I move: "That the Bill be now read a Second time."
The Bill which I have brought before the House today deals with one of the major public health problems of our time. It is a problem which arises from the consumption of a traditional consumer product, tobacco, which itself is the cause of an epidemic of illnesses and premature death. This epidemic is wholly preventable and the Bill is a further measure designed to control and reduce the consumption of tobacco products with a view to diminishing the toll of self-induced illness resulting from these addictive products. My concern with the discomfort, illness and disease suffered by passive smokers is also reflected in the manner in which the Bill is constructed.
Before discussing the detailed provisions of the Bill I feel it is important that the House should be made fully aware of the serious nature of the public health problem caused by smoking. Thirty years ago when smoking had become widely established it was not regarded as a health problem. However, the medical evidence which has accumulated since then is both damning and conclusive.
Smoking is now known to be associated with coronary artery disease, cerebrovascular disease, chronic bronchitis and emphysema, cancer of the bronchus, the lung, the trachea, the mouth, the throat, the pancreas, the bladder and the kidney. Those who promote and support the development of legislation of this type are often described as subjective critics, as being zealous, misguided or working on defective evidence. I would like to put it on the record of this House that the medical evidence worldwide against tobacco smoking is conclusive. The statistics on the effects of smoking on public health in this country are horrifying.
There are over 16,000 deaths each year from smoking related illness in Ireland and it is estimated that as many as 5,000 of these deaths are directly due to smoking. Put another way, 100 Irish people experience premature, and often painful, death every week, directly as a result of tobacco smoking. Thousands of other Irish people suffer from painful and debilitating diseases, such as emphysema and lung cancer, directly as a result of tobacco smoking.
There is also a popular misconception put around by subjective critics or those with vested interests that the people who die or who are disabled as a result of smoking are elderly and would have died anyway. Deaths from smoking related illnesses accounted for 52 per cent of all deaths of those aged 35-64 years in 1982. Smoking is the single most important cause of death in middle age. The damage to public health from tobacco smoking is of epidemic proportions and no Minister for Health could fail to take appropriate action to do all in his power to reduce the resultant toll of illness and death.
Tobacco smoking and its resultant illnesses also impose an enormous strain on the health services. Each year about 480,000 days are spent in hospital as a result of smoking-related illnesses. It is estimated that the hospital cost alone associated with these smoking-related illnesses is in excess of £50 million. The costs of our-patient services, general medical services, disability payments and days lost at work are likely to pose equally high costs to the Exchequer.
The Government have considered all the aspects of the tobacco issue and its implications and decided that public health considerations far outweigh the marginal economic impacts which a gradual reduction in tobacco consumption over a number of years will effect. Smoking is a social habit which directly affects public health, public policy, families and individuals. Many middle-aged adults are cut off in their prime leaving young families.
In addition to self-induced illnesses the medical evidence now indicates that the health effects of smoking also impacts on non-smokers through breathing in air which contains other people's smoke. This is called passive smoking. Until the late seventies researchers felt that this was simply a social nuisance, but they have now shown that it poses significant public health risks. Passive smokers breathe in the smoke that comes from the end of a lit cigarette as well as the smoke exhaled by the smoker. The unfiltered smoke of the smouldering cigarette is more dangerous than that inhaled by the smoker. Exposure to tobacco smoke leads to a rise in pulse rate and blood pressure. People with bronchitis, emphysema, asthma and chronic lung disease are all adversely affected when forced to remain in smoky atmospheres. Those suffering from certain forms of heart disease are vulnerable to any reduction in the oxygen carrying capacity of the blood as happens when they are forced to breathe in a smoky atmosphere. Similarly, people with angina are more prone to suffer attacks when exposed to a smoky atmosphere.
There is emerging evidence of an increased risk of lung cancer for non-smokers who are exposed to passive smoking for many years. The weight of evidence available indicates that about a third of the cases of lung cancer in non-smokers who live with smokers may be attributed to passive smoking. It is also estimated that about a quarter of the cases of lung cancer in non-smokers in general, may result from passive smoking.
Smoking is now a minority habit. Two thirds of the Irish adult popultion choose not to smoke. In addition, research has shown that almost half of those that continue to smoke admire those that do not smoke; feel that smoking is a dirty habit and that the rewards of smoking do not justify the costs. The research has also shown that almost half of smokers cannot break their addiction despite having negative attitudes to smoking and being aware of its harmful effects. Three-quarters of smokers indicated that they would like to smoke less and over half of all current smokers expressed a moderate to strong wish to give up smoking. Smoking is highly addictive and once you have become a smoker it is difficult to give up, even if you want to.
The actions which I am therefore proposing in the Bill support the wishes of the majority of smokers and non-smokers alike. The tobacco industry and the pro-smoking interests cannot present themselves as the sole representatives of the smoking population when over half of that population have indicated a desire to overcome their addiction. Recent research has also shown that 56 per cent of Irish smokers strongly agree that smoking should be confined to special smoking areas. The controls on public smoking contained in the Bill therefore represent the majority wish of smokers as well as non-smokers and there is not a majority of public opinion to support the argument that smokers should be free to smoke everywhere.
On 11 February the European Parliament adopted a resolution which welcomed the measure taken by various member states to introduce a smoking ban in public places and called on other countries to follow suit with a view to the complete prohibition of smoking, both in public buildings and in enclosed spaces which are open to the public.
The European Communities Europe Against Cancer programme has also targeted the reduction of tobacco consumption as the main priority in reducing the high levels of morbidity and mortality from cancer, in the EC. The programme was debated by an EC Council of Health Ministers in May 1987 which I attended, and there is widespread support amongst the member states for initiative aimed at reducing the incidence of cancer in the Community. Under the Europe Against Cancer programme, the Euopean Commission, by the end of this year, will be submitting to the council a proposal for the control of tobacco smoking in public places. The contents of the Bill are therefore in line with developments in the European Community generally. They are also in line with international developments.
By 1982, 31 countries had enacted legislation restricting smoking in public places. This number has increased continually since then. More than 80 per cent of the states in the USA make it illegal to smoke in certain places or mandate that smokers be segregated from non-smokers. In Belgium, for example, smoking is restricted in public transport, public buildings, hospitals and other health institutions, schools, theatres and cinemas. In this country the voluntary prohibitions on smoking on the DART services, introduced some years ago, and the more recent introduction of smoke-free bus services by Dublin Bus has indicated the popularity of these controls and the willingness of the public to abide by them. With little or no enforcement, an environment has been created overnight on the DART and Dublin buses which respects the rights of the non-smoker and, more importantly, it has been accepted by the smoker. It is heartening to see that once the conditions are provided the result required is actually attained.
The control of smoking in public places is also in keeping with developments in health policy. Shortly after taking up office I announced the establishment of a health promotion unit in my Department and the establishment of an advisory council on health promotion. The development of an emphasis on health promotion is an attempt to create, through public policy, an environment which is protective of, and conducive to, healthy living. The control on smoking in public places is the type of action which makes the healthy choice the easy one for the smoker and protects the health of non-smokers. It is the type of action which will be increasingly necessary if we are to reduce the enormous burden of preventable illness here.
The Bill, as drafted, is an enabling piece of legislation which gives the Minister for Health power to make regulations to prohibit or restrict smoking in a variety of public places. The places which are designated in the Bill are those in which there is a high level of public support for smoking control. They are all enclosed public places which smokers and non-smokers are forced to share. The discretionary power to prohibit or restrict smoking will allow me to consider the nature of the areas concerned and the duration of stay in them, before drafting my specific controls. In view of the growing evidence of the health risks of passive smoking it is imperative that the Minister for Health should retain the power to prohibit smoking totally in any area where he feels that the public health risks are unacceptable. An example that readily springs to mind in this respect is the maternity wards of hospitals.
Under the provisions of the Bill the owner, manager or person in charge of the public places in question has the primary responsibility for enforcing the controls on smoking. In the event that individual smokers fail to comply with the restrictions they can be fined a sum not exceeding £100. However, I would expect, on the basis of existing controls on smoking that there will not be any great difficulty in getting public co-operation with regard to these controls. In the event that prosecutions are necessary regarding the enforcement of these controls, I have made it an express provision of the Bill that it will be a defence for the owner or manager of the public place to show that they had taken all reasonable steps to ensure that the prohibitions or restrictions were enforced.
In addition to controls in public places I have included a number of other provisions which are necessary to update the law in relation to tobacco. Under section 3 of the Bill, I have updated the law on the sale of cigarettes to children. At present it is an offence to sell cigarettes to persons under 16, under the Children Act, 1908. However, the provisions of that Act, allowing for a maximum fine of £2 are well out of date.
Research has shown that smoking among schoolchildren is a significant problem. One study of Irish adolescents between 11 and 13 years of age found that 49 per cent experimented with smoking. The earlier a person begins smoking the greater the damage to health. The evidence indicates that if people had not started smoking in their adolescent and teenage years they are very unlikely to begin in adult life. The evidence indicated that we need to take a strong stand on teenage smoking and the provisions of section 3 of the Bill are designed to have this effect. I will be referring to under-age smoking again when dealing with section 6. Under section 3 any person who sells or makes available tobacco products to children will be liable to a fine not exceeding £500. Highly addictive products such as tobacco should not be made available to children under any pretext and the Bill has been drafted accordingly.
Since young people often purchase cigarettes from automatic vending machines section 3 (2) of the Bill is drafted to ensure that these machines are properly supervised. This is a common international response to this problem. In Canada a legal duty is imposed on the person in charge of a vending machine to make sure it is not used by children. Similarly, in Finland the sale of tobacco products from vending machines is permitted only where the machine is under supervision. Cyprus has banned vending machines altogether.
Section 4 of the Bill also deals with restricting the access of children to cigarettes. Under the old maximum prices orders for cigarettes, it was illegal to sell cigarettes singly. However, the previous Government removed this provision when they abolished the relevant maximum prices order. My Department consistently receive complaints about unscrupulous shopkeepers who break packages of cigarettes and sell them singly. Single cigarettes are a particular attraction to children with limited money and a desire to experiment with cigarettes. The provisions of section 4 of the Bill will outlaw this undesirable practice and should restrict further the current access of children to these addictive, carcinogenic products.
Section 5 of the Bill gives the Minister for Health the power to determine what additives are used in tobacco products and to prohibit specific additives which he thinks are particularly injurious to health. At present a voluntary agreement exists between my Department and the Irish tobacco manufacturers which achieves the objectives of section 5 of the Bill. However, this agreement does not extend to importers of tobacco products and the statutory provisions set out in section 5 will ensure that the Minister can treat imported and Irish manufactured products similarly. With the drive towards low tar cigarettes and the development of tobacco technology, an ever-growing list of additives and tobacco substitutes are being used in tobacco products. It is imperative that the Minister for Health should have statutory power to control these additives in the interest of public health, just as statutory powers exist in relation to the use of additives in foodstuffs.
Section 6 of the Bill deals with the evergrowing range of products known as oral smokless tobacco products. These are a range of tobacco products largely developed in the USA and Scandinavia which are designed to be used by being placed in the mouth and sucked or chewed. These products contain high levels of nicotine and this is absorbed through the mouth. They are highly addictive and are often marketed at people who wish to give up smoking but who cannot break their addiction. The section is thus preventative in this context and further strengthens our controls over under-age smoking contained in section 3.
The World Health Organisation has stated that smokeless tobacco is not a safe alternative to cigarettes. The World Health Organisation's International Agency for Research on Cancer has extensively reviewed these products and has reported that there is sufficient evidence that the oral use of both chewing and sucking tobaccos is carcinogenic to humans. A group of experts meeting under the aegis of the World Health Organisation in June 1987 called for a pre-emptive ban on smokeless tobacco, wherever possible, to prevent a new public health epidemic from a new form of tobacco use. The use of certain forms of smokeless tobacco has been prohibited in Hong Kong, Israel and New Zealand. The UK Government have now announced their intention to ban certain smokeless tobacco products under the Consumer Protection Act. The federal government in Australia have also announced a similar intention.
In 1985, when it was first proposed to import some of the new smokeless tobacco products into this country, the then Minister for Health made an order prohibiting their importation under the Health Act, 1947. This order was subsequently challenged in the High Court and in a judgment delivered in September 1987, Mr. Justice Hamilton found the order to be ultra vires the power of the Minister under the Health Act, 1947. The public health basis for the order was not an issue in the judgment.
Section 6 of the Bill currently before the House is intended to restore the effect and intention of the previous order and to ensure that no other smokeless tobacco products can be promoted in this country. To allow forms of nicotine addiction which are not yet established in the country to be promoted, particularly to our young people, would be irresponsible of me as Minister for Health. To allow new products and products not widely used, which are known cacinogens, to be marketed would be indefensible.
The remaining provisions of the Bill are of a more technical and routine nature, providing for the enforcement of the Bill. Section 9 of the Bill is included to amend the procedures whereby summary proceedings may be brought under the Tobacco Products (Control of Advertising, Sponsorship and Sales Promotion) Act, 1978. The revised section will make it easier to take summary proceedings under that Act. Sections 10, 12 and 13 are standard provisions and section 11 simply repeals the relevant sections of the Children Act, 1908, which will be replaced by section 3 of this Bill.
In conclusion, I would reiterate that I am bringing this smoking control legislation before the House as major public health legislation. The smoking controls proposed in the Bill are designed to minimise the risks of passive or involuntary smoking and to provide a healthier smoke-free environment. They will also help to deter young people from smoking by conveying the idea that non-smoking is the normal majority behaviour. They will provide support to the majority of smokers who wish to stop smoking and who want smoking to be confined to special smoking areas. Finally, they will enact a type of smoking control that has wide public support among smokers and non-smokers alike.
The restrictions on the sale of cigarettes to children are the minimum necessary to counter the increasing prevalence of smoking among school children, particularly young girls. The prohibition on the manufacture or sale of oral smokeless tobacco products is in line with international developments. It is a vital initiative if we are to ensure that the damage wrought to the present generation by tobacco products is not visited on the coming generations through new tobacco products.
In view of the fact that tobacco smoking is the largest single cause of ill health and premature death and that this Bill is designed as a major advance in tackling the problem, I commend it to the House.
