if one prefers to call it that, can only go so far. It has a place in the overall scheme but its effectiveness is quite limited. It seems to become less effective as the level of smoking drops. As we heard today, we are lucky to have a relatively low level of smoking in Ireland, with only one quarter of the population smoking. Those smokers are the hard core and, as such, the most difficult to persuade to change their attitude.
We must face up to the fact that among some groups in society, namely, young people and women, smoking levels are increasing. We are fortunate that research also shows us the way forward. Repeated studies show the most effective persuader against smoking is price. Senator Ryan mentioned the danger of smuggling but I understand cigarettes are far more expensive in Northern Ireland than in the Republic.
Significant rises in the price of cigarettes consistently produce significant reductions in the number of people smoking. There comes a point when everybody realises it is simply not worth it to continue smoking. That point is reached when the impact of smoking really hits the pocket. It is not surprising the latest report of the Office of Tobacco Control makes a renewed plea to the Government to sharply increase the price of smoking well above the rate of inflation. Small increases have no effect on changing behaviour while sharp increases do.
In the past, the Government ignored such pleas and we must ask why. Cynics might state the Minister for Finance wants to protect the revenue he raises from tobacco duty. I do not subscribe to that view. The political reluctance to do what is best for the health of the country and its citizens is due to the fact that cigarettes feature in the cost of living index. A sharp price increase in cigarettes would be immediately reflected in the inflation rate. Today we heard people discussing our high inflation rate compared to other parts of Europe. Inflation is also a threat with regard to the programme for the future and 2016.
The inflation-linked index is a show-stopper and as a long-time implacable foe of inflation, I understand that. However, a sensible way out of the dilemma would be to remove cigarettes from the basket of goods which the Central Statistics Office uses in reckoning the monthly cost of living index. The problem would instantly disappear. Once cigarettes were removed from the basket they would not affect the rate of inflation no matter how much they cost. No wider political downside to a sharp increase in the price of cigarettes would exist. Smokers would object but the wider body of taxpayers would not be affected in any way.
Lobbying for a substantial increase in the price of cigarettes while the link to inflation remains is whistling in the wind. We know it will never happen. Serious campaigners against smoking should concentrate on getting agreement to remove cigarettes from the basket of goods used in calculating the cost of living index. If that is done, the political impediment to raising the price will immediately fall away. I urge the Minister of State to bring this to the attention of the Minister for Finance.
I thank the Senators for their contributions this afternoon. It was interesting to listen to people give honest opinions rather than feel they must defend a particular party line.
As Senators are aware, the impact of tobacco consumption on public health has been well documented in numerous reports from many agencies and organisations, both nationally and internationally. The range of diseases and ill health, including lung cancer and other cancers, heart disease, emphysema and chronic bronchitis, associated with tobacco smoke leaves us in no doubt of the absolute necessity to maintain an effective public health campaign. We will maintain that campaign.
I will deal with some of the issues raised, including price increases. I accept the maintenance of a high price for tobacco products is an important factor in preventing people, particularly children, from experimenting with tobacco. That is one reason we will introduce a ban on packets of fewer than 20 cigarettes. I hope to be in a position shortly to announce a date for its commencement. We recently placed an advertisement in newspapers informing the industry of our intentions and we will go ahead with this.
When a ban on smoking in the workplace was first proposed it was strongly opposed by the tobacco and drinks industries. We were warned about the devastating effect it would have on employment. Their main fear was a downturn in profits but the main plank in their argument was that unemployment levels would increase, which did not materialise. Few families in the country have not been affected by tobacco, alcohol or both.
The tobacco industry glamorises its product. Normally, young pretty women are seen smoking in sexy ads aimed at young people. The reason is new people must be recruited on a regular basis because their customers are dying. As Senator Bradford stated, 6,000 people die in this country each year from smoking-related illnesses. Campaigns are aimed at recruiting young people and the earlier they can do so the better.
The drinks industry works in a similar way. Last week, we were fortunate to host a wonderful event, namely, the Ryder Cup. It was a great success watched by approximately 1 billion people throughout the world. It was unfortunate that when it finished, the sporting idols to whom we all looked up glamorised drink in the manner they did after winning the competition. It was an opportunity which could have been used in a far more worthwhile fashion. That is a matter for another day.
In the advertisements run by the tobacco industry, no mention is made of the cancers, infected lungs, heart disease or discoloured teeth which are a result of smoking. We are all familiar with research showing the dreadful impact and effect smoking can have on a person's health. We have made a great deal of progress and given great hope to other countries on what can be achieved. It is important that we do not rest on our laurels but that we continue to build on the success we have enjoyed.
Earlier, I mentioned my recent visit to the United States to receive an honour on behalf of the Government. We are regularly visited by people from countries which wish to learn from our experience. I always make the point to them that while the Government, particularly the former Minister for Health and Children, Deputy Martin, showed great leadership, the support of Opposition parties and trade unions was an extremely important factor. All parties had individual members who were opposed to the measure but as parties we supported it, which made it easier to implement and contributed greatly to its success.
Senator Henry raised the issue of point of sale advertising. The tobacco industry is challenging in court a measure to get rid of advertising in shops, such as colourful tobacco holders. We were banning that type of advertising and trying to ensure that tobacco would be sold from an enclosed area so it would not be possible to see where the product was in a shop and a customer would need to ask the person behind the counter. Those are some of the measures being opposed. However, we are confident that we will be successful in that regard and we will continue with the battle.
It was nice to listen to Senator Henry sharing some of her experiences and the knowledge she has from her professional life. I also listened to Senator Scanlon who took a tough decision in quitting what had been the habit of a lifetime. He has given others hope of what can be achieved. I will pass on Senator Quinn's remarks to the Dominicans at Newbridge College. They will be delighted they had such an influence on him. I hope they will have the same success with their present day pupils as they had with the Senator.
It is all about new challenges. While some Senators raised issues and recommended certain measures, no single measure will bring change. However, the combination of measures will succeed in reducing the number of people smoking. As I said, we have seen a reduction. In 1998 some 31% of the adult population smoked. Last year the figure had reduced to 24%. We want to ensure the figure continues to drop and we will make every effort to ensure that the reduction in the number of smokers continues.