Public Health (Tobacco) (Amendment) Bill 2003: Second Stage.

Thursday, 4 March 2004

Seanad Eireann Debate
Vol. 175 No. 18

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Question proposed: “That the Bill be now read a Second Time.”

Minister of State at the Department of Health and Children (Mr. T. O’Malley): Information on Tim O'Malley  Zoom on Tim O'Malley  The battle against tobacco is one of the most important health challenges facing us. It is clear the Government has prioritised tackling the huge negative impact that tobacco products have on the health of the nation — be this an impact from active smoking or from exposure to second hand smoke.

The impact of tobacco consumption on human health globally and nationally is well documented. Tobacco smoke is the leading preventable cause of death and disability in Ireland. Medical evidence has repeatedly confirmed tobacco as a cause of cardiovascular disease, including heart attack and stroke, common cancers, chronic obstructive pulmonary disease, asthmatic attacks, low birth weight babies and sudden infant death syndrome. Approximately 7,000 deaths in Ireland each year are attributable to tobacco related illness. Smoking tobacco products is one of the unhealthiest things a human being can do.

Life expectancy is lower in Ireland than the EU average and the diseases which contribute primarily to this are heart disease and cancer. Tobacco use is the leading preventable cause of these diseases. Smoking is a major causative factor in some 90% of the 2,000 deaths from lung cancer each year and increases the risk of other cancers such as cancer of the mouth and throat. Smoking is also a primary cause of cardiovascular disease, the greatest single cause of mortality in Ireland. Tobacco is a significant burden to individuals, families and society through death, illness and medical costs. Reduction in tobacco [1563]use will increase life expectancy in Ireland and result in happier, healthier and better quality lives for many Irish people.

Evidence has accumulated year on year of the enormous worldwide threat to human health from consumption of tobacco products. Studies carried out internationally in recent years have also confirmed there is a significant risk to the health of the non-smoker from inhaling environmental tobacco smoke referred to as second hand smoke or passive smoking.

The Public Health Tobacco Act 2002 was enacted in March 2002. The Act is the most comprehensive anti-tobacco legislation ever in this country and confirmed the commitment of the Government and the Oireachtas to the battle against the tobacco epidemic. The Act brought together a number of legal instruments and replaced two existing Acts, the Tobacco Products (Control of Advertising, Sponsorship and Sales Promotion) Act 1978 and the Tobacco (Health Promotion and Protection) Act 1988 and incorporated certain provisions of the Government’s policy, Towards a Tobacco Free Society. Strong legislative measures are an important public health instrument in countering the tobacco threat.

The main provisions contained in the Act are as follows — a comprehensive ban on tobacco advertising, including in-store advertising and displays, and on all forms of sponsorship by the tobacco industry; registration of tobacco retailers and tougher penalties for those convicted of under age sales; a ban on retail sales of packs of cigarettes of less than 20; tighter controls on sale of tobacco products from vending machines; a ban on the sale of confectioneries, normally intended for children, which resemble a tobacco product; public disclosure of all aspects of tobacco including toxicity and addiction; and a prohibition on the smoking of tobacco products in the enclosed workplace with limited exceptions.

The tobacco industry and other related trades commenced legal challenges to the Public Health (Tobacco) Act in June 2002. During the judicial hearings, which involved three sets of proceedings, the court was advised by the State of a problem in regard to a requirement to notify the EU Commission at Bill stage of some of the measures enacted to comply with two EU Directives 98/34/EC and 98/48/EC. These directives, known as the transparency-technical standards directives, require draft technical regulations to be notified to the EU Commission and to other member states in advance of their adoption.

The procedure is intended to provide transparency and control with regard to technical regulations which impose binding legal rules, regulating the characteristics required of a product such as levels of quality, performance, [1564]safety or dimensions, including the requirements applicable to the product as regards the name under which the product is sold, terminology, symbols, testing and test methods, packaging, marking or labelling and conformity assessment procedures. National measures of this nature could create unjustified barriers to trade between member states. Their notification in draft form and the subsequent evaluation of their content in the course of the procedure help to diminish this risk.

The procedure was not followed at Bill stage with the 2002 Act and, as a result, 14 of the 53 sections of the Act are affected. These sections relate mainly to the sale and marketing of tobacco products. However, other important aspects of the Act such as the establishment of the Office of Tobacco Control and the power to regulate smoking in the workplace remain in place.

As the Act is a public health measure, it was considered originally that it was not notifiable to the Commission as a technical regulation. It was also considered that the requirement to introduce commencement orders in the case of the Act would allow for notification of the commencement order in draft form, thereby meeting the requirements of the transparency directives.

Following correspondence and discussions with EU Commission officials on this matter and having obtained legal advice from the Office of the Attorney General, it became clear that any attempt to commence the affected sections would result in considerable uncertainty as to the enforceability of the sections in question. The court was advised of the attempts made through the Commission to resolve the issue and each set of proceedings was discontinued. Accordingly, the Minister decided that the quickest and most appropriate way of resolving the issue was to repeal the affected sections and to reintroduce them by way of a new Bill which would then be notified under the transparency procedure and, on completion of this procedure, would be re-enacted.

The Minister was advised by the Office of the Attorney General that with a view to assisting in the defence of any challenge brought to the re-enacted legislation, the amending Bill should be used as an opportunity to strengthen the Act in a number of areas. This is being done by, among other things, changing the Long Title of the Act to indicate that the Act is designed to give effect to as many of the EU and international measures as have been adopted at that date. The re-enacted legislation will include those EU measures relating to tobacco products to be transposed into national law.

The Minister was also advised by the Office of the Attorney General that the provisions for smoke-free workplaces should be introduced by means of primary legislation — that is by way of [1565]a Bill — rather than by means of secondary legislation, namely regulations. This will strengthen the Bill in the context of a possible legal challenge.

Since the enactment of the legislation, there have been many positive developments at European and global level. Directive No. 2001/37/EC of the European Parliament and Council was introduced on the approximation of the laws, regulations and administrative provisions of member states concerning the manufacture, presentation and sale of tobacco products. Among other provisions, the directive requires larger and more visible and effective health warnings on cigarette packs and provides for member states to make use of graphic warnings. The EU has also introduced Directive No. 2003/33/EC on the approximation of those laws, regulations and administrative provisions of member states which prohibit tobacco advertising and related sponsorship. The effect of the directive will be to deny the tobacco industry direct access to the public, particularly young persons, through print and other media. While Ireland has imposed a ban on tobacco advertising and sponsorship since July 2000, we have always recognised the need for strong measures at EU level in the area of advertising of tobacco products and sponsorship by tobacco companies.

A Council recommendation on the prevention of smoking and initiatives to improve tobacco control was introduced on 2 December 2002 against a background of 500,000 smoking deaths annually in the European Union. There is concern among member states at the numbers of adolescents and children who continue to take up smoking. Smoking remains the biggest cause of preventable death in the European Union. The Council recommends that member states adopt appropriate legislative and other measures to reduce morbidity and mortality from tobacco. Reports on the measures taken should be provided to the Council.

The World Health Organisation framework convention on tobacco control was adopted at Geneva on 21 May 2003. This historic and ground-breaking international treaty seeks to protect many millions around the world from the devastating impact of tobacco consumption and exposure to tobacco smoke. The treaty addresses all aspects of tobacco control, including the traditional health interventions on advertising and sponsorship, passive smoking and retail licensing. It addresses economic and trade issues including taxation policy, international trade and smuggling. Other elements of the convention include product specification and issues of compensation and liability.

Ireland has always advocated strong international tobacco controls. Many countries have already signed the WHO convention including, in September of 2003, the Minister for Health and Children on behalf of Ireland. The [1566]convention will make a significant contribution to the protection of future generations from the predatory practices of the global tobacco industry.

The section of the legislation dealing with indirect advertising is being removed as the EU directive on the advertising and sponsorship of tobacco products does not cover indirect advertising. Indirect advertising is often referred to as “brand stretching”. The removal of the section will serve to insulate the Act from further legal challenge. The provision on the prohibition of smoking of tobacco products in specified places is being amended to include the principles and policies which will inform the making of regulations under the relevant section.

During the Irish Presidency of the European Union, a major conference on tobacco control will be held in the mid-west region. Ireland has always recognised the need for a strong, unified EU approach to tobacco control and health. Many developing countries look to the European Union to initiate strong measures in this vital area of public health. The Irish Presidency is an opportunity to make further developments in this regard.

Much has been achieved to reduce the incidence of smoking in our population. Through a combination of measures, which included legislation, regulation, health promotion and education, we were able to achieve in 2002 the 27% level for 2002 reported in last year’s SLÁN survey. More recent surveys conducted by the Office of Tobacco Control indicate that smoking levels have dropped to almost 25%. This is welcome news. The reduction achieved will have many benefits, particularly for future generations which will come to accept non-smoking as the social norm.

The smoke-free workplace provisions in the Bill will come into force from 29 March 2004. The primary purpose of the “smoke-free at work” initiative is to protect workers and the public from exposure to harmful, toxic tobacco smoke. The “smoke-free at work” initiative is based on emphatic independent advice from experts. The report, Health Effects of Environmental Tobacco Smoke in the Workplace, published in January 2003, was commissioned by the Office of Tobacco Control and the Health and Safety Authority. It was prepared by an independent expert scientific group. The report reaches blunt conclusions about the risks posed to health by tobacco smoke and the measures necessary to protect employees.

The facts speak for themselves. Second-hand tobacco smoke is a cause of cancer, heart disease and respiratory problems. Employees require protection from exposure to second-hand smoke at work and current ventilation technology is ineffective at removing the risk to health. Legislative measures are required to protect workers from the adverse effects of exposure. A national public information campaign, “smoke-[1567]free at work”, is under way across television, radio and print media. A series of print materials for workplaces, employees and the general public is now available on-line at the new “smoke-free at work” website. The campaign will provide guidance and information to all sectors of society in preparation for 29 March. Information will also be available on-line from the websites of the Office of Tobacco Control and the Health and Safety Authority.

Monitoring of compliance with the smoke-free requirements in the food and hospitality sectors will be the responsibility of officers of the health boards and the Office of Tobacco Control. Health boards are in the process of filling vacancies in their established environmental health officer complements in the tobacco control area. The emphasis of the campaign will be on compliance building and harnessing widespread public support for a smoke-free environment.

Adapting to the new measures will require some adjustment, particularly for those in workplaces which have not benefited from the existing statutory controls on the smoking of tobacco products. I am confident people will adjust as they did when cinemas, theatres, hair-dressing salons, aeroplanes and numerous other settings became smoke-free. The trade union movement is strongly supportive and I am encouraged by the willingness employers’ organisations in various sectors have demonstrated in recommending that their members comply with the new measures. Most people are law abiding and responsible. I expect the vast majority of employers, employees and members of the public will respect these important new public health measures.

Our success in improving health nationally is linked to further reducing the level of tobacco use. In particular, this involves preventing young persons starting to smoke. If the incidence of tobacco use can be reduced further, we can make considerable progress towards a tobacco-free and healthier society. No matter how comprehensive, legislation alone cannot create and sustain the environment necessary to prevent people starting to smoke or assist those who have already started to quit. Our anti-tobacco strategy will be multi-faceted. It will contain strong legislative controls and effective enforcement powers. It will include a fiscal element and the supports required by smokers to quit.

The implementation of our comprehensive strategy will, in time, effect the necessary attitudinal changes in society to tobacco consumption. Attitudinal changes will be followed by the necessary behavioural changes. We owe it to ourselves, the younger generation, and, indeed, future generations to ensure we win the war on tobacco. We must ensure that the children and young people of today do not become future victims of the tobacco industry by [1568]being induced to smoke tobacco products or through exposure to and inhalation of environmental tobacco smoke. I commend the Public Health (Tobacco) (Amendment) Bill 2003 to the House.

Mr. Feighan: Information on Frank Feighan  Zoom on Frank Feighan  I welcome the Minister of State and join him in saying that this is a battle against tobacco. It is one of the most important health challenges the country has faced. We in Opposition wish to lend whatever support we can to ensure the blight of tobacco will not be a threat to this or any other country.

I once attended a conference on cannabis smoking. I was struck by a statistic which indicated that more people have died from smoking tobacco, since its introduction over 200 years ago, than in the First and Second World Wars. I found it difficult to understand how this drug has taken such a hold on western Europe, including Ireland, given its cost and damage to health. Any measure that can prevent the smoking of tobacco, which is harmful to children, workers in the workplace and customers, is welcome.

The 2002 Act brought together a number of legal instruments and replaced two existing Acts, one of which was the Tobacco Products (Control of Advertising, Sponsorship and Sales Promotion) Act 1978, which was welcome because at the time we used to have the Carrolls All-Stars. As a teenager I found it strange that icons of sport, GAA, football and hurling, could be associated with tobacco. That Act has helped those of us who aspired to sport to realise that smoking harms not only one’s health but one’s chances in sport. The Tobacco (Health Promotion and Protection) Act 1988 incorporated certain provisions of the Government’s policy, Towards a Tobacco Free Society. The main provisions of the Act were a comprehensive ban on tobacco advertising, including in-store advertising and displays, and all forms of the tobacco industry. This is where I am confused.

My family business is a newsagents. Tobacco sales was always a major part of a newsagent’s trade. To get around the so-called ban where one had a tobacco stand in the newsagents, the tobacco companies have installed a form of vending machine. Legally, they are able to circumvent the law by installing these machines. There are photographs of all the tobacco companies on the machine, for example, Carrolls, Major and so on. When a customer comes into the newsagents, I have to turn around from the till and press a little button and the cigarettes come out. I do not believe that policy was thought out sufficiently. It is business as usual. One can say that, as a newsagent, I should not sell these products. Whatever legislation was brought in has been circumvented by the multinationals and it is business as usual. There are serious profits from [1569]the sale of tobacco because these machines do not come cheap and they are installed free of charge in every newsagents and every retail outlet in the country. I do not believe anything can be done about it.

I agree with the registration of tobacco retailers and tougher penalties for those convicted of under age sales. I compliment the health boards, and particularly the Western Health Board, in that on five occasions in the past two years we have received a letter from the health board which had carried out on-the-spot checks. It sent a young teenager to the newsagents and thankfully my staff were vigilant and denied the teenager the cigarettes. I welcome these tough spot checks. If we had sold cigarettes to an under age person, I have no doubt the full rigours of the law would have been applied. I welcome the pro-active approach of the Western Health Board in ensuring cigarettes will not be sold to under age persons.

The ban on the retail sale of packs of less than 20 cigarettes is welcome as are the tighter controls on the sale of tobacco products from vending machines. If teenagers could not get cigarettes in a retail shop, they went to vending machines and now they have to be located in an area which is visible to the public and the owner or manager. That is a welcome development. I also welcome the ban on the sale of confectionery, normally intended for children. It was crazy that children could have toy cigarettes or sweet cigarettes, copying the habits of their peers or their adult friends.

Public disclosure of all aspects of tobacco including toxicity and addiction is welcome. We are all aware that tobacco kills. Countries, such as Australia, have gone much further in that their tobacco packs are very graphic. The UK has advertisements showing people who suffer from lung cancer saying they did not think “this little weed kills”. It does kill.

The reason the Bill is before the House is that procedures were not followed under the 2002 Act. As a result, 14 of 53 sections of the Act are affected. These sections relate mainly to the sale and marketing of tobacco products. I am concerned that, perhaps, we did not give sufficient attention to that Bill. The EU directive will deny the tobacco industry direct access to young persons. There will be a difficulty because the legislation ran foul of the European Commission. The words “control of the sale” and “control of the marketing” had implications and fell foul of EU competition law. This should be a warning to us that there are lawyers looking at the Bills we pass. We should be more vigilant and spend more time on these Bills.

The legislation has provided for a change in penalties. It would not have been prudent to send publicans to prison. The prisons should be used for much more sinister gangsters — I am not saying publicans are gangsters. I was a publican. [1570]Although the financial penalty has been increased to €3,000, publicans can afford to pay it and would prefer to do so rather than go to prison. It is difficult to clarify the extent of the publican’s responsibilities. Who is responsible? It is very difficult if a customer is in the pub — this is a separate issue — but I would never sell a ticket to a customer because it offended him or her. If one would not sell a ticket, one would not tell a customer to stop smoking because that custom would be lost. I wonder whether environmental protection agents or health board agents will have the backup of the law at a time of night when it would be difficult to deal with people with drink taken. While I welcome the Bill, I foresee difficulties ahead.

I am concerned with the issue of pub ventilation. A significant amount of money was spent installing proper ventilation equipment into pubs following the introduction of clean air legislation, and this was promoted by the health boards. While such measures cost pubs as much as €70,000, they are no longer useful. The equipment was installed to eradicate smoke and to protect customers and bar workers but is no longer necessary. A pro-active measure could have been introduced so that this money was not wasted. Many high-tech, smoke eradication units are now worthless, an issue we should consider.

I support the Minister and any measure which protects people in workplaces and public areas from the ravages of smoke inhalation, which has killed many. The sooner we are rid of the scourge of tobacco, the better.

Mr. Glynn: Information on Camillus Glynn  Zoom on Camillus Glynn  I congratulate the Minister for Health and Children, Deputy Martin, and the Ministers of State, Deputy Tim O’Malley and Deputy Callely, on the introduction of the Bill. I am glad Senator Feighan has firmly indicated his party’s support for this imperative measure. All fair-minded people will acknowledge that the Minister and his Ministers of State have been pathfinders and have driven this measure to its current position. Nobody said it would be easy, and it will not be. However, it is never too late to do the right thing. What Minister for Health and Children worth his or her salt would not introduce a measure such as this in the long and short-term interests of the nation?

The point of this prohibition has been lost in many of the arguments against it. In excess of 7,500 people die every year as a result of smoking related illness and many more are seriously ill. What impact does this have on our health services? We hear ad nauseum in this Chamber of the number of hospital units which need to be opened and made operable. Many hospitals would be redundant if smoking was stopped and this has been proven.

This is a choice between saving lives or profits and we should choose lives every time, a point paramount in the mind of the Minister and every [1571]right thinking person. Given the expert opinion on smoking and its effects, it can only be seen as a long-term form of suicide. Over the years, smokers have asked what harm they are doing to anyone but themselves by having a cigarette. That myth has been exploded by increased knowledge of the effects of environmental tobacco smoke and the arguments of public health experts. The public and workplace employees are increasingly aware of the threat to their health from toxic tobacco smoke and of the necessity of the measures being introduced to protect them.

It is important that this initiative is based on emphatic advice from health experts. As a member of the Committee on Health and Children, with Senator Feighan, I was interested to hear Dr. Howell tell the committee that tobacco addiction is greater than heroin addiction. There is proof that a famous world leader was able to kick a heroin addiction but not smoking, which speaks for itself. There is consensus within the international scientific community and the World Health Organisation about the damaging effects of tobacco smoke and that there is no safe level of exposure to this known carcinogen.

It has been suggested that designated smoking areas should be allowed as a compromise. This ignores the fact that staff would still be required to work in such areas. Also, tobacco smoke is not stagnant. It permeates the entire atmosphere of a room regardless of where the smoking takes place and without regard to areas which are designated as “smoking” or “non-smoking”. This is not a realistic or acceptable option.

The suggestion has been made that improvements in ventilation technology, referred to by Senator Feighan, can deal with the problem of second-hand smoke. On 30 January 2003, a report, The Health Effects of Environmental Tobacco Smoke in the Workplace, was published by the Health and Safety Authority and the Office of Tobacco Control. The research, which included an examination of international research, was drawn up by an independent group of scientists including specialists in toxicology, epidemiology, occupational medical services, public health medicine specialists and a radiation-aerosol physicist. The group of scientists concluded there is consensus among the international scientific community that environmental tobacco smoke in the workplace increases the risk of lung cancer by between 20% and 30% and that involuntary smoking increases the risk of heart disease in non-smokers by between 25% and 30%. Given this evidence, it cannot be said that only the smoker is harmed and it indicates the degree of addiction associated with tobacco products.

When representatives of some of the tobacco companies attended the Committee on Health and Children, they denied to hell and back that [1572]smoking was addictive. I told one of the representatives that if the facts jumped up and bit him on the nose, he would still deny them. Not alone did the tobacco companies withstand the reduction of the level of contaminants in cigarettes, they increased it to make smoking more addictive. When one considers that smokers staring death in the face will still continue to smoke, is it not the case that, in tandem with other substance addictions, smokers suffer serious denial and delusion?

Reference has been made to smoking among the young and to peer pressure. I agree with Senator Feighan that the health boards have done a marvellous job in promoting the anti-smoking campaign. A survey was carried out among leaving certificate students in a number of secondary colleges in County Westmeath. A very high percentage of the boys and girls smoked, notwithstanding all the publicity about the risks associated with smoking. It is a social drug, which makes it all the more dangerous. We have drug squads trying to prevent people taking drugs like LSD, yet here we have a social drug killing people on a daily basis and sending many others to our care institutions.

The group drew particular attention to the 2002 decision of the International Agency for Cancer Research of the WHO to declare environmental tobacco smoke a known carcinogen. Research shows that ventilation technologies are inadequate to give workers full protection from the hazards of tobacco smoke. The Federal Occupational Safety and Health Administration in the US and the American Conference of Governmental Industrial Hygienists have concluded that even proposed new technologies such as displacement ventilation systems, which may reduce environmental tobacco smoke exposure levels by 90%, still leave exposure levels which are 1,500 to 2,000 times the acceptable risk level for hazardous air pollutants. That is an important point and should settle the argument that ventilation systems are the answer, because they are not. Senator Feighan referred to this earlier.

The expert group concluded that a smoking ban remains the only viable control measure to ensure that workers and patrons are protected from exposure to the by-products of tobacco combustion. It is very important to bear in mind that the majority of Irish people, 70% of the population, do not smoke. The smoking ban being introduced on 29 March does not come a minute too early. If the same level of discussion and effort applied to seeking loopholes in the legislation was focused on promoting the improved environment which workers and the public can look forward to, those now voicing their concerns would be able to look forward to an opportunity to substantially improve their business and work environments. The fact that [1573]the majority of people will benefit is surely the basis on which to plan for the future.

Irish respiratory consultants have backed the proposed workplace ban on smoking, saying it would save many people from a debilitating killer disease. The Irish Thoracic Society annual conference passed a motion urging all politicians, employers, including publicans, and the general public to support the move. Their support coincides with World Chronic Obstructive Pulmonary Disease Awareness Day. The symptoms of COPD range from coughing and sputum production to shortness of breath. It affects well over 110,000 people in Ireland and accounts for almost 10,000 hospital bed days a year. The conference heard of World Health Organisation statistics which show that Ireland has the second highest COPD mortality rate of 28 industrialised nations, behind only Hungary. We have a place on this graph of which we should not be proud.

Vested interests here may continue to try to divert the debate on the ban away from the core issue of health, but there is no arguing with the fact highlighted by lung experts that tobacco smoking is one of the major risk factors for death and disability in Europe. A recent report from the Office of Tobacco Control indicates that the cost of smoking to the State amounts to around €5 million per day. One does not have to be a rocket scientist to work out what that costs. We should think of all the projects we could bring on stream if we did not have to spend that money. Not only will this ban save lives, but it will also save our economy money that we can put into other areas.

It is not right to expose workers in Ireland to a carcinogenic that is as dangerous as asbestos and I welcome the Minister’s courageous and relentless determination to potentially save the lives of these workers. However, we must live in the real world. We cannot expect to impose the ban everywhere people live. People have rights, even though those rights may sometimes impinge on others.

I welcome the Bill. As the Minister said, Ireland holds the European Presidency and should show the way by ensuring the ban is effective. People have asked who will enforce the ban and I believe the public will do it. I do not doubt that. I had a group of visitors in the House yesterday from a retirement club in Mullingar. Two of them left the visitors’ bar because of the amount of smoke in the atmosphere. One lady said if she stayed in the bar for any length of time, she would have to be carried out. I commend the Bill to the House and I thank Fine Gael for indicating its support. All right-minded people will support it.

Dr. Henry: Information on Mary E.F. Henry  Zoom on Mary E.F. Henry  I welcome the Minister of State. After a lifetime in medicine I warmly welcome the legislation, but I wonder what the country is [1574]coming to. We have a major conference of our EU Presidency on sexually transmitted disease and now we are leading the way with a ban on smoking in the workplace. We are tackling incredible subjects and I am delighted to see it.

Evidence has existed for decades suggesting that passive smoking is an extremely serious problem. There are increased incidences of respiratory disease among children and cot deaths and while we cannot say those children smoke, there are higher levels of both in households where parents smoke than in non-smoking households.

Senator Glynn was right in describing those who smoke as engaged in long-term suicide. I was glad he also mentioned addiction, as this seems to be the most difficult addiction to deal with. I know people who gave up smoking easily and, never having smoked myself, I find it hard to understand how difficult it is for some people to give up. I am delighted more efforts are being made through the health promotion unit of the Department of Health and Children to help people give up smoking. The advertising campaigns have been very good and the help lines also appear to be useful to people.

Senator Glynn said some people find smoking more difficult to give up than heroin. I dealt with a pregnant woman some years ago in the Rotunda who was addicted to both heroin and tobacco. The nurses’ strike was on and we had to discharge her. I was concerned about her so I went to see her later that day and she was smoking at the door when I got there. She said she could keep off the heroin but not the cigarettes. She was proud of herself in hospital because neither was available. She was a very intelligent young woman and it had to be very difficult for her when she knew how much damage she was doing to herself and her unborn child.

People in the workplace deserve our protection from passive smoking and it is right to bring in this ban. I have visited Canada since it banned smoking in restaurants and pubs and human life is continuing. The weather was cold but some people stood outside to smoke. I regret to say that they were mainly European. Knowing this debate was coming up, I asked a publican if there had been much drop in trade and he said there had been a drop in the counter trade for a while. He had made up for that with the table trade, as many more people came in to eat because there was no smoking, and when I spoke to him his bar trade had returned to what it had been.

We have such a problem with alcohol that we should avoid too much moaning and groaning about a drop in its consumption. Yesterday on the Order of Business a Member said that children would not be able to go into pubs during the summer. The Leader said she felt a pub was a most unsuitable place to have children and I agree. I did not get a chance to agree with her [1575]because she was responding to the Order of Business. I find it profoundly depressing to see small children asleep at 10 p.m. and 11 p.m. in pubs and welcome the fact that we now take these issues more seriously.

There has been a welcome drop in the percentage of people who smoke in Ireland to 25%. This is quite something because 20 years ago the figure was approximately 50%. We are getting somewhere and our figures are better than quite a few other countries. However, one black spot is in respect of young women, among whom there is an increase in the number who smoke. In this regard, the bans on advertising are very important.

I listened with care to Senator Feighan’s remarks about vending machines which may get around some of the proposed bans in shops. How long will retailers be given in order to change the displays in shops? Many small retailers have cigarette displays, the facades of which take up a huge amount of space advertising tobacco products.

Excellent legislation has come before the Houses of the Oireachtas in respect of which regulations have not been introduced to enforce it and I am worried that may be the case with this Bill. I hope any regulations which are required to enforce the Bill are introduced as rapidly as possible. For example, Senator Feighan referred to candy cigarettes, which it would be a great pity not to ban because I am sure the confectionery companies would not go out of business without them. It seems ridiculous to promote cigarettes to young children in this manner and tell them later they cannot smoke.

It has been demonstrated that young women are very much drawn towards smoking what are described as “light” cigarettes, which numerous surveys have shown are just as harmful as regular cigarettes. The associations with being slim and sexy are always present in cigarette advertisements. I was depressed to discover a few years ago that Tower Hamlets, a health district in east London, had a higher death rate from lung cancer than from breast cancer among women. It is the first place in which this happened and I would hate to see it happen here. We are making huge efforts to reduce the incidence of death from breast cancer, therefore, let us try to do the same in respect of lung cancer.

As I walked to the House this morning, I was interested to note that almost every young woman I passed had a cigarette in her hand, although most of them must have burnt out as they walked along. There are many young women among those who smoke outside office buildings in which smoking is prohibited. The efforts made to stop women smoking will have to be redoubled.

It is despicable to see the advertising by tobacco companies in developing countries. If we [1576]have any influence as President of the EU, I would hope we would use it to do something about this. I attended the Cairo conference on population ten years ago. The only bit of Cairo I saw were the Pyramids, beside which was the bizarre sight of an advertisement for Camel cigarettes. I suppose it is a good brand to advertise because of the presence of camels there but it was depressing to see in a country with so much poverty and in need of a great deal of health promotion.

This legislation will be enforced by people in pubs and restaurants, certainly in the latter. It is much more difficult to get a table in a non-smoking area than a smoking area. One often has to take one in the former because there is none in the latter. I am concerned about the large number of places which are exempted from the Bill. For example, it could be hard in a nursing home for someone to say “I do not want you smoking near me”, if the people are sharing a living area. I hope this will be examined carefully. We have had problems in the psychiatric service with people being rewarded with cigarettes, although the practice has stopped as far as I know. I hope we are careful in the areas which have been exempted.

I would like to see hotels and guest houses included in the ban. They must have an adequate supply of non-smoking rooms because there is nothing worse than booking into hotel and having to take a smoking room. Most people do not want to smoke in their bedrooms. Therefore, from a commercial point of view, the hotels would be well advised to look at this because it is hard to sleep in a room in which people have smoked.

I am glad to see the legislation about ten being the minimum size of a packet of cigarettes. This will help reduce the numbers sold to school children. I still see children being served cigarettes and I have objected. I am sorry it is not easier to make complaints about shops selling cigarettes. One would need an environmental health officer under one’s arm. On one occasion when I complained, the man told me that he knew the customer’s family. It is quite immaterial to me whether one is related to someone or not, one is not supposed to sell cigarettes to children. This is a difficult issue.

Does the Minister have to make orders for sections 15 and 16, which are important parts of the Bill, or will they come into force on 29 March? I sincerely hope so. I am looking forward to seeing these measures enforced in the Dáil bars. It will be very interesting.

Like the Minister of State, I was extremely pleased that we were one of the first countries to sign the World Health Organisation framework convention on tobacco control but I would be more pleased if we ratified it. Signing shows that the spirit is willing, but is the flesh weak? It would be great if we got around to ratifying the convention. I hope the Office of Tobacco Control [1577]will have all the powers it needs to carry out the functions which Members of the Oireachtas intend and that it will have adequate funding to do so. I am delighted to see this Bill before the House.

Ms Feeney: Information on Geraldine Feeney  Zoom on Geraldine Feeney  I welcome the Minister of State to the House.

We all knew this Bill was coming but it rings sweet in one’s ear to have it before the House. I listened to Senator Feighan state that his party would support the Bill. It is getting all-party support, which is pleasing. That is the way in which we must proceed in the battle against tobacco.

It is wonderful that Ireland, a small State on the periphery of Europe, is leading the way in the fight against tobacco. As has been rightly outlined by Senators, smoking is a huge health issue — probably one of the greatest we have ever had to deal with. It is all the more welcome that we are doing something positive by introducing this Bill.

Last May, the House debated alcohol and tobacco consumption on a Private Members’ motion. We were all well-versed and advised at the time by groups such as the Cancer Society, ASH and the Irish Heart Foundation. I remember being touched by correspondence I received from Dr. Fintan Howell of the Irish Medical Organisation, which outlined that 7,000 of our citizens die annually from smoking related diseases. This is a terrible scandal. If the same figure applied to deaths from road, building site or waterway accidents, the nation would search high and low for a solution to the cause.

I was also interested to read the fact — one has to assume it is a fact when it is printed on ASH paper — that smoking kills six times more people in Ireland each year than road accidents, work accidents, drugs, murder, suicides and AIDS combined. That scared me. If the figure was a quarter of that, there would be uproar, but we sit and take it. As there is a battle on and we face opposition, people seek compromise, but there cannot be any compromise on smoking. The best compromise on smoking is not a compromise at all but an outright ban. I ask those who seek a compromise to think about what they are doing. Are all their concerns really commercial and are they putting them ahead of their workers’ health? Do they honestly believe that hotel and bar workers are not entitled to the protection in the workplace that the rest of us enjoy? Do they honestly believe that there can be a compromise on health?

  3 o’clock

I went through the Bill to find out what I might say today that was different from what I had said in the past because one feels one is repeating oneself and has said everything before. I know people do not remember it, but one feels that one is giving the same speech as seven or eight months ago. I was touched to see that the smallest [1578]amount of cigarettes that will be allowed to be sold in a packet will be 20. That will have a positive effect on those who try to buy cigarettes. I had a grin on my face when I saw that provision because I remember, when I was at secondary school, going into the shop on the corner when I went home for lunch in the middle of the day, buying loose cigarettes and putting them in the little geometry pencil box that I had in those days. If the cigarettes stayed in there for two or three days, how sick one felt after smoking stale tobacco. I am so glad teenagers now do not have to stoop so low as to carry loose cigarettes.

The Bill is beneficial. I am the mother of four young adults — they are not so much teenagers — and three of them, to my detriment, are smokers; I hate to see them smoke. My 21 year old son said the other day that he was dying for 29 March to come because it meant that he would start saving, as he will no longer be able to spend the money that he is spending on cigarettes. That gives me confidence that the ban will work.

As Senator Henry and Senator Feighan said, confectioners will now have to get rid of the little boxes of sweet cigarettes. I remember them too. As young girls of six years of age, we would go around with them in our mouths and stand in front of mirrors looking at ourselves with the things in our mouths and practising how to smoke the real ones. It is no wonder that so many of us smoked. We would even sharpen the ends of them and make them redder than they were when they came out of the box. The boxes had all sorts of cards in them, which meant that we were collecting cards as well as buying the packets of sweet cigarettes.

As I said, 29 March will be a watershed in many people’s lives. On the third floor of this building, where my office is located, there is one Senator who likes a cigarette. I am sure that he is watching the debate on the monitor. I said to him that I betted he would give them up and he told me to go into the Chamber and tell the House that he was waiting for 29 March to come because he is going to quit. I know several people who are using 29 March as the day that they will go cold turkey.

In March last year, in the run-up to the date that was to be set for the smoking ban, we said the same things. The advertising we have seen has been extremely effective, especially the graphic billboards to which we have become used around the country that show blood seeping from a brain. As a non-smoker, I find that difficult to cope with so I can only imagine what it is doing to somebody who is smoking up to 40 cigarettes a day.

We need not worry about how the ban might be policed. I doubt whether we will make much money from the penalties that are to be imposed on those who are found to be in breach of the ban because smoking has become so antisocial that smokers are feeling intimidated; they do not like being the only one or two in a large group who is [1579]smoking. Senator Henry is smiling. She said that she looked forward to seeing how the ban would work in the bars in the Oireachtas and I suppose she really means the Members’ bar. I feel the ban will police itself there because so many of us are non-smokers that the smokers will feel hugely uncomfortable lighting up in front of us.

It is terribly sad to see the amount of young women who smoke nowadays. We are all aware of it. My eyes are drawn to it the whole time because I have two young daughters, who are aged 17 and 18 respectively, who are not allowed to smoke in front of me. I do not want to hear about them smoking, but I know that they are smokers. I see other young girls like them smoking on the street or outside buildings. For whatever reason, it seems that a higher percentage of girls smoke than boys. Perhaps the girls feel that it is cool, chic or sexy, but boys do not seem to be as foolhardy about damaging their health as young women.

I commend the Minister for bringing the Bill before the Seanad. I am glad that we have got to the point at which it will be brought into law.

Mr. McDowell: Information on Derek McDowell  Zoom on Derek McDowell  The Labour spokesperson, Senator Ryan, is unfortunately not able to be here today, so I am filling in for him.

I confess to being a little confused about the purpose of the Bill. I am aware that it essentially re-enacts 14 sections of the Public Health (Tobacco) Act 2002, but I am not sure what happened to those 14 sections in the interim period. Perhaps the Minister of State could clarify for me whether, during that period, those sections were commenced or which ones were or were not commenced. Perhaps he could also clarify whether there were any prosecutions under those sections that clearly applied during the interim period and whether the view of the Department of Health and Children and the legal advice that it is getting is that the law as we thought it to be will stand up. Are we effectively admitting that the law was infirm over the past year or so, at least in respect of those 14 sections? If so, how stands any prosecution that may have been taken for offences that were created by the 2002 Act? I am interested to hear the Minister of State’s clarification of those matters.

The Minister of State and the Minister, Deputy Martin, got a fair measure of grief in the Lower House due to the technical oversight, as we shall call it, of not putting the provisions through Brussels. I do not intend to repeat that today. It is remarkable that something of that nature can happen, but I am disposed to believe that it was human error and that, when one thinks of something as a public health measure, one does not think of it concerning trade restrictions. Nonetheless, it is unfortunate that it happened and it is compounded by the delay that arose subsequently in submitting to Brussels the [1580]regulations on the smoking ban in the workplace. That does not give the impression of the highest degree of confidence that one might expect from the Department or the Office of the Attorney General. The most important thing to do is to repair the infirmity. The Labour Party will co-operate in doing that and did so in the Lower House.

On the more substantive issue, the figures adduced by the Minister during the course of his presentation are frightening. He referred to 7,500 annual deaths from tobacco related illnesses and listed a frightening number of pretty horrible diseases such as lung cancer and emphysema where smoking is a major contributor and which lead to an unpleasant death. All the figures hide the reality of individual suffering. Many of us have relatives who have been affected by cancer, heart disease and so on, brought on specifically by tobacco-related carcinogens.

Other statistics are more interesting. The Joint Committee on Health and Children produced a report a number of years ago which suggested that 80% of all smokers start smoking between the ages of 14 and 16. This emphasises the importance of trying to discourage kids from starting to smoke. Almost everyone starts smoking at an age when it is actually illegal for them to buy cigarettes. This means we must do everything possible to cut off the various means through which children are encouraged to smoke, such as advertising, sponsorship of sport, vending machines and so on. I know this Bill is intended to deal with some of those means through which children are targeted.

One point that is very striking is the behaviour of the tobacco companies which are huge multinational conglomerates in a very profitable industry. They were not only aware of the addictive qualities of nicotine for many years, they also hid this fact. They had a deliberate plan of concealing it for as long as possible and, to an extent, they continue to deny that nicotine is an addictive substance. It is now proven that they also added extra nicotine and carcinogenic substances to tobacco for many years to ensure they got people hooked, specifically children who were more liable to addiction. This is an unscrupulous industry that has deliberately targeted children to make exorbitant profits.

When dealing with a multinational industry, we must act on a multinational level. There is an overwhelming argument for dealing with this on an EU basis. In that regard Ireland has been to the fore in taking a lead in issues such as the workplace ban and the ban on sponsorship. We saw very clearly what happened with the Belgian grand prix when the Belgian Government attempted to ban sponsorship and the grand prix was effectively pulled by the tobacco company that sponsored it. These companies are profitable and unscrupulous and will do everything in their [1581]interest for as long as they can continue to push the weed.

My party supports the smoking ban, as do I personally. I agree that 29 March will be a remarkable departure if those who promised to give up smoking on that day do so. That will bring a further improvement in the numbers the Minister outlined, which I feel are already encouraging. He stated that the number of smokers was now down to 25% of the population, a reduction of 15% or 16% in a short period of time. In the past, the numbers dropped very slowly, perhaps by 1% over a two to three year period. It is probably an exaggeration to refer to the recent reduction as a collapse but it is significant and suggests that with a concerted effort over a whole range of areas — health promotion, prevention of tobacco companies targeting children or trying to break the links between the movie industry, sport and smoking — results can be achieved. What is most important is that it is no longer trendy to smoke in Ireland. That is something which produces a momentum. When smokers are under threat there is a social pressure which is probably the most important factor in reducing the number of smokers. Legislation can play its part but ultimately it is people’s evaluation of themselves and social pressure that will bring about the reduction we all seek.

There has been some reference to the nanny state and its effects. This is an argument with which we must engage. The suggestion is that it should be entirely up to individuals whether they choose to smoke. However, there is a likelihood that sooner or later one will become a burden on the State and its taxpayers because one will end up in hospital requiring lengthy treatment. Moreover, passive smoking damages the health of others so it is not a choice for individual smokers and is one they cannot be allowed to make. If we can use the law as well as social pressure to discourage people from smoking, then that is what we should do.

Mr. Browne: Information on Feargal Browne  Zoom on Feargal Browne  It is obviously an embarrassment for the Government to be back here only two years after the Public Health (Tobacco) Act 2002 was enacted. A catalogue of mistakes were made in a straightforward Act, the first of which was the failure to notify. We are now back dealing with the Bill, some aspects of which amuse me. I do not agree with my colleagues about the idea of banning the retail sale of cigarette packs of less than 20. That would lead to an increase in smoking. The reality is that if one buys 20 sweets instead of ten, one will probably consume them all. I can see the logic of it from one angle but I can also see the other side of the argument, even the fact that it is targeted at children. There will always be someone who wants to scrounge cigarettes and one would be far less inclined to share from a box of ten than a box of 20. I never [1582]smoked, as I have enough bad habits between drinking and politics, but I have noticed this among friends of mine who smoke. I always resented that some people felt an obligation to scrounge cigarettes, they never had money to afford their own. That is one downside of a sales ban on cigarette packs of less than 20.

Some of us are getting a little carried away and we are forgetting that we are dealing with humans. The road to hell is paved with good intentions. I was amused when Senator Feeney spoke about her son and his decision to quit smoking on 29 March and that from then on he would become an excellent human being. I would love to see a debate in six months among all these smokers who are now going to stop smoking and lead a fantastically healthy lifestyle. I am conscious of this myself. Last year I did a ten mile road race in Ballycotton and promised myself afterwards that I would lose weight and exercise. Next Sunday I will do the same race, unfortunately the same weight as last year if not slightly heavier, with less training done than this time last year in spite of my good intentions. Perhaps I am an exception, but I think I suffer from human frailties like everyone else. I was speaking to a lady in Carlow County Council a few moments ago. She is delighted the ban is being implemented on 29 March because she wants to give up smoking. I joked with her that it might not happen. I do not think it will happen because many people will still smoke. If one asks anyone on the street on New Year’s Eve about their new year’s resolution, most will say they are going to the gym three times a week at least, they are giving up the drink for weeks on end, eating healthy food and cooking at home. The reality is, however, that by February or March the gyms are fairly empty.

The smoking ban is a smokescreen for the Government’s failure in many areas of health. The Minister, Deputy Martin, has got away with blue murder by introducing the smoking ban and diverting people’s attention from the real health issues. The Minister will be aware of a case I brought to his attention recently, in which I acknowledge he has been of assistance. The case involved a 48 year old stroke victim from Carlow, who cannot get into the St. Michael’s Rehabilitation Hospital in Dún Laoghaire and faces going to Bristol. We have heard nothing recently about the diagnostic health centres earmarked in the health strategy. These are the real health issues but the smoking ban has been used to try to divert the public’s attention from them.

I wonder where will we be in six months or a year. I suspect the ban will not be implemented in many pubs. The Minister might correct me but, as far as I am aware, there are 10,000 pubs in Dublin and 10,000 outside Dublin. It appears that 31 health inspectors will monitor the situation, which does not appear adequate. We are very [1583]quick in Ireland to introduce legislation but we are very bad at enacting it. Earlier this week, the ban on cocktails was raised in the Seanad, because the legislation was passed but it has not been enforced. There are other issues such as “happy hour” and so on.

I query the ban on advertising cigarettes. The advertisements on cigarette boxes are very graphic. They list the side effects of smoking and indicate that smoking kills. When I ask my friends if it has an impact on them, they say it has not. They choose to smoke, even though they are aware of the health implications. Advertising the health risks makes no difference, because people will still smoke.

It is all very well to talk about banning sponsorship by tobacco companies, which is acceptable in regard to major events. I am conscious, however, that many smaller county football teams, juvenile teams and so on are heavily dependent on such sponsorship. Anyone involved in sporting or voluntary organisations will be aware that one does not have a long line of sponsors knocking on one’s door each day offering to sponsor teams. One would be very lucky to get one person to sponsor them. This aspect of the legislation should be looked at again. There should not be an outright ban in this regard because it could have a devastating effect on small rural communities. I can see the logic behind it but I query it.

When the smoking ban is introduced, in reality people will not be allowed to smoke in pubs, therefore, vending machines should not be allowed in pubs. Why put temptation in the way of people? At the beginning of the night, when people are sober, they may adhere to the law, but towards midnight, after a few pints, they might look for a cigarette. Having vending machines on the premises may be putting temptation in their way. We all know the story of Adam and Eve and, unfortunately, we have not learned anything from it.

While I am anti-smoking, I am annoyed about some of the stupid arguments put forward on the smoking ban. The Irish Times quoted a survey carried out in a hospital where 95% of patients were smokers. It concluded that smoking caused these people to be in hospital, which is not the case. There are genetic factors and so on involved, therefore, we should not get too carried away with the smoking ban. We should be careful how we analyse results and figures.

In my 30 years, I have noticed a big change in the gender balance of smokers. Far fewer boys smoke than girls. Perhaps girls smoke in order to lose weight and so on. I am aware that the Department of Health and Children is tackling the issue of obesity and weight management. I do not know how we can prevent girls from smoking. Boys appear to smoke less and less but, [1584]unfortunately, girls appear to smoke more and more.

When the Minister of State, Deputy Brian Lenihan, was last in the House, I asked how the Government plans to deal with the projected loss of revenue from the sale of cigarettes. Perhaps it will save money in the long term in terms of health but that could be in 20 or 30 years’ time. In the meantime, if more people stop smoking there will be a severe loss of revenue from the sale of cigarettes. How much revenue does the Minister of State anticipate will be lost?

If the smoking ban is to be successful, it will have to be EU-wide. Given that Ireland holds the Presidency of the EU, has the Minister used his unique position to promote the ban on smoking EU-wide and what has been the reaction in other countries?

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  I welcome and support the legislation. However, the Government must take responsibility for much of the uncertainty about the legislation because of the extension of dates and mistakes made when drafting the Bill initially which resulted in loopholes that could be contested. All of this led to uncertainty. If there is a difficulty in implementing the legislation, surely it is as a result of the inadequacy of the original legislation.

I ask the Minister of State to give an undertaking that health boards will no longer be allowed to use children as pawns, investigators or testers by being sent into various premises to purchase cigarettes. As a former member of a health board, I have asked the CEO of the Western Health Board on various occasions to stop using children in court cases to prove a particular person sold cigarettes to under age people. This is wrong. If this continues following the enactment of the legislation, it will be a criminal act on the part of health boards or other agencies who use children in this way.

There have been headlines in local newspapers of court proceedings where the health board fined the owners of premises because cigarettes were sold to children. There is something terribly wrong with an official of a health board sending children into a premises to try to buy cigarettes. I ask the Minister of State to immediately issue health boards with a directive to desist from such an activity. Various Senators said that they see many young people, particularly young girls, smoking cigarettes in public. How can we reconcile that with the health board, as the agency of the Minister in this instance, testing the effectiveness of the ban by using children? Is there nothing else in this Bill whereby we can test the effectiveness of legislation other than to use children? I ask the Minister of State to stop this continuing.

Those of us who, during a daily routine, go into various places with which we would normally associate smoking, such as pubs, have no doubt [1585]that the air is cleaner and that people are now conscious of the need for cleaner air and the need to stop smoking. It is difficult to reconcile with the legislation the list of exemptions made. As Senator Browne said earlier, the Minister has never given any justification for them. There is no justification for this list of exemptions, particularly as they relate to health situations. We are talking about health, and the diseases caused by smoking, yet these irreconcilable exemptions are made.

The Minister mentioned the importance of education regarding non-smoking. We are supposedly putting forward education as a way in which we can strengthen the smoking ban, but whether it is the Minister for Education and Science or the Minister for Health and Children who will take responsibility, the Government has done nothing except put the notion on paper and abandon it. It has been simply pushed out in the public arena so that someone or some enthusiastic group might take it on, such as teachers or health advisers. We have done nothing to follow through on it. If we intend to use the idea of education as a means of reducing smoking, we must do something by way of follow-up and encouragement, in whatever way we can, to provide the wherewithal. We might send advertising into the schools, or use some information process, rather than just letting the notion stand and hoping something will happen.

Senator Feeney said that the public will enforce this legislation. It is a weak and wishful position if the legislation is being published in the hope that the public will implement it. If the legislation in this instance is based on that strategy, as the only effective way of implementing it, God help us. It will not work. The idea of using “reasonable force” is not practicable. We are putting something on paper and we must find better ways of implementing this legislation by way of encouragement regarding the health aspects and asking people to do the right thing, which will benefit us all as citizens. We face great difficulties here and the uncertainty we had before is shown repeatedly in the provisions of this Bill, and in the initial failure to bring forward an Act without having to withdraw it and amend it to such an extent. We might be the leaders in Europe in this area. We might have hastily put together this legislation to show we are doing something in the health area, but it is too important for such an approach. I hope the Bill succeeds, but the record of the Minister and the Department regarding this legislation has been unbelievable, uncertain and woolly, to say the least.

Minister of State at the Department of Health and Children (Mr. Callely): Information on Ivor Callely  Zoom on Ivor Callely  I thank all the speakers for their contributions on Second Stage. It is evident with regard to the threat to public health from tobacco consumption that there is [1586]strong support in the House for this important public health initiative.

I listened with interest to the last few speakers and I have been monitoring the debate. Senator Burke indicated much concern about the Public health (Tobacco) (Amendment) Bill 2003. He gave a wide berth to the provision and delivery of our health services. Senator Browne gave them a similarly wide berth and indicated that the Bill is a smokescreen, using that word as a pun I presume. We can measure what we have done in the health area under Fianna Fáil-led Administrations since 1997. We can also measure what was done prior to 1997. We remember that one of the illustrious leaders of Fine Gael was Minister for Health and some people will remember him for the particular manner in which he went about his business, which may not have been seen at the time, or even today, as compassionate as some people might have liked.

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  The Minister of State is at the bottom of the can now. It is totally unbecoming and unfair to the Minister involved. I do not know what provoked that response.

Mr. Feighan: Information on Frank Feighan  Zoom on Frank Feighan  The Minister of State is getting ready for the weekend.

An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  Order, please. The Minister of State without interruption.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  I also say to the Labour Party that in the recent past it also had the opportunity of having a Minister for Health. I would like to use one particular measure to endorse what I believe is the very strong commitment of Fianna Fáil-led Administrations since 1997 regarding the improvement of our health services. Two very good strategies have been introduced, in the cardiovascular and cancer areas. People ask what the good is in coming up with a piece of paper and they say that there must be funding to back it up. In 1997-8 we spent approximately €3 billion on our health services. In 2003 the final spend on health was approximately €9.2 billion. Accordingly, we have trebled the money put into health.

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  Has the Minister of State ever visited an accident and emergency department?

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  We have also gone from a figure of about 60,000 people employed in health to close to 100,000 people. We have the strategies and the personnel, and we have put the money in place.

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  What has gone wrong?

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  Having said all that, we are still not satisfied with the efficacy and the efficiencies within the health services.

[1587]Mr. Browne: Information on Feargal Browne  Zoom on Feargal Browne  Neither are the people.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  We have our health strategy and the implementation of the various reports that have been undertaken on behalf of the Department. We recognise that there are some difficulties in the provision of our health services, which is why we are again taking innovative steps to ensure that we will have a first class health service in place.

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  It is taking a long time.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  I must address some of the comments made, fairly and squarely. From the responses I am getting, I think I might be hurting a little bit.

Mr. Browne: Information on Feargal Browne  Zoom on Feargal Browne  Not as much as the patients on the waiting lists.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  It is important that people understand the genuine commitment of this Government to the improvement of our services. We will not be found wanting in regard to the improvements-——

Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  That is electioneering talk.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  ——we intend to put on our record. If one looks at the comparisons, they will certainly stack up in favour of this Government and its predecessor.

Senator Ulick Burke asked if this legislation was just a piece of paper. We are a long way from that which is what he may want or what his party might have done in the past. Leaflets have been given out in schools, there has been a public awareness campaign and an education programme has been put in place. They are absolutely superb and I will ask my officials to ensure he gets an information pack on what is available. I think he will be quite impressed but if he is not, I ask him to come back to me. Indeed, if he has any suggestions, other than what has been undertaken, I would welcome hearing them.

I refer to the point Senator Ulick Burke made about the use of under age persons to purchase cigarettes. If that is happening in the manner he outlined, I suggest the matter be taken up with his chief executive officer. If he fails to achieve success in that regard and feels it necessary for the Department of Health and Children to get involved, I would be happy to receive some details from him. The Senator also said the Government was responsible for delays with the Public Health (Tobacco) (Amendment) Bill. The Minister, Deputy Martin, with good intent, indicated he was proceeding in a particular way.

In a European context, we are showing the way and are being innovative.

[1588]Mr. U. Burke: Information on Ulick Burke  Zoom on Ulick Burke  It will be a long time before the other member states get it in order if they take as long as us.

An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  Senator Burke, allow the Minister of State to continue without interruption.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  In a European context, we had some new ground to cover which created some delays. Concerns were raised about nursing homes, prisons, psychiatric hospitals and other locations which have been exempted. We then had to identify the most appropriate date for implementation which has now been agreed. Delays were not the fault of the Government.

Senator Browne gave me a bit of a hard time but he made kind comments on a case with which I am helping him. I see a former esteemed Member of the other House in the Visitors Gallery. I know the Cathaoirleach will give out to me but I am delighted to see my former colleague, Deputy John Browne.

An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  The Minister of State should not mention people in the Visitors Gallery.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  He was a friend of mine and we worked well together.

An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  That is not relevant. I have informed the Minister of State of such before.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  Senator Browne indicated that he was never a smoker. I am a former smoker and I am not that different from many other former smokers in that when I decided to give up cigarette smoking, I did not do so on my first attempt. It takes a number of attempts and it is quite difficult for those who are addicted. Giving up smoking is quite a difficult process and there are many failures. However, this Bill is not only about giving up smoking; it is about the quality of the environment in the workplace. We are not asking people to cut off their fingers to stop smoking. We are saying people should be able to go to work and enjoy their work in unpolluted, environmentally friendly circumstances. If that leads to more people kicking the habit, it will be tremendous. Supports are in place to assist people who need to kick the habit.

My constituency colleague, Senator McDowell, asked if the 14 sections were ever commenced. The 14 sections are being re-enacted on legal advice to ensure they can be enforced. The fact they were not originally notified cast doubt on their enforceability. That is the information I have.

Mr. McDowell: Information on Derek McDowell  Zoom on Derek McDowell  I know that. I am not clear about the position in between. Are we now saying the law was bad and was not enforceable during that time?

[1589]An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  The Senator may raise that point on Committee Stage.

Mr. McDowell: Information on Derek McDowell  Zoom on Derek McDowell  I am not trying to be combative; I am just trying to clarify an issue.

Mr. Callely: Information on Ivor Callely  Zoom on Ivor Callely  I will try to clarify that issue for the Senator but my information is that they are being re-enacted on legal advice and were never commenced.

Public health authorities in many countries have grappled with the problem of how to prevent people taking up smoking and how to get smokers to break their addiction once established. The introduction of the Public Health (Tobacco) (Amendment) Bill is innovative. I have been contacted by a number of member states and have done a number of radio and television interviews. Some member states are looking at the innovative measures Ireland is now applying and will closely monitor the success or otherwise of this Bill.

We all acknowledge there is no single solution to dealing with the tobacco epidemic. A comprehensive approach of the type being undertaken by the Government through the Public Health (Tobacco) Act 2002, this amending Bill and through education, information and smoking cessation programmes is necessary to maintain the battle against tobacco on all fronts. Strong legislative measures will remain an important public health instrument in countering the tobacco threat.

Much has been achieved to date in reducing the incidence of smoking among our population. The level of smoking of 27%, which the surveys have shown, is in stark contrast to the level of 43% which prevailed in the 1970s. This welcome reduction translates into lives saved, serious illnesses prevented and avoidance of the pain and suffering involved in death brought on by tobacco-related diseases such as lung cancer and emphysema.

I am also aware that much effort in promoting and supporting tobacco free initiatives has been, and is being, carried out by a range of groups and organisations. I take this opportunity to congratulate them and wish them continued success in the various mechanisms being undertaken. The Joint Oireachtas Committee on Health and Children published two reports on health and smoking and their conclusions left no one in any doubt of the nature of the threat posed by tobacco consumption. I also take the opportunity to congratulate a number of legal practices in Ireland which are closely monitoring the issue of litigation against some of the tobacco companies. I understand solicitors Ward and Fitzpatrick have initiated proceedings in that regard.

The cardiovascular health strategy group, Shaping Healthier Hearts, also made clear the importance of reducing smoking levels to reduce [1590]the incidence of heart disease, one of the greatest causes of mortality in Ireland. Organisations such as the Irish Cancer Society and the Irish Heart Foundation carry out splendid work in advancing the health message in the field of smoking cessation. The positive health message is getting through. Smoking tobacco products and environmental tobacco smoke are seen for what they are because direct and second hand smoke inhalation causes grave and serious risk to individuals and significant risk to the health of the smoker and non-smokers.

The introduction of smoke free indoor workplaces from 29 March will be another positive step in the smoke free initiative that the Government is undertaking. Many workplaces are smoke free and employers and employees realise the benefits of working and socialising in a clean, smoke free environment.

Addiction to tobacco-based nicotine is powerful and difficult to break. As a former smoker, I understand the difficulties smokers experience while trying to quit. According to research, most smokers commence their addiction before adulthood. Most people who quit only succeed after a number of attempts. The Department of Health and Children is undertaking an enhanced smoking cessation programme to further assist people trying to quit. Services available to smokers wishing to quit are being used more frequently. The national smokers quit line is well established and widely used. More than 14,000 people have called the number since it was set up last October. Nicotine replacement therapy was made available to all medical card holders who smoke. The national Break The Habit campaign was developed on a partnership basis between the Department, the Irish Cancer Society and the health boards. Additional smoking cessation officers have been recruited by the health boards.

Not long ago, smoking was considered the norm, despite increasing health concerns about the effects of tobacco smoke. The intervention of successive Governments on public health grounds across a wide front has achieved much in reducing tobacco smoking and exposure to tobacco smoke. Credit must be given to my colleague, the Minister, Deputy Martin, and the Government for bringing forward this powerful, positive legislation.

Tobacco use remains a significant burden on individuals, families and society through death, illness and medical costs. The positive measure being undertaken across a broad front in reducing tobacco use will increase life expectancy in Ireland and result in happier, healthier people and a better quality of life for all. I thank the Members for their contributions.

Question put and agreed to.

[1591]Committee Stage ordered for Tuesday, 9 March 2004.

An Cathaoirleach: Information on Rory Kiely  Zoom on Rory Kiely  When is it proposed to sit again?

Mr. Moylan: Information on Pat Moylan  Zoom on Pat Moylan  Next Tuesday at 2.30 p.m.


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