Dáil Éireann debate -
Wednesday, 14 Mar 1962

Vol. 193 No. 10

Committee on Finance. - Adjournment Debate: Cigarette Smoking and Lung Cancer.

Mr. O.J. Flanagan

I addressed a question to the Minister for Health to-day. I asked :

... if he would take steps to warn the public through advertisements in the newspapers about the danger of contracting lung cancer from cigarette smoking and if he will ask each local authority to organise a campaign against cigarette smoking so as to safeguard the public against the possibility of large scale lung cancer.

The Minister replied :

The public is aware, from the extensive press and television publicity which has been given to the matter, of the relationship between excessive cigarette smoking and lung cancer, but for such as might wish to examine the matter in greater detail, information can be supplied by my Department on request.

I raise this matter from a strong sense of public duty in the hope that the Minister for Health, charged with responsibility for the Department of Health, will give a lead in this matter. Such a lead is all the more urgent in view of the information he himself gave the House earlier today. He told us that in 1954 there were 4,213 deaths from cancer; in addition, there were 606 deaths from lung cancer. In 1960, deaths from lung cancer increased to 648. In 1961, there was a further increase in the deaths from lung cancer, the figure for that year being 680.

In the circumstances, it is only natural that we should examine the report, some 70 pages in length, submitted by the Royal College of Physicians in Britain on the subject of cancer.

Mr. S. Flanagan

How many died on the roads in Britain in the period covered by the report?

Mr. O.J. Flanagan

Clearly, lung cancer is, according to the report, demonstrably attributable to cigarette smoking.

Mr. S. Flanagan

How many died of T.B.?

An Ceann Comhairle

Deputy Seán Flanagan should allow the Deputy to proceed.

Mr. S. Flanagan

He is a terrible hypocrite.

Mr. O.J. Flanagan

The conclusion drawn from the report is that cigarette smoking is the most likely cause of the recent world-wide increase in deaths from lung cancer, and the death rate is at present higher in Britain than in any other country in the world. Again, yet another conclusion drawn from this extensive report is that cigarette smoking is a contributory cause to an increasing death rate from tuberculosis in elderly people. But the report goes even further. It says that cigarette smoking probably increases the risk of dying from coronary heart diseases, particularly in the early middle age. It is also stated that cigarette smoking is responsible for many early deaths from heart failure.

Sir Robert Platt told a Press conference in London that last year in Britain there were 20,000 deaths from lung cancer in men; in all cases, the disease was attributed to heavy cigarette smoking. Those 20,000 deaths do not take account of the numbers of cigarette smokers who died from coronary trouble, heart failure or tuberculosis. There is convincing evidence of a very definite link between lung cancer and cigarette smoking, indeed between cigarette smoking and an increasing death rate.

The trend in this country also shows an increase. It is in that situation that I think the Minister should give a lead. As Minister for Health, he should take all the steps necessary to warn people against cigarette smoking. Such a warning could be given in many ways. The Minister told us he has a number of leaflets in his Department and, as each child leaves school, the Minister will ensure one of these leaflets is put into the child's hands.

Apparently that is as far as the Department of Health is prepared to go in this very serious situation. I put it to the Minister that it is his duty in this alarming situation to give a lead. The Minister said today the county medical officers were familiar with the situation. If all the Minister can do is issue a leaflet, what more can the county medical officers do?

The Minister has a serious obligation. As head of the Department of Health, responsibility in this matter lies at his door. He should forthwith examine the situation revealed and take the necessary steps to ensure that our people, particularly our youth, are discouraged from smoking cigarettes.

I do not advance the argument that every man and woman should immediately stop smoking cigarettes. I am myself a non-smoker. But in the interests of smokers, and in the interests of public health generally, I think they ought at least to cut down on their consumption of cigarettes. As well as that, an all-out effort should be made to discourage those leaving school from cigarette smoking. Those unaware of the seriousness of the situation should be informed and also discouraged.

Efforts should be made by each local authority to have a publicity campaign against smoking organised by the local health authorities. The Department of Health might use a considerable amount of public funds for this very important publicity campaign. The support of the Press should be solicited. The Press could be used for extensive and large-scale advertisements drawing attention to the dangers of smoking. Suitable advertisements could be put in all the public papers, for example: "Don't Purchase Cancer At 3/4d. Per Pack" or a slogan like: "If You Want To Live Don't Smoke", etc., which would focus attention on the seriousness of the matter.

At one time T.B. was a very serious plague in this country. It has been revealed that there is an extraordinary and astonishing number of deaths from cancer. No cure has been found for that dread disease. We are not spending enough on cancer research. In the United States and elsewhere substantial sums of money are spent on cancer research. We will probably have to depend on the results revealed by research in the United States and elsewhere but, at least, we should do our part to maintain the present health of our people and to prevent a further growth of lung cancer by advising young people not to smoke.

I suggest to the Minister that the support of the cinema proprietors should be solicited in this campaign. They could put warnings on their screens about the risk of lung cancer associated with smoking. Suitable posters could be published—in substitution for the few leaflets the Minister has—at railway stations and on notice boards in public places and at prominent places in provincial towns. The help and assistance of Radio Éireann and Telefís Éireann should also be solicited. The Department of Education should be approached by the Minister for Health with a view, not to warning children when they are leaving school, but to having frequent talks in the schools advising children against cigarette smoking and warning them of its very dangerous effects.

I raise this matter in the hope that the Minister will take a more serious view of it than he has up to the present. I cannot say what weight of influence from the manufacturers may be behind the Minister, but he should not worry about that. He is responsible for the health of the people, the health of the nation. It is his responsibility to advise people against heavy cigarette smoking if he sees there is a danger of fatal results from that habit.

I hope and trust that people will get together and start a great voluntary effort warning and advising our people against cigarette smoking. If such a movement were undertaken I am sure it would have the co-operation and support of everyone, and the goodwill of the Minister. I trust his Department will be more alive to their responsibility and duty in this regard to the public.

Minister for Health (Mr. MacEntee)

The tirade we have just listened to is apparently based on statistics which I furnished to the Deputy, and a number of other Deputies, in reply to Questions Nos. 8 and 9 which were addressed to me to-day. Those statistics show that the number of deaths which were diagnosed as being due to lung cancer in 1957 was 606, and that in 1961 it is envisaged it may be 680. The Deputy assumed from that that lung cancer was more prevalent in this country in the year 1961 than it was in the year 1957. That is an unfounded assumption. After all, a great deal of money is being spent and a great deal of research is being conducted, in order to ensure that cancer will be diagnosed in every case in which it occurs.

It is quite possible—I am not suggesting that it is positively true but it is possible—that the increase in the number of deaths now recorded as being due to lung cancer is due to the fact that our cancer services have been expanding and improving and that methods of diagnosis are very much more accurate than they were in 1957. I must say I was surprised when I heard that Deputy Flanagan had notified the Chair that he proposed to raise this question on the Adjournment. I could not see what reason he could have for doing so. I understand now that there may be one or two reasons: first of all, that the Deputy is a sort of political pharisee and that he raised the question in order that he might parade his virtues and be able to inform the House, and through the House, the country, that he neither drank nor smoked.

Mr. O.J. Flanagan

The Minister should not be offensive.

Mr. MacEntee

If he wants to single himself out in that peculiar way, he is entitled to do so, but I hope he will do it with some sincerity. The Deputy has attacked the Minister for Health apparently because he thinks the Minister does not appear to be as active as he should be.

Mr. O.J. Flanagan

That is it.

Mr. MacEntee

Of course, if the Minister is inactive, it is up to Deputy Flanagan or any other member of the House to spur him on and make certain that he does his duty. On 6th June, 1959, I wrote a letter to Deputy Flanagan. I shall quote the first paragraph:

Last year I examined the reports of a number of scientific investigations which had been made in different parts of the world into the marked rise which had taken place in recent years in the death rate from cancer of the lung, with particular reference to the possible association between tobacco smoking and the disease. These investigations showed with regard to lung cancer in men that the death rate is higher in smokers than in non-smokers, and is the highest among heavy cigarette smokers.

I invited the Deputy to co-operate with the Minister for Health in bringing this fact home to the general public. What was the response which I got from Deputy Flanagan? He did not even answer my letter, in contradistinction to my usual practice. I receive letters from Deputy Flanagan and other Deputies and the least that can be said is that they get an acknowledgement and, whatever matter they bring before me, at least, I look at and investigate to see if I can help Deputies out of their difficulties.

Here is a case where Deputy Flanagan was written to by me—in a letter signed by me personally—inviting him to co-operate in a campaign to bring home to our young people, in particular, the dangers which are inherent in excessive cigarette smoking.

Mr. O.J. Flanagan

Hear, hear!

Mr. MacEntee

I am glad the Deputy agrees with me. After all, I am trying to do my duty. The Deputy is a public man, and a very important public man in his constituency. He headed the poll at a number of general elections. A man with such a commanding influence among people who know him could be of the greatest possible help to the Minister for Health and to the health authorities in a matter of this kind, but I have never heard that Deputy Flanagan once raised this matter at any health authority meeting in the county of Laois. I have never heard him speak. I have never seen a letter written by him on this subject. What happened? He thought Deputy Dr. Browne was on a good thing, politically, and he became the whipper-in to Deputy Dr. Browne. When Deputy Dr. Browne put down this question, Deputy O.J. Flanagan wanted to get a little of the limelight. He stole Deputy Dr. Browne's thunder. He gave notice he would raise this question on the Adjournment in order that he might advertise himself, a little, too. That is why I call him a political pharisee.

The Deputy had one or two slogans —quite useful slogans, I will admit. It only shows his expertise as a politician. He is able to coin a phrase. He coined phrases tonight and flung them across the floor of this House. I began to wonder if Deputy O.J. Flanagan, when he was advocating that we should engage in a Press campaign, was thinking of starting an advertising agency himself and wanted to show the people what sort of goods he could deliver to his customer. That is not the way in which I approach this question.

If I were raising this matter on the Adjournment, I should go to the root of it. I should try to deduce evidence that the people did not fully realise the dangers inherent in excessive cigarette smoking. So far as the Stock Exchange may regard it, so far as one hears among those with whom one associates, there are very few people in this country who do not realise that if you smoke excessively you are incurring the risk of premature death. When people realise that, what is the use of carrying out an intensive advertising campaign?

We are getting to the root of this matter through the schools. We are pointing out to the young people that if they want to lead healthy, active lives the best thing for them to do is not to start smoking at all. When we are doing that—and we are doing it at some expense—why should we spend money on a campaign which is really not likely to be very highly effective?

I saw the Deputy in the Opposition Lobby on the Vote on Account. He voted against providing the necessary sum—£49 million, or whatever it may be—to carry on the public services for another few months. He voted against it because he felt it was an excessive burden on the people. In that £49 million there is provision for old age pensions, for all the social welfare benefits, for the education of the children, for the health services, for assisting agriculture to develop and become competitive. All these things were embodied in that Vote on Account and Deputy O.J. Flanagan voted against it because he thought the sum we were asking for was excessive, that the people could not bear it.

Now he wants to impose an additional burden—and, I think, an unnecessary burden—on their backs by asking me to intensify a campaign which has already been conducted, in the most effective way, in getting at the evil at the root and in trying to persuade young people not to form the habit of smoking. Everybody knows —it is the common experience of mankind, we do not have to prove it— if people are told by a Government to do a thing, their first reaction as independent persons is to ignore what the Government ask them to do, particularly if it affects their private lives and ordinary habits of living. Therefore, as I said in reply to Deputy Dr. Browne this afternoon, we have to bear in mind that, in order to secure the proper response from adults, we have to conduct these campaigns with some sense of responsibility and discretion—and that is the line I have taken.

I do not think there is any reason for me to be apologetic. I have dealt with this problem—it is a great problem for the Minister for Finance—in a rational way guided and directed by ordinary common sense.

Mr. O.J. Flanagan

May I assure the Minister that he will have my support and co-operation in every effort he may make in this matter?

The Dáil adjourned at 11 p.m. until 10.30 a.m. on Thursday, 15th March, 1962.