When one is in the position that Deputy MacEntee is in as Minister for Health it is important that he speak with great caution on matters of this kind because that is to me a perfectly reasonable interpretation of his statement—a statement which he made here in the course of a debate when he was not under any pressure. It seems to me to be an attempt to mislead the public and it is something which he should not do because, certainly, it is not a true statement of fact.
If that were true, it would destroy completely our case against cigarette smoking. If it were true that everybody gets these diseases equally there could be no case for us asking that the tobacco companies be asked in some way to tell the public that in smoking cigarettes they are running grave risks of getting these diseases.
The Minister, again, in his completely outrageous misrepresentation of the case made by me, implied that I wanted to go to the lengths which they went to in the United States of America in imposing total prohibition. I do not think it is possible to prohibit the use of cigarettes at all. I do not think it would be effective. It certainly was never effective in schools. If we are to believe Dr. Flynn and Dr. Corridan, children smoke all the time. So it would be absurd to expect that prohibition would be an effective measure.
I believe that if every time he takes out a packet of cigarettes the individual is reminded that cigarettes may cause lung cancer, or these other diseases, he will have the advantage that we, as doctors, have of being fully conscious of the great dangers associated with cigarette smoking. It is, I suppose, a great help to some of us who see people who have contracted lung cancer, possibly as a result of heavy smoking, in cutting out smoking, because it is a dreadful experience to see someone suffocating after being subjected to some of these dreadful operations that have to be performed.
I confess I am very frightened of the idea of lung cancer and I think this fear of lung cancer is one of the reasons why so many doctors have given up this practice of cigarette smoking. It is just as hard for us as for others. I personally was a heavy smoker and I found it very difficult to give it up. Contrary to what the Minister for Health says, that I did not like smoking, I did like smoking very much but because of the likelihood of lung cancer developing, because it struck me as being such a stupid thing to expose oneself unnecessarily to the chance of getting this disease, I decided it was worth the effort to give it up.
The doctor is in a better position to judge than the ordinary person and it is for that reason I felt it would be a help to put the ordinary person into a comparable position, to give him the assistance we have, of seeing somebody dying of the disease, in the course of our profession. The Minister suggested that I thought cigarette smoking is the sole cause of lung cancer. I did not suggest that at all. How could one suggest that when it is a fact that non-smokers get lung cancer? It seems to me that the Minister really goes outside the reasonable bounds of the rules of debate when he, at a loss for reasoned criticism or argument, manufactures statements which the person against whom he is debating never made at all. I did not suggest that cigarette smoking is the sole cause of lung cancer. However, I do not think that anybody seriously doubts that it is a cause.
One of the Minister's extraordinary achievements is his production of this literature—this small amount of literature—in which he goes to some trouble to explain to young people the dangers of getting lung cancer from smoking. In this leaflet, which appears to be directed towards adults —there is an adult on the front of it— he gives most of the statements which were made by me in trying to convince the House of the necessity for some sort of control over cigarette advertising. It is he who makes these remarks in regard to lung cancer: there is a higher death rate in smokers than in non-smokers; a higher death rate in heavy smokers than in light smokers; a higher death rate in cigarette smokers than in pipe smokers; a higher death rate in those who continued to smoke than in those who gave up smoking. Four times the Minister mentions the word "death" there. In his speech here the other night, he ridiculed me for using what he described as old-fashioned methods, the old-fashioned idea of trying to frighten people about death.
That is an astonishing suggestion from the Minister. Are we not all frightened of dying? Are we not all reasonable people frightened of death? It came as a surprise to me that the Minister would think it was old-fashioned to tell people: "You may die if you carry out such a practice", in the hope they may decide: "I do not want to die." The reasonable animal response, even leaving aside the human being, is to escape from unnecessary avoidable death, and it is a very powerful argument when used to a person as a reason for taking any particular action.
The use of the suggestion to people that: "This may kill you; this may cause you to get a disease which will kill you" seems to be perfectly reasonable and not the ridiculous suggestion which the Minister implied here the other night. As I say, it is the fear of death from lung cancer which seems to dominate the Minister's leaflet in attempting to persuade people not to smoke or to desist from smoking. Fear of death is quite clearly the dominating motif of this leaflet and yet the Minister thought my suggestion about death and the likelihood of death was old-fashioned. That he should think it was old-fashioned to use this fear of death as a device for trying to persuade people to desist from doing something runs completely counter to the whole basis of the present road safety campaign whereby the Minister for Local Government is attempting to make people drive safely so that they will not kill one another.
I do not know if the Minister gave very serious consideration to the speech he made the other night. It contained so many contradictions and silly statements that it is difficult to believe it could have been made by a responsible Minister. This Department of Health leaflet, the Minister's leaflet, contains this statement:
The number of deaths from cancer of the lung has greatly increased within the past few decades; since 1950 alone the number of such deaths in this country has more than doubled. Scientists and doctors have devoted a great deal of study to the cause of this and, recently, they have been considering whether it might be the result of tobacco smoking which has also increased greatly in recent decades.
He then went on:
... patients suffering from this disease were interviewed and their previous histories and habits as regards smoking and any other factor that might be of interest were compared with those of a group of patients without lung cancer. The results of nineteen such enquiries in different countries (in Britain, the USA, Finland, Germany, Holland, Norway and Switzerland) have been published and they all agree in showing that there were more smokers, and fewer non-smokers, among the patients with lung cancer, and a steadily-rising death rate from lung cancer as the amount of smoking increases.
I am portrayed by the Minister as a scaremonger who is trying to terrify the unfortunate public by the fear of death if they go on smoking cigarettes. This is a leaflet put out by the Department of Health with the Minister's full authority. Who is the scaremonger? Who is the killjoy? Who is the bare-bones who asks a cigarette smoker to read this kind of stuff? They are perfectly true, perfectly legitimate, perfectly reasonable conclusions based on scientific truths. Yet, when I quote precisely the same authority, arrive at precisely the same conclusions and make precisely the same suggestions as are contained in this leaflet, I am anathematised by the Minister with various bowdlerisms to which he resorts when he knows he has no useful constructive comment or criticism to make.
The Minister is in the difficult position that he spends a certain amount of money—not half enough— trying to stop people smoking. These leaflets are directed at youngsters; they are given to teachers and clerics with the one object and that is—whether he works hard enough at the job or not is another question—to stop people smoking, if not this generation, then the next or even the generation after that. The simple purpose is to stop youngsters and adults from smoking cigarettes. Why does he want to do that? Why should he destroy, as he will, if he and other Ministers in similar positions throughout the world have their way, this great industry in the US and other countries? Surely he is not doing it because of a whim or a sudden decision that he does not like tobacco men? Surely he is doing it for the perfectly good reason that he is concerned for the public health, because he is convinced that cigarette smoking is a dangerous habit, that it causes lung cancer, and because he is effectively convinced of the evidence.
He tried to go around it and dodge the evidence and suggest that the evidence was not quite as watertight as he would like it to be; that he is not absolutely satisfied and that there are certain questions that have not yet been answered. Yet, in the face of these doubts, he tells us he intends to stop a whole generation of youngsters from getting what he thinks are the pleasures and enjoyments of smoking cigarettes. Why should he do that? Surely it is an irresponsible act if he is not absolutely convinced of the necessity of doing so? The fact is that he is convinced of this necessity and convinced of the case against cigarette smoking but he is in the position of having a colossal vested interest in the tobacco industry. He has a tremendous amount of income, increasing year after year, and he is putting this financial interest, the moneyed interest, before his responsibilities to public health because he is not prepared to face the financial difficulties in which he would find himself if he brought this practice to a stop very much more quickly than he proposes.
Yet, other countries with a greater sense of responsibility in the matter, other countries with the same vested interest in the tobacco industry from the revenue point of view, have decided to put what they feel is a matter of conscience above the economic needs of their societies. As so frequently happens here, we preach one doctrine and practise another. The Minister knows quite well that year after year as the cigarette smoking habit continues unabated—even worse, it is increasing each year—so will the number of unfortunate people going to St Luke's and various cancer hospitals continue to increase because the Minister will not face his responsibilities as a Minister for Health who knows of these truths and is unwilling to act on them.
In his own booklet, Smoking And Health, A Summary of Surveys of the Evidence, issued in March, 1964, it is stated that deaths from lung cancer went from a figure of 56 in 1925 to 298 in 1950 and to 697 in 1962. So that 697 people died of lung cancer and a percentage of those died avoidably and unnecessarily because they had this smoking habit. He also gives the figures of deaths from coronary heart disease and they have gone up concomitantly with smoking. In 1950, the figure was 2,906; in 1962, it was 4,539, almost double. The Minister knows quite well that he is conniving or continuing to connive at the sale of a commodity which contains a substance which is poisonous in so far as it contains carcinogens. The Minister has suggested that the evidence is based on figures alone. I do not know what the Minister would like, how he would like more proof, whether he would like those carcinogens injected into a human being so that we could have a human experiment to prove to his satisfaction that the injection or inhalation of these carcinogens is how an individual gets lung cancer.
The Minister knows that through a considerable amount of scientific and medical research it is possible to be absolutely certain, on the basis of statistical evidence from surveys carried out of various kinds currently and retrospectively, beyond all doubt of what happens in certain circumstances. I do not think there is any doubt whatever that the case in regard to lung cancer has been proved. The extraordinary thing where the Minister is concerned is that he is so hesitant about accepting the evidence in regard to lung cancer because there is the uncertainty he complains about, while in regard to the fluoridation of water, he had no such hesitation at all, despite the fact that various eminent medical and scientific authorities in various parts of the world are convinced of the damage that can result from putting fluoride in water.
I do not think there is any responsible group of scientific or medical authorities anywhere in the world who put forward seriously the suggestion that there is no relationship between cigarette smoking and lung cancer and all these other diseases. I do not think anybody has put forward any serious case to controvert the relationship between cigarette smoking and lung cancer. One suggestion was put forward by the tobacco companies and, having spent a couple of millions, they eventually got a report, but I do not think anyone took it seriously.
Recently the Minister was asked a question by Deputy Noel Lemass about cigarette smoking. Deputy Lemass asked whether the Minister had seen a report of a jury case in a Federal Court in the United States for damages against an American tobacco manufacturer. The Minister replied he had seen the report. The jury decided that cigarettes are reasonably safe and wholesome for human consumption and, in spite of that finding, the Minister went on to say:
...notwithstanding the finding of the American jury, I shall continue the campaign which I have initiated to discourage smoking, and to impress on children and adolescents, and on their parents and others who may be in a position to influence them, that, on the basis of statistical evidence gathered in a number of scientific investigations in different countries, the highest medical authorities are convinced that smoking is dangerous to health in that it may give rise to lung cancer, heart disease and other morbid conditions and should be discouraged.
Were I Minister for Health one could imagine me giving an answer like that, with my views, and the strange thing is that the Minister spent the best part of an hour, or more, in this House attempting to discount the significance of the evidence put forward as a result of scientific investigations in different countries. His whole case was that these investigations were not convincing, that there was some element of doubt and, because of that, any suggestion, such as the suggestion I put forward, that people should be reminded in the simplest, plainest terms that cigarette smoking may cause lung cancer, was not well founded. But he was quite precise in his answer to Deputy Noel Lemass that cigarette smoking may give rise to lung cancer. That is all I was suggesting and because I made that suggestion the Minister spent the evening abusing, ridiculing and pillorying me.
The Minister, in one of his most tortuous and evasive arguments, suggested that so long as tobacco is allowed to be smoked, it must be allowed to be sold and it must be allowed to be manufactured; and, if it is permitted to manufacture cigarettes, why make it illegal to advertise them? When I first suggested that he should do something about advertising, he told me that he had no power to take any action, and I said that he could, of course, take power. That is what Parliament is for. That is one of the great privileges of being in Government and being a Minister: one can look for power if one has not got it. All this rigmarole: "If it is permissible to manufacture cigarettes, then one must allow them to be sold", is completely irrelevant.
If we decided that it was undesirable to sell cigarettes because of the danger to public health, because of the likelihood of many people becoming mortally ill as a result of smoking cigarettes, no matter what happens to tobacco in other countries and no matter how much tobacco is manufactured, there is no reason in the world why we should not take any decision we want to take here. As we know, various noxious drugs of one kind or another are manufactured in various countries, including the ones I mentioned earlier, marijuana, hashish, opium, morphia, cocaine, and so on. They are manufactured in different countries, but that does not mean that they should be advertised here or sold here. The Minister's argument is an extraordinary one.
