John Crown (Independent)
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I will take about 20 seconds of the four minutes allocated to me to state I am very supportive of Senator Cullinane's Adjournment matter. There is an extraordinary team of doctors working in oncology in Waterford Regional Hospital, and it has three of the hardest working oncologists. Those women are incredibly well trained and have done a wonderful job with routine care and the involvement of the Waterford hospital in the national research initiative. I express my great appreciation for the work of Dr. Horgan, Dr. O'Connor and Dr. Calvert.

I have not been in a position to follow today's news stories, but I understand there have been further disclosures of child abuse. I would like to talk about another form of child abuse, which takes place in our country every day. We are all aware of it and decreasingly tolerant of it. We need legislation to ban the exposure of young children to cigarette smoke, which contains harmful chemicals, in small enclosed spaces. When we are stuck at traffic lights every day, we often see one or more adults smoking in other cars even though children are strapped in with them. It should be possible to enforce a smoking ban in cars. This is not a crazy form of the nanny state or an attempt to heap further misery on hassled mothers and fathers who may be addled as they ferry their children around each morning. If they have addiction thinking, they might think their stress levels will be reduced if they have a cigarette.

There are unanswerable reasons to legislate definitively to ban smoking by adults in cars when children are present. One could go further and argue that smoking should be banned in front of children in any enclosed space, including rooms in people's own homes. Children are more vulnerable than adults to the effects of cigarette smoke for two reasons. First, they breathe more quickly. The respiratory rate of a young child is faster than the respiratory rate of an averagely fit adult. As a result, there is a greater exchange of chemicals into a child's system per minute than would be the case with an adult. Second, their weight is smaller and therefore they have a higher amount of exposure per kilogram of body weight. The relative impact of the potentially noxious chemicals in cigarette smoke on a young child is far greater than the impact on an average-sized adult. The issue of choice arises as well. An adult who is a non-smoker can choose to be in the company of smokers or to ask them to stop. Children often do not have that choice. Infants, by definition, never have that choice.

When a cigarette is lit in a car with the windows closed, within a minute the measurable occupational level of toxic emissions is 30 times higher than the level at which the US Environmental Protection Agency advises people to flee the streets, go into their homes and close their windows. If it is 30 times higher than the level that is considered dangerous, it is extraordinarily dangerous for children to be exposed to it. What does it actually do? Is this a vague theoretical concern or do we have quantifiable data? The data based on literature are very clear. Diseases like asthma, lower and upper respiratory infections, bronchitis, otitis or ear infections, meningitis and, chillingly, sudden infant death syndrome are more common in children who are exposed passively to second-hand smoke. The British Medical Association has suggested the data would indicate there is an increased risk of childhood cancers - not respiratory cancers, but lymphomas and tumours involving the nervous system - among children who are exposed to second-hand cigarette smoke. I have seen some data to suggest that people who grew up in a house where they were regularly exposed to second-hand cigarette smoke as children have a higher risk of developing lung cancer as adults, even if they do not have a smoking history themselves.

Ireland would not be the first country in the world to attempt to legislate for a ban on smoking in cars. As I have said, we could go further by banning smoking in all enclosed spaces. Many individual states in the US and many countries around the world have already activated the process of introducing protective legislation of this nature. I believe we should give serious thought to extending the current regulations to ban smoking completely within the confines of Leinster House, but that is a different day's work. I ask the Minister of State to bring the urgency of this matter to the attention of the Minister, Deputy Reilly. This is different from the mobile phone question we considered earlier, which continues to be the subject of genuine controversy. We should provide for some kind of warning about the potential, but as yet unproven, risks associated with mobile phones. This is different because we know there is a risk. Every adult who lights a cigarette, a cigar or a pipe in an enclosed area when a child is present is engaging in a form of child abuse.

Kathleen Lynch (Cork North Central, Labour)
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I am responding on behalf of the Minister, Deputy Reilly. I am aware that this matter was raised by Senator Crown yesterday during the debate on the Public Health (Tobacco) (Amendment) Bill 2001. As a result of the introduction of the smoke-free at work legislation in 2004, and other tobacco control measures since then, awareness of the risks of smoking and exposure to second-hand tobacco smoke has increased significantly. It is recognised that smoking in the car exposes all the occupants to harmful environmental tobacco smoke, which is a carcinogen that contains cancer causing substances and toxic agents that are inhaled by the smoker. There is no safe level of exposure to environmental tobacco smoke. Exposure to cigarette smoke is particularly dangerous in enclosed spaces such as cars. Parents and others with responsibility for the welfare of children have a particular responsibility to ensure such exposure does not take place.

Legislative measures have been introduced in a small number of countries to prohibit or discourage smoking in cars when children are present. The nature of the measures and of the accompanying compliance and enforcement arrangements have been variable and far from consistent. In some jurisdictions, smoking in cars is treated as a driving offence. Other jurisdictions have introduced an education tool aimed at highlighting the dangers of smoking in cars. Any proposal to introduce a ban on smoking in cars must be based on evidence, such as data on the extent to which it occurs and the risks to public health it poses. Consideration will need to be given to the extent to which it may be appropriate to deal with this question as a road safety and a public health issue.

The successful introduction of measures with regard to smoking in cars would benefit from the roll-out of a public information and education campaign to mobilise public support. A similar approach proved successful when the smoke-free at work initiative and subsequent tobacco control initiatives were introduced. These provisions were underpinned by a clear evidence base and good planning. Public opinion was mobilised through a public education and information campaign. Simple, clear and enforceable legislation was introduced. Proposals relating to smoking in cars are being considered in the context of the tobacco policy review that is under way in the Department of Health. The review is expected to be completed and submitted to the Minister for Health within months. The Minister, Deputy Reilly, has signalled that he is in favour of legislating in this area. However, he would like a public information and education campaign to highlight the dangers associated with exposure to environmental tobacco smoke in cars and to mobilise public support in advance of the introduction of legislation. I think the Senator is pushing an open door.

John Crown (Independent)
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I understand how legislative priorities can vary. Any delay in this regard would lead to real and quantifiable health problems for individuals. I suggested the other day that it would be easy to amend the original 2002 Act by including two one-line paragraphs. The first paragraph would ban smoking in vehicles in the presence of children, which is the conservative position. The second paragraph would ban smoking in any enclosed area in the presence of children. I believe it could be done with universal cross-party support. It could be enacted very quickly. The Minister of State said that a public information campaign would be essential. I suggest we would be pushing an open door with the public because there is overwhelming support for this measure. There would be no opposition to be overcome. We must remember that the tipping point for the original legislation, as introduced by the former Minister, Deputy Martin, was the exposure of people to carcinogens in a work environment over which they had no control. People did not think they should leave their jobs because others were smoking. The problem is far greater in this case because it affects young children. If the original ban was necessary in the interests of adults who could voluntarily leave their jobs, we should introduce this ban urgently in the interests of young infants, who are not aware of the problem or are unable to articulate it, and of older children, whose relationships with their parents may mean they are not in a position to say what should or should not be done.