I wish to share time with Deputy Callanan.
Public Health Tobacco (Amendment) Bill 2003: Second Stage (Resumed).
Question again proposed: "That the Bill be now read a Second Time."
An Leas-Cheann Comhairle
Is that agreed? Agreed.
I congratulate the Minister for Health and Children, Deputy Martin, and the Minister of State, Deputy O'Malley, on addressing the fatal scourge of smoking in Ireland and prohibiting smoking in the workplace. Many of those arguing against the ban on smoking in the workplace seem to ignore the reason behind it. Some 7,500 people die every year as a result of smoking related illness. If we have to choose between saving lives and protecting publicans' profits we must choose lives every time.
The adverse impact of tobacco consumption on health is well documented. Citizens are well aware of the threat tobacco smoke causes to their health and the majority support the Government's stance on this issue. This initiative is based on advice from health experts. 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 it.
We cannot compromise on the health of employees. Those who suggest that there should be designated smoking areas ignore the fact that staff would still have to work in these areas. 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 designated as "smoking" or "nonsmoking". This is not a realistic or acceptable option.
We have heard people suggest that improvements in ventilation technology can deal with the problem of second-hand smoke. International research disagrees with this assertion. Numerous studies have concluded that even the best ventilation systems do not give workers adequate and full protection from the hazards of tobacco smoke. The 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 exposure levels by 90%, still leave exposure levels which are 1,500 to 2,000 times the acceptable risk level for hazardous air pollutants. 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 byproducts of tobacco.
The majority of Irish people do not smoke and it is the Government's duty to protect these people. Almost 70% of Irish people do not smoke. It is a pity that there are people in this country who put considerable time and effort into trying to stop this ban rather than embracing a plan that will save the lives of thousands of people every year.
I welcome this amending Bill as it will strengthen the Act in a number of areas and will therefore protect it from any legal challenge. While vested interests may try to divert the debate from the core issue of health, there is no arguing with the fact highlighted by the lung experts that tobacco smoke is one of the major risk factors for death and disability in Europe. Not only does smoking kill about 7,000 people annually but it can also cause disease resulting in gangrene and amputation. Passive smoking has also been identified as a contributory cause of cot death.
A recent report from the office of tobacco control indicates that the cost of smoking to the State amounts to about €5 million per day. 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 cigarette smoke that is as dangerous as asbestos.
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 in places where people live. This does not just include private homes but also prisons, psychiatric hospitals, hospices, nursing homes, sleeping accommodation in hotels and guesthouses. I understand that exemptions must be made in these areas because they make sense.
Making sense would be a new departure for the Government.
However, no other exemptions would be acceptable.
Sections 1 to 3, inclusive, and section 19 contain standard provisions in respect of the Short Title, commencement and definitions of key terms used in the Bill. The maximum fine which may be imposed on a person guilty of an offence under section 47 has been increased from €1,900 to €3,000 while imprisonment has been removed as a penalty. The increase in the maximum fine is not particular to the smoking offence outlined in this Bill but is part of an increase in the level of fines for summary convictions generally.
Having spoken to people in the catering industry and, in particular, to publicans, I am aware that they are concerned that they will bear the brunt of fines or imprisonment if a person is caught smoking in their establishment. I do not smoke and hope to see the day one can attend a function or spend an evening in the local pub or hotel without having to send one's clothes to the dry cleaners the next day or hang them out on the line.
Boring.
Deputy Johnny Brady should be aware that he is looking at a humble sinner. We are not perfect.
It is the nanny state. Should we all eat lettuce and be in bed by 8 p.m.?
The person who commits the offence by smoking in the toilet of a public house should be as liable as the owner of the premises. I ask the Minister to consider that.
The poor Minister has been asked many questions on the matter in recent months.
I am sure the Minister and the Minister of State will examine these issues. They are important.
The Minister is confused by the contradictory messages he is receiving from the benches behind him.
The Bill provides for the establishment by the Office of Tobacco Control of a register of all persons who carry on, in whole or in part, the business of selling tobacco products by retail. It also makes provision to allow the charging of a fee by the office of social registration. The Bill prohibits certain marketing practices, including the sale by retail of cigarettes in packs of less than 20, the manufacture and supply for sale of oral, smokeless tobacco products, the sale of confectionery which resembles a tobacco product and is normally intended for children and the sale or supply of tobacco products which do not bear a warning as prescribed by the Minister. The sale or supply of tobacco products which do not bear a number in such form as may be prescribed by the Minister is also prohibited. All of these measures are welcome.
The Bill provides that the Minister may prescribe the standards and requirements to be complied with in the manufacture and sale of tobacco products. In addition, the office may require a manufacturer to provide information relating to the composition of proper tobacco products. It may also require the testing of tobacco products. Subject to certain requirements, the office may publish certain information and the results of tests. The Bill prohibits the making of certain claims about tobacco products and the sale of these products by means of self service. A derogation of the latter prohibition will be made for tobacco vending machines in licensed premises. These machines will be subject to regulations which will be made under the provisions of the Bill.
The sale of tobacco products to persons under 18 is banned and a provision is made whereby the Minister can prohibit and restrict smoking in specified places. We all welcome the prohibition on the purchase of cigarettes by persons under the age of 18. Unfortunately, there have been shopkeepers in many towns who sold one or two cigarettes to young people on their way to and from school. It is sad that people are greedy enough to sell individual cigarettes to young people.
We all did it.
I hope this practice is cut out and banned once and for all.
I hope Deputy Brady never smoked any.
I never did. We all know it has happened.
Many of us have done it.
It is sad. It is not the children's fault. It is greedy shopkeepers who have done this down the years.
I will conclude and allow my great friend from Galway to speak. I am sure he has great concerns on this issue.
I compliment the Minister for Health and Children, Deputy Martin, for bringing forward the Public Health Tobacco (Amendment) Bill. The Bill represents the most comprehensive anti-tobacco legislation ever introduced in this country. It provides for a comprehensive ban on tobacco advertising, including in-store advertising and displays, and all forms of sponsorship by the tobacco industry. Provisions are made to introduce registration of tobacco retailers and tougher penalties for those convicted of sales to persons who are under age. The Bill includes a ban on retail sales of packets of cigarettes of less than 20, tighter controls on the sale of tobacco products from vending machines and a ban on the sale of confectioneries which resemble a tobacco product and are normally intended for children. The legislation will require the public disclosure of all aspect of tobacco, including its toxicity and addictive qualities. The Bill also improves protections against passive smoking.
Tobacco smoking is very bad for public health. Medical evidence has repeatedly confirmed that smoking causes heart disease and stroke. It can also cause cancer and other health problems. Smoking tobacco products is one of the most unhealthy things a human can do. Life expectancy is lower in Ireland than the EU average. The diseases which primarily contribute to this are heart disease and cancer, and tobacco use is their leading cause. Smoking is a major factor in 90% of the 2,000 deaths caused by lung cancer each year. It also increases the risk of other cancers, including cancers of the mouth and throat. Smoking is also a primary cause of heart disease which is the greatest single cause of mortality in Ireland.
Tobacco represents a significant burden to individual families and society through deaths, illness and medical costs. Reducing tobacco use will increase life expectancy and result in happier, healthier lives for many people. Year on year, evidence has been accumulated of the enormous worldwide threat to human health posed by the consumption of tobacco products. In recent years, studies carried out internationally have confirmed that there is a significant risk to the health of the non-smoker who inhales environmental tobacco smoke. This is referred to as passive smoking. I had my own bad experience in 1973 when my father died of lung cancer caused by chain smoking. I watched him for his last six months of life coughing and trying to get his breath as a result of his lungs giving up. I appeal to all smokers, especially young smokers, to give up the habit before it is too late. I do not want another family to go through the same experience we did in 1973 due to tobacco smoking.
I congratulate the Minister for Health and Children for putting the health of the people before anything else. I support his proposals for banning smoking in the workplace. It is the right way for the people of this country to have their health preserved.
I welcome the debate on the Bill. I will put forward a different view and back it up with facts from the international and medical fields. I will challenge some of the points raised by Deputies earlier in the debate. I will put forward a different view that may not be politically correct or popular in this day and age, but I will call it as I see it and it will be a straight and comprehensive view.
So far, we have not had a balanced discussion on this issue. The flow seems to be in one direction. We need to examine the facts clearly and see the reality. We also need to respect choice and reject the idea of a nanny state and health police trying to tell people over 18 what they should do in their personal lives. I represent the voices of working people over 18 who want a choice and would like to go to their local pub to have a pint and a cigarette. What is wrong with that? What is the big deal? The point was raised about vested interests. The only vested interests in this debate are people who want to go out and enjoy themselves in a social setting. Despite this, people want to remove it from them.
I respect non-smokers and people who work in the trade. We can protect them and I will put forward proposals to do so but, above all, we must face the reality. Smoking is bad for a person, but too much of anything is bad for a person. Drinking is very bad for a person, as is over-eating. We have a crisis in this country with obesity. These are the realities so let us bring some balance into the discussion.
Environmental tobacco smoke, or passive smoking as it is called, is classified as a human carcinogen by the World Health Organisation. The issue is not about the nature of a carcinogen but what it does. Almost everything we touch, eat and wash can be described as carcinogenic to some degree. I am sure that the Minister for State at the Department of Health and Children, Deputy Tim O'Malley, is aware of the number of carcinogens that are present in a cup of coffee, for example. Are we to ban coffee?
On the figures of the numbers of deaths in Ireland, this is a matter about which the Government must be open and honest. A figure of 7,000 deaths in Ireland each year is widely quoted and was widely quoted in the debate as being attributed to tobacco-related illnesses. There is no scientific foundation for such a statement. However, we have all been fed this so often that we have begun to believe it. The figure relates to the number of deaths from cancers in Ireland.
Let us study the figures. The National Cancer Registry of Ireland gives a figure of 7,500 deaths from cancer occurring every year. The most common cancers within this figure are skin, large bowel, lung, breasts in women and prostate in men. It does not indicate that these are due to smoking. These are the facts. The original assertion was a lie. A number of people have quoted this figure in recent months. However, like the figure of 7,000, it is lodged in the public mind and, unfortunately, many people believe it.
The Minister may not be aware that the American Environmental Protection Agency study, which gave rise to this type of figure, was found by the federal courts in the United States of America to have, "knowingly, wilfully, and aggressively, disseminated false information with far-reaching regulatory implications in the United States and worldwide". On account of this, the court ordered a summary judgment against the EPA and nullified the agency's environmental tobacco smoke, ETS, risk assessment.
If one closely examines the expert report that was launched by two Ministers on the day the Minister for Health and Children announced his intention to introduce a ban, it was described by the Minister as being "unequivocal in its requirement for such a ban". Clearly the Minister should examine the report in more detail. The report is couched in numerous caveats, such as "maybe", "could be" and "might be". On one matter it is clear. In its conclusions, it recommends further research to assess the dangers of environmental tobacco smoke, especially in the hospitality industry. The report states: "that such a report is unequivocal in demanding a ban on smoking in the workplace, is bending the truth to an outrageous degree". These are the facts.
We all support proper ventilation. It has been proved that it can be effective, even though listening to the debate in the Chamber and on radio and television, one would think ventilation was not an issue and that air supply could not be improved. The Minister's advisers have shied away from this claiming that outdated technology of one air change per house was ineffective. We moved on from that point years ago. We now have specifications in force for 12 air changes per house. There are pubs throughout the country certified by the health boards as a result of the six-year old, ongoing initiative for clean air in pubs. That is the reality. I accept that some pubs need to get their act together, but they should be targeted and put under pressure by the health boards. One should not blame the average working man or woman – the taxpayers of this country – for the inefficiencies of others.
New studies are emerging about the efficiency of ventilation equipment, for example, the research carried out by the University of Glamorgan. Its research shows that ventilation can be highly effective at protecting bar staff and customers from the adverse effect of environmental tobacco smoke. In the United States, the Oak Ridge National Laboratory of Tennessee's study of restaurant and tavern workers in 16 cities and more than 1,500 subjects concluded a well-known toxicological principle that the poison is in the dose, and it is clear that the ETS dose is quite low for most people. A study carried out on ETS levels in the Canadian restaurant-pub, the Black Dog, indicated that ETS component concentrations in the non-smoking section were not substantially different from those measured in similar facilities where smoking was prohibited. The WHO suppressed its own 1998 survey results, which questioned the perceived health risks of ETS.
On 16 May, the British Medical Journal published a major peer-reviewed study on the health impact of ETS in California. This major analysis, based on 118,000 California adult studies from 1959 to 1998, concluded that the results of the Californian CPS 1 cohort did not support a casual relation between exposure to ETS and tobacco-related mortality, although a small effect was not ruled out. Given the limitations of the underlying data on this and other studies of ETS, and the small size of the risk, it seems premature to conclude that ETS causes death from coronary heart disease or cancer.
The editor of the British Medical Journal decided it would be a form of scientific misconduct not to publish this study. The research was initially commissioned by the American Cancer Society which then refused to publish it when it discovered the results. It was eventually published with funding from the tobacco industry. I accept that point. It is a fair comment. However, the Health and Safety Authority now claims that it was tobacco industry research, when it was first published in the British Medical Journal.Let us be honest and open in this debate. I will take criticism directed at me on the question of smoking and health and I will accept the reality, but I also urge people to listen to the debate. The Government's position was taken on the basis of misleading, selective and cherry-picked scientific evidence with all contrary evidence being suppressed. That is my point in the debate. If we are claiming to be democrats, we must be open. If one is claiming to be a progressive democrat one must be twice as open.
Reliance is placed, even in the expert report, on experts who have lost credibility. One such expert, James Repace, was the individual who sought to prove that 150 bar workers died in Ireland every year from the effects of environmental tobacco smoke. He now recognises that this as a lie, so that figure should be disregarded.
As someone who likes a drink and a cigarette – I will be open and admit that I smoke – I mix regularly in public houses and talk to bar workers, some 60% of whom in this State smoke. Despite this, people who claim to represent them and lecture the nation on the issue have not even asked them for their views. I do not think it is a very democratic state of affairs. I would also criticise the ICTU in that regard, because it did not consult its members on the issue. There should be a broader debate on this matter.
The proposed ban is based on a selective reading of the report on the health effects of environmental tobacco smoke in the workplace. More research is needed into the level of exposure of Irish workers to such smoke. The health effects of environmental tobacco smoke are far from proven, according to many studies. Those who have come to the conclusion that a smoking ban is the only option have not engaged in a thorough examination of the alternative control measures that could be put in place, such as quality ventilation or smoking rooms. Some sensible suggestions have been put forward. Why should there not be designated areas where people can have a cigarette and a drink? There is no big problem in that regard. Such a measure would protect staff. Why are the ordinary people being hammered again? I refer to the working men and women who pay their taxes and want to have a break every now and then.
In arriving at the decision to ban smoking, sufficient consideration has not been given to advances in technology which reduce environmental tobacco smoke levels by more than 90%. The report on the health effects of environmental tobacco smoke in the workplace, commissioned by the Health and Safety Authority and the Office of Tobacco Control, acknowledges that the number of studies with direct observation of occupational exposure to environmental tobacco smoke is limited.
The Minister for Health and Children should assess the economic impact of the proposed smoking ban. It is difficult to quantify this impact, but there are serious grounds for concern. I know from travelling in European countries like Italy and Spain that people from such countries will think twice about coming here after the ban has been introduced. They come to Ireland to enjoy particular dimensions of life in this country, such as music and social interaction. We do not have the sun – we have plenty of rain – but we have pubs, music and social interaction. When I spoke to people in Italy earlier this year, a common theme was the level of social interaction in Ireland. People from such countries like to go to Irish pubs to have a drink and a cigarette in peace, but the Minister is telling them that they will not be able do so. I do not wish to engage in scare tactics, but I advise the Minister to pay attention to next year's tourist figures. Tour operators, particularly those bringing tourists from continental Europe and short break visitors from Britain, have expressed concerns that the proposed ban will substantially reduce the volume of their business in Ireland.
Although I am critical of the Government and taking a politically incorrect view, I am also putting forward suggestions that can bring some balance to the debate. At least 50% of each area of a hotel, for example, could be clearly designated as a non-smoking area. I accept that the bar and service counters, where there is a concentration of staff, should be strictly non-smoking areas and that effective air handling and ventilation systems should be in place to provide at least 12 air changes per hour. The performance and maintenance of air handling and ventilation systems should be subject to technical certification, similar to the present certification system for passenger lifts. Clear evidence of the proper maintenance of air handling equipment should be kept on record and made available to health and safety inspectors. Hotel bedroom literature should include leaflets outlining the harm which tobacco smoking could cause. Such sensible suggestions should be considered during this debate, but the Minister, Deputy Martin, the Minister of State, Deputy Tim O'Malley, and others who want to introduce a new nanny state will not take account of them.
I respect the rights of non-smokers such as Deputy Callanan, who spoke earlier about his genuine health concerns. Just as non-smokers should always be facilitated, they should accept the rights of other people. I have said that I do not want to live in a nanny state. We should be able to accommodate each other. The State should be keen to accommodate difference, but the Government is not keen to accommodate the 35% of people who smoke. It will not surrender to those of us who are being hammered. This statement applies equally to other policy areas. There is plenty of room for compromise on this issue. I have urged the Government to carry out the research required from its own report and to consult fully with everybody.
The Government should talk to everybody rather than giving its opinions and lecturing the nation, as such an approach does not work. I have been surprised by the approach that has been adopted. The Minister thought that it was a trendy and popular issue to pursue, while distracting the public from the problems in our hospitals, such as waiting lists. He is engaging in the politics of distraction. I feel that a sensible and productive agreement can be reached which avoids the problems with the current proposal.
Science and truth have been manipulated and betrayed in pursuit of what the perpetrators believe is a legitimate cause – to discourage smoking. This is a clear case of the end justifying the means, regardless of the cost to society. I ask the public to listen to all the arguments that have been made before making an informed decision.
I support sections 4 to 18 of the Bill. Section 4 relates to the "prohibition of advertising of tobacco products" and section 8 provides for the "prohibition of certain marketing practices". I accept that people under the age of 18 have to be defended and that we have to be very careful. There is a need for legislation to deal with the retail sale of packets of less than 20 cigarettes and certain marketing practices.
As the title of the Bill suggests, this is a public health issue. We have a duty to promote public health, but we should not be distracted from certain issues by blaming those who enjoy a cigarette and a pint. There are between 35 and 40 people on trolleys in Beaumont Hospital, which is in my constituency. Why are such people on waiting lists? I do not want to be told that the people in question are smokers. Having visited the hospital and spoken to patients many times, I know that 99% of the illnesses for which patients on trolleys are being treated are not related to smoking. I ask the Minister and his Cabinet colleagues to get off the stage in that respect.
My understanding of public health relates to protecting society, defending patients and improving the health services. Although the Government has been in power for almost seven years, over two terms, some people cannot even get a bed in a hospital. It is a disgrace. We should take a reality check when we discuss these issues.
We should wake up to the real problems, such as disability services. I am glad that the Minister of State, Deputy Tim O'Malley, is present because I have tormented him about this issue for the last six months. Such issues need to be dealt with. While I welcome the fact that last week's budget provided an additional €25 million, when one speaks to families and the almost 2,800 people who are on waiting lists, one is told that another €10 million is needed. The reality is that people with intellectual disabilities and their families were seeking €35 million, but they were given €25 million. The Government gave €15 million to Punchestown, which was absolutely over the top.
I would like to mention the serious and comprehensive Hanly report in this context. Although this is supposed to be a public health debate, nobody has mentioned the golden hour – the first hour after a person is injured, for example in a traffic accident. The Government proposes to move certain services from communities. Most GPs and medical personnel say that there is higher chance of saving a patient's life if he or she is treated in the first hour. This is a public health issue. The Government proposes to relocate services so that it will take people two or three hours to get to a hospital. It is not acceptable.
I will not take any lectures from the health police about the realities. If one speaks to ambulance drivers, nurses, doctors and people in rural areas, one will be told that the golden hour is very important. I am quite lucky because I live in an urban area which is within ten minutes of Beaumont Hospital or the Mater Hospital. People in other parts of the country have to drive for two hours to get to a hospital. The Government is walking away from these issues rather than discussing them. It will not even question them.
I mentioned earlier the rights of workers. As somebody who has been active in the trade union movement for 20 years, I respect the rights of workers. Most of the workers I have met have not been consulted about the proposed ban. Some 60% of workers have said that they will live with a compromise on the smoking issue. Some of them would love to see such a compromise. I know of many non-smokers who like to go to bars to have a pint and to enjoy the smell and atmosphere of smoke. One does not hear that mentioned very often. It seems that people are afraid to say it. I will not take any lectures on morality or health in this regard.
I hope that prisons and psychiatric hospitals will be excluded from the proposed smoking ban. When I spoke to a psychiatric nurse recently, I was told that assaults on staff would increase by 50% if patients no longer had the right to sit down and have a smoke. Serious problems in prisons and hospitals have often been defused when a member of staff gave a cigarette to a person to help him or her to calm down for five minutes. Such problems were resolved in a peaceful manner. Nurses have expressed their concern to me that the Minister's proposals will aggravate matters.
I referred to old folk who have worked all their lives, many of whom are in their 90s. I do not accept that the Minister should decide they cannot have the right to enjoy a drink or a cigarette, whether they be in old folk's homes or at home. The Minister's ideas are off the wall.
In the area of advertising we have a duty to protect citizens. They must be given the correct information. Children must also be protected as they have rights. Adults, however, have rights as citizens. They should always have the right to make decisions. We are supposed to live in a democratic society, though some of us would even question that. There are now people who tell us regularly what we can do in our private and social lives. We must broaden this debate and listen to the facts. I welcome the opportunity to debate the Bill and put the other side of the case.
I am grateful for the opportunity to discuss the Public Health (Tobacco) (Amendment) Bill 2003. When the Minister for Health and Children, Deputy Martin, announced that he would impose a total ban on the sale and distribution of tobacco products in public houses and many other public places, he was taking a very hard line on what had been common practice among our citizens up to then. He regularly and stridently asserted that there would be no dilution whatsoever of his campaign or his determination to ensure that there would be no exemptions to the imposition of the ban on tobacco products in the various places he outlined.
Now the Minister has diluted the original proposal so much that it must be embarrassing for him to look back at his original speech where he set out his intention to have a total ban. In the hospitality industry, the landlord of the property rather than the customer must police the rules, which makes the Bill an interesting step into the unknown. It is ironic that, if one broke the law as provided the Bill and suffered the penalty of jail, that might be the only occasion when one could smoke a cigarette, because of the exemption for people in prison.
The types of changes that have been made to the Minister's original intentions have caused it to degenerate into a farce. He wanted to be whiter than white and stronger and more coherent in his determination to ban tobacco smoking throughout the country than his counterparts in any other member state of the EU. He wanted to go further than anyone else to make his name by banning tobacco smoking throughout the State in public houses and places of work and recreation. I am not surprised that he has run into difficulties with this, considering that he could not gain the support or backing of his own Cabinet colleagues or Ministers of State in his own party. No sooner had his proposals hit the airwaves than his own Cabinet colleague, the Minister for the Environment, Heritage and Local Government, Deputy Cullen, was out of the traps to ensure a rethink of the ban. Notwithstanding that, even more hypocritical was the Minister of State at the Department of Enterprise, Trade and Employment, Deputy Fahey. The lie—
I am sorry, Deputy, but the word "lie" is not appropriate.
The word was used before but it was not taken up.
I am sorry, but the Deputy is well aware that, in this House, the word is not parliamentary language and should be withdrawn.
It is totally untrue.
The Chair has been here on many occasions when either he or his predecessor ruled on the word.
I will withdraw the word "lie" and substitute the word "untruth".
It was totally untrue.
It was totally untrue and demonstrated the completely hypocritical intentions of the Minister of State, Deputy Fahey, who is obliged to sign the regulations on behalf of the Department of Enterprise, Trade and Employment before their implementation. The Minister of State had to hurriedly return to the country to face the consequences of the revolt he was generating. As with his position on the community employment schemes, he must now do another U-turn, sign the regulations and behave himself in the way that one would expect.
What Bill are we on?
Can I have clarity on that?
We are on the Public Health (Tobacco) (Amendment) Bill, which the Minister for Health and Children, Deputy Martin, and the Minister of State at the Department of Enterprise, Trade and Employment, Deputy Fahey, have an obligation to implement. Am I in order?
Yes, the Deputy is in order.
This is the second stab at the Bill, and I am not surprised that even the Ceann Comhairle should get confused.
Does the Deputy support the Bill?
Many members of the Government are confused about the position they are taking on the Bill. The Minister for the Environment, Heritage and Local Government, Deputy Cullen, and the Ministers of State at the Department of Enterprise, Trade and Employment, Deputy Fahey and at Agriculture and Food, Deputy Treacy, got in on the act, the last-named to ensure that some of his publican friends in Galway were on board regarding the matter. We have seen political schizophrenia over the last few months on—
It is a courageous public health move.
I did not interrupt the Minister of State.
Please allow the Deputy to speak.
It set out to be a courageous Bill, but it has now been diluted so much that there will be many places to smoke, including prison, which the Minister originally intended should be included under the ban.
Fine Gael is supporting the Bill in the interests of public health, and we would like the Government to support Fine Gael in its implementation rather than kow-tow politically to the frightened 40 whom we recently saw signing petitions to the Fianna Fáil Parliamentary Party on other issues. This indicates that the Government is not at one over a great deal of current legislation, including this Bill and the issue of decentralisation. There is much division in the Government at present, while, at the behest of the publicans, the Bill has generated heated argument around the country. In particular, it has surfaced at political meetings.
It was a diversity of views with a unity of purpose.
The proposals regarding the policing of the ban are interesting. Who will police the ban on smoking in public houses?
The smoke police.
I have reservations about asking the owner of the property, or the landlord licensed to trade from it, to do what amounts to the job of environmental health officers. That will not be workable. Deputy Finian McGrath mentioned that many of the workers in those establishments have had reservations about the implementation of the Bill, and perhaps their union, Mandate, was not representing their views totally accurately, since it has said at national level that it is in favour of it. I welcome that. Ultimately the only way to police it is peer pressure from customers who will insist that those sitting beside them do not smoke. That is perhaps how it should be formulated in the Bill, rather than expecting the publican and his staff to impose the law of the land on his premises through thick and thin. That principle signals to me that we are gradually heading towards a police state. We are expecting others to implement the provisions of this legislation, as well as the Intoxicating Liquor Act.
We should have a "smoke-ometer" for the inspections.
Even though we are getting a second opportunity to implement the regulations in the context of this Bill – I welcome the fact that it is a public health Bill – the exemptions and changes dilute the original intention to the extent that it may be a completely different Bill from that originally drafted. The Minister came under enormous pressure from legal advice, as seems to be the case in many aspects of legislation when the legal advice from the Attorney General or the Parliamentary Counsel comes into play at the eleventh hour, making Bills completely different from what was originally envisaged. This happened this week with the Personal Injuries Assessment Board Bill. At the 11th hour, the Attorney General suggested that the Tánaiste table an amendment which completely changes the tone and content of the Bill.
Will the Minister of State indicate if the EU has given approval to these regulations and, if not, when will it do so? We expect the implementation of these regulations in the context of the approximation of laws and the implementation of various directives at EU level. If negotiations have taken place, when will there be agreement on a Common Position among member states?
I welcome section 13 which bans the sale of tobacco products on our streets. This practice has been carried out for many years by people on O'Connell Street, Henry Street and others throughout the city. Although Finance Bills tried to deal with this a number of times, I am glad this Bill deals with the issue to give certainty to the ban on the sale of tobacco products on streets. This activity was generating considerable income for paramilitaries and criminal groups which used these products to launder money on the street. At the same time, retailers of such products have to pay rates and wages and compete with them.
Fine Gael accepts the legislation and the fact that we cannot have passive smoking, given the reports from the Health and Safety Authority.
Good.
Mr. Beegan has regularly indicated his difficulties in regard to health and safety issues and now, not only will he be able to reside in County Kilkenny, but work there too after the implementation of decentralisation. He will also be able to ensure that the staff required to implement this Bill will be put in place and that it will be workable. We should revisit how we will impose the proposed sanctions on landlords and people renting property in the sale and distribution of products in regard to the smoking ban. It is a serious imposition on landlords that, through no fault of their own, a person could light up in a public house and the landlord would have to bear the consequences.
I appreciate the Deputy's views.
Rights and responsibilities are important but we must not impose the law on people who do not have the legislative backup to impose that section in practice. It would be quite unfair if publicans were to go to jail for the actions of others. Will the Minister of State clarify that point?
When the Deputy concludes, I will put some information on the record in that regard.
I look forward to the Minister of State indicating whether the EU has given approval to the regulations and when they will be signed into law.
Guidelines to staff employed in licensed premises for complying with regulations prohibiting smoking are being finalised by the Office of Tobacco Control which is in contact with representatives of the licensed trade.
The Minister of State will have an opportunity when he comes to reply.
I too welcome the Bill.
It is of concern that the introduction of the Bill did not comply with EU regulations because it has created uncertainty. It questions the will of the Government in regard to the legislation's introduction, although I do not question the Minister for Health and Children.
There is no uncertainty.
Yesterday, we heard that the Government will bring forward the legislation to establish the inspectors in April or May. Why was that not done at the same time as this Bill? It would have made sense for both Bills to be taken together. However, this Bill will come into force at the end of February but the legislation for the policing of it will not be published until April or May and, given how long it takes to process legislation, may not be passed until after the summer. This casts doubt on the Government's will to examine the full picture in respect of the European aspect and the policing of the regulations.
The Deputy should be fair. No doubts have been cast.
As other Deputies have pointed out, publicans have credibility in regard to policing the legislation and are now subject to a fine of €3,000. I note that the penalty of imprisonment has been removed and a fine of €3,000 is being introduced. While many publicans might not have a problem with such a fine, I know many who would, particularly in rural areas where many bars only open at 9 p.m. Such a fine would have an enormous effect on rural publicans in areas in which it will be more difficult to comply with the smoking ban because many customers are elderly and have limited choices, as opposed to cities where there are choices. Publicans will now have to insist that those people stop smoking.
While we fully support the Bill, the fact that publicans will be fined if they do not implement it is problematic. There is also a danger that people who are drunk and highly charged may become violent if a publican insists they stop smoking. Nevertheless, it is necessary to eliminate smoking in the workplace and we hope that, over a period of years, it will be eliminated in all workplaces. The Government should set a target of five or ten years over which smoking would be slowly eliminated from the areas which have been exempted, since prison officers, psychiatric nurses, prisoners and psychiatric patients have a right to a smoke-free atmosphere. We fully appreciate why, at this stage, implementing it on a blanket basis will not work in those areas and will create hardship. However, the principle is now established and there should be a long-term plan to phase out smoking. The ultimate objective is that smoking would be eliminated rather than banned after people realise how harmful the effects of smoking are.
Hear, hear.
I was a member of the Oireachtas Joint Committee on Health and Children which examined smoking and its impact on health. One woman who appeared before the committee was in a wheelchair and almost required a ventilator because of smoking. The woman required constant treatment just to stay alive and she was only in her 50s. She came before the committee to tell us the effect smoking had on her life.
I congratulate the Deputy and the Committee on the manner in which they highlighted that fact.
I do not agree with those who try to claim that smoking does not affect one's health, but I respect their right to do so. However, they are wrong and they are misleading people who may be influenced by those who make such claims.
I welcome the principle behind the Bill. The Joint Committee on Health and Children was unanimous in stating in its report that smoking is a cost on the basis that it affects people's enjoyment of life, particularly in their latter years. It is also a cost to the State, to taxpayers and, in the main, to the Department of Health and Children which must deal with people who have tobacco related illnesses.
There are some doctors who believe that a person who is ill due to the fact that they smoke should be treated differently from someone who is also ill but who does not smoke. I do not subscribe to that but one can sometimes understand their point of view. It has been stated that, in the case of waiting lists, preference should be given, in terms of obtaining hospital treatment, to people who do not smoke and who look after themselves physically. I do not share this view but it has been put on numerous occasions to the committee of which I am a member by those who are involved in the medical area.
This matter was debated during the summer and Government backbenchers openly commented on it. Headlines appeared in my local newspaper about my colleague in Limerick West and his view that the ban should not be instituted. To say the least, this debate distracted people's attention from the grave difficulties being experienced in the health area.
We have witnessed what is happening in hospitals in Dublin and throughout the State. People are being left on waiting lists and those responsible for hospital management are getting—
Many good things are happening.
Deputy Neville, without interruption.
I do not dispute that fact. However, the efficiency and effectiveness of the health services must be called into question if a person is obliged to wait six months for an operation.
We have the treatment purchase fund.
Yes, we are sending people abroad for operations after a period of waiting. Is it not a serious reflection on the Department and the health services that we are obliged to do so? An eminent cardiac surgeon recently engaged in strong criticism of the treatment purchase scheme and the costs incurred on foot of it. The doctor in question stated that investment should be made in the health services so that people can have their procedures here.
They can have them here.
My point relates to waiting lists. It is not acceptable that hospital authorities should have to complain that they are obliged to deal with patients in the back of ambulances in hospital yards as was the case during the summer. We should have been debating these issues at that time. The Minister of State can shake his head but, being a representative of a Dublin constituency, he is familiar with the problem. In the mid-west regional hospital in Limerick, people are obliged to wait hours to be seen in the accident and emergency department. Such delays would not be acceptable in the private sector but they are unavoidable because of the lack of investment.
That is not true. There has been a great investment in accident and emergency services.
Nobody should be obliged to wait on a trolley for 24 hours before being admitted to hospital. Approximately 15 to 30 years ago, people only had to wait two hours before being admitted.
While the Hanly report can be criticised, it contains a number of worthwhile proposals. One of these is that relating to a consultant-led service which would help alleviate the position vis-à-vis waiting lists.
I am not sure how this relates to the Public Health Tobacco (Amendment) Bill 2003.
It relates to the Bill because this matter was debated during last summer in order to divert attention away from the issues that are really relevant in respect of—
It is in order to make a passing reference.
That is what I am doing.
We cannot have a detailed debate on the Hanly report or any other aspects of health policy.
The Minister of State will agree that this matter was the cause of some distraction during the summer. People in his party ensured that this was the case.
That is untrue and unfair.
Letters of protest from Fianna Fáil backbenchers were sent to the Minister.
I appreciate any genuine—
The Minister of State must allow the Deputy to continue without interruption.
These were displayed in bars throughout the country. That was a source of distraction.
I welcome the Bill. As already stated, I do not know why we must wait until April or May to publish legislation to deal with the policing of this measure by the relevant officers. I accept the principle behind the Bill, namely, that smoking is seriously injurious to health and is a cost to the State. The sooner the better all aspects of this matter are tidied up.
The timing of the Minister of State, Deputy Brian Lenihan, who has just arrived in the Chamber, is brilliant. He has again ensured that he will not miss my contribution to this important debate.
It is uncanny.
Yes. I welcome the opportunity to speak on the Bill, particularly in the aftermath of the contribution of Deputy Finian McGrath which I followed with some interest. It was refreshing to hear a politically incorrect approach from the Deputy. I welcome his initiative in this regard because it is only when one hears both sides to an argument that one can tease out the substance of a debate. The Deputy's contribution, which ran contrary to almost everything previous speakers had stated, has added a great deal to the debate.
I enjoyed the Deputy's approach because, perhaps like him, I see myself as a tobacco addict. I must admit that I will go to my grave a smoker. I do not smoke at present but I still wake up each morning and admit to myself, in my heart of hearts, that I am addicted to tobacco. Members of Alcoholics Anonymous are supposed to wake each day and admit that they are addicted to alcohol. I must admit that I will forever be addicted to tobacco.
I do not smoke anymore. I grew up a couple of years ago when the advent of married life steadied my outlook and enabled me to give up the demon cigarettes. If I am in a pub, however, and have had a couple of pints and cigarette smoke drifts into my nostrils and thence, through my capillaries, into my blood, filling my veins with nicotine, the first thing I want is a cigarette.
While, on one hand, I am turned off by the obnoxious smell of tobacco smoke and the fact that smoking is a disgusting habit, on the other hand I must admit that tobacco is my friend because it relieves the craving I, as a smoker, feel and relaxes me. Even though I know in my heart and mind that smoking increases my blood pressure, quickens my pulse and sickens my stomach, it satisfies that part of my brain that feels tobacco is its friend and it relieves a craving.
We must recognise in debating this Bill that former smokers and smokers will find it difficult to accept this legislation. On the one hand a little devil will be telling them we are taking away their friend while on the other a rationale voice will be telling them tobacco is not good for them and that it is not fair or right that a non-smoker should have to inhale their smoke. That is the real essence of this debate.
Deputy Finian McGrath said his civil liberties are being infringed when he is prevented, following a hard day at work, from relaxing, having a pint, breathing in tobacco and having that lovely therapeutic sense that only an addicted smoker, as I was, has when satisfying his or her craving. Deputy McGrath should also recognise the right of the 70% plus people in the population who are equally entitled not to have to inhale smoke into their veins while in the pub. His contribution was interesting and important. It will always be difficult to make the direct causal link to show the exact number of deaths caused and the illnesses suffered by bar staff who inhale cigarette smoke.
It is always difficult to legislate on matters such as this. One is always on a knife edge in terms of whether one is being excessive and when one should react to scientific information. Increasingly, the 70% of the population who do not smoke feel, regardless of scientific evidence, that they have a right to have a pint in a pub and not to have to inhale smoke into their lungs. That is why this measure, while certain provisions of it are very controversial, has been politically popular and welcomed. Most citizens feel this is the right thing to do. We will have to wait and see. We are in an experimental era. I believe this legislation may lead to an increase in the number of people going to pubs and restaurants because they will be healthier and cleaner environments. However, we will not know until this legislation is enacted.
It is unfortunate that the Government, in terms of its management of this legislation, has sent out mixed messages, particularly in regard to its introduction. There was obvious confusion about whether the Taoiseach believed in his Minister and whether he would back up and carry out this measure. He now seems intent on following through on what he said. It is unfortunate the legislation will not come into force in January when most people expected it would be introduced. If it is not introduced, because of EU regulations, until later in the year, that will send out a message of poor Government and poor management of our affairs. I regret that.
My final point relates to my addiction as a smoker, why I was addicted and what happened to make me become a smoker. It is important to analyse why a large percentage of our population continue to smoke, given all we know about its effects on health, the messages we have sent out and the restrictions we have put in place. One explanation that made sense to me, as a confirmed former smoker, was in a sense a Freudian analysis of why people take up smoking. People will say it is difficult to smoke that first cigarette, that it is not natural to take a stick of chemicals, burn it and inhale its fumes and that it tastes horrible and makes one feel sick. Unfortunately, it puts the addictive drug into one's bloodstream and once there the body will always cry out for it, ensuring the person remains addicted.
The Freudian explanation sets out why we begin that process and what makes a 14, 15 or 16 year old person take up smoking. I do not remember who presented the argument but it pointed out that when smoking at a young age, people are saying to the opposite sex, "Look how healthy I am, look at the fine specimen of a human being I am that I can actually take this poison. I am such a strong male, or female, that I can ingest this rubbish and remain strong and healthy." That, to me, made a certain amount sense. Showing off to the opposite sex is the main reason many people take up smoking. Looking back to my early teens, that might have been the reason I began smoking. It is those types of deep rooted factors that contribute to people taking up smoking. We must continue to address this issue.
We will not achieve a reduction in the number of people smoking by introducing strict regulations. We must work at clever psychological advertising tactics which point out that smoking is not sexy. It is very difficult to stop smoking and to rid oneself of the minute by minute, day by day, need to ingest the chemical into one's veins. Advertisements relating to death or to people having lung cancer do not work. What I thought worked was the advertisement, made two or three years ago, which put out the view that smoking is not sexy. It contained a character whose teeth were blackened and stained by cigarette smoke. That was a very strong and successful advertising campaign. We need to continue in that line as well as putting in place legislation and restrictions like the ones with which we are dealing today. We need to target people, particularly females, at a young age by illustrating that smoking is not sexy, that they do not need to smoke to be seen as an adult or fit person. We should demonstrate that it is far sexier not to smoke.
I welcome Deputy McGrath's contribution. He said all addicts will feel they are being restricted by this nanny State. I hope they will also realise that smoking is not good for them and that it is not fair that the person sitting opposite has to inhale their smoke. Deputy McGrath should recognise the right of non-smokers to have a drink and to work in a smoke-free environment. That is the reason this Bill is being supported by all sides of the House.
If the famous North American Indians had had the benefit and inspiration of the current Government in terms of smoking they would have survived as a serious entity for a lot longer. If Cochise, Mangas Coloradas or Crazy Horse had been able to call on the current Government in their pursuit of perfecting deflection and decoy through the use of smoke they would have been very successful and would be leaders in their society to this date. Unfortunately, they did not have the assistance of this Government or its inspirers. They were left to using smoke signals which, occasionally, became entangled and often sent out the wrong signals.
That is not the case in this instance. The Government wrung its hands and tore its hair and wondered what it could do to deflect public attention from the real issue of delivering health services. The Government met with its well-paid political consultants who had obviously been watching old western films and thought of the smoke signals. They felt it could be done with smoke and mirrors.
The Minister and his advisers sat in a circle and decided they were going to protect the people from themselves and proposed a smoking ban that turned out not to be a ban at all. My party generally supported what the Government suggested. We did so presuming that the Government intended doing what it set out to do. The Government's intention has now become vague, hence the confused smoke signals.
The Minister announced that this measure was good for the people and that he was going to enforce it. Suggestions were made that it might be difficult to enforce and police, but the Minister dismissed these and said he had the answers. Then the Minster for the Environment, Heritage and Local Government, Deputy Cullen, rose up from the benches and said this would not happen on his watch. Other members of the front, back and nether benches took up his cry. While these benches are currently empty, I know the Members are here in spirit. Each Member in turn said this could not be allowed or tolerated.
A smoker like me will weigh up an issue such as this, but for the general good of public health, one has to come down on the side of the righteous, whether or not they are correct. Perhaps they are simply being politically correct. How was the Government able to give so many confusing signals while pretending that everyone was on the same side? The North American Indians did not perfect deflectors and decoys to the same extent as the current Government. The Government succeeded in creating controversy about smoking in public places. The Government then asked itself whether it would support its own proposal. The reason this Bill has come before the House for a second time is that the Government was not sure that it would be able to see through its own proposals. Parts of the legislation had to be submitted to Brussels to be tested on equality grounds etc. The public is asking whether this Bill will ever be enforced and what is the Government's exact intention. The message the Government has given is that it is not serious about this. It is merely a smoke and mirrors method of deflecting public attention from real issues.
As Deputy Finian McGrath said, smoking is definitely not good for one. I know this, as I am a sinner in this regard; I am not perfect and have never pretended to be. Unfortunately, many others in this country are not perfect either. Too much drinking is also bad for one. Jesus changed water into wine and I do not recall that He ever did the reverse.
The Deputy is wandering from the Public Health Tobacco (Amendment) Bill 2003.
I think this is relevant. Others have spoken about the police state and the politically correct society we propose to have. The Government proposes to superimpose itself on the wills, ways and lives of the people, either through this measure or by other means. I have a sense of deep unease about where we are heading. There may have to be a smoke police. The Minister for Health and Children has suggested that we should have a fat police to police those that are slightly overweight. I will not go so far as to say where that might end.
The public feels this measure will become an Irish solution to an Irish problem, that no one will enforce the Bill and that everyone will have a different interpretation of it.
I am glad the Deputy quoted a former Minister for Health and Children and Taoiseach.
I assure the Deputy that while many inspirational thoughts can be gleaned from his side of the House, I will not outline them now.
If the public concludes that the Government is not serious about what it is doing, as seems to be the case given the various opinions it has espoused, this measure will not work and we are only going through a charade. If this is the case, we must ask how far we are prepared to proceed with this proposal.
The public thinks that smoking in public places cannot be stopped and that smokers are to be thrown on to the streets. As things currently stand, one cannot smoke at home as one may have a problem there, one may smoke in one's car and one certainly cannot smoke in a public place. While I understand this, where are the addicted going to be pushed? While I have no difficulty in not smoking for two or three days, some people cannot do this.
Exceptions are now being made. Prior to this, the Minister said there would be no exceptions and that the measure would be enforced in all cases. What is going to happen to staff who are employed in places where the exceptions are being made? Earlier in the summer, people suggested to the Minister that exceptions might be made in the case of prisons, nursing homes – as elderly people felt they were entitled to their addiction at this late stage of their lives – and other places. The Minister initially refused to consider this and only came up with this notion late in the day. I received a letter from a relative of an elderly nursing home patient. This elderly man was deeply distressed at the thought that he would not be allowed to have an occasional cigarette. The message that what being sold originally was totally different to the message that is being sold now. If no exception to the ban was so centrally important to the success of the legislation, what are the Minister's thoughts on the proposal before us? I am not saying I am opposed to this proposal and I understand exceptions have to be made. If such high stock is set on the need to enforce this ban without exceptions, where does it leave the Minister now that exceptions are acceptable to the Government?
Other speakers have suggested that it might have been better had the Government decided to phase in the ban from the very beginning and to designate smoking zones in public houses and restaurants. This would have worked well, although it might not have been quick enough or politically correct. Furthermore, it would have given people time to get used to the ban and adapt their lifestyles to it.
I do not know what will happen but I hope young smokers are not pushed out of hostelries on to the streets. This has happened in other jurisdictions and it is not a good thing, no matter what we may think. A means should be found to ensure it does not happen here. I will not suggest to the Government how it should go about this but it is its responsibility to find a way. It was so self-righteous when the ban was first contemplated that it believed the right approach was to be totally on the side of enforcement. It could even have banned smoking altogether, which would have solved all the problems.
There are country areas with very few entertainment facilities, especially in the winter, or places where people can go to have a drink. People go to the pub to have a drink and sometimes to play cards, snooker or pool. This is their way of life and they may have difficulty pursuing it if they smoke and if the regulations are to be enforced in the way indicated. Some will say the rules were changed because smoking is bad for one and that this can be proven. This is fine, but other things are also bad for us. Forcing young people on to the streets is certainly not a great idea. The Government should have regard to some of the side issues that will have an impact in this area.
This legislation is directed at the public to protect their health. They all accept that smoking is not good for them and that it should be curtailed and eliminated as soon as possible. However, some suggest that deaths allegedly caused by the carcinogens in smoke will be prevented when the smoking ban is introduced. This is not true, as Deputy Finian McGrath stated. Such deaths will continue. Let us not be too self-righteous. Those who wish to be politically correct should recognise that people will die from the very same smoking-related illnesses after the introduction of the ban. However, I accept the principle of the legislation, provided it is realistic, workable and not written on a tablet of stone as if it were the result of divine inspiration and as if one would be condemned to exterior darkness for all time and not a true and responsible citizen if one did not follow the line pursued by the Government.
If the great native American leaders had had the benefit and inspiration of the smoke detectors and deflectors available to the present Administration, they would have succeeded, although I know Crazy Horse had a fair amount of success without help from any quarter. It is probable that they would now be part and parcel of leading society. Maybe they would even have been converted to the same line of thinking as the Government in respect of smoking, even though they were and still are very well-known participants in that particular area.
Two views obtain in respect of the smoking ban. This first is that one should live and let live. The second – the purest view of today – is that we should stop smoking. We accept the latter view but one must include a proviso that when we proceed in this direction we should be realistic, take cognisance of established practices and achieve our objective without causing too much discontent and disruption to society.
We fret obsessively over the health of the economy. We monitor rates of growth, inflation, unemployment and a host of other indicators but we need to remind ourselves that economics is a means rather than an end. It is time to hold the Government to account regarding the health of the people as well as that of the economy. It is very important that we do so. I compliment the Minister on addressing the public health concern regarding smoking because it was necessary to do so.
The public health service provides a vital safety net when we are ill, but in practice it makes a relatively small contribution to protecting and promoting positive health and well-being and preventing premature death. Most people understand and accept the role of the State in safeguarding our health by, for instance, insisting on acceptable standards of food hygiene in the hospitality industry, prohibiting driving whilse under the influence of alcohol or drugs, or requiring compliance with speed limits on our roads. Few would argue that involvement of the State in these areas represents an unacceptable infringement of our personal freedom or interference with our civil liberties.
Unfortunately, however, when the State intervenes to protect the health of the population in a way that threatens commercial vested interests, the spectre of the nanny state is raised and the notion that the State should not interfere with our personal choice in matters related to health. The debate on the imminent ban on smoking in the workplace, including bars and restaurants, provides a clear example of this phenomenon. Smoking causes approximately 5 billion deaths world-wide each year, including approximately 7,000 deaths in Ireland. As a cause of death in this country, smoke dwarfs all other factors in our external environment. Paradoxically, our reaction is muted because deaths from smoking are so common.
Faced with a Minister for Health and Children who is genuinely committed to tackling this scourge, opponents claim he should focus on the real problems of the health service, such as waiting lists and over-crowded accident and emergency departments. The need for adequate access to high-quality health services for all is clear and we should not underestimate the challenges we face in this area. However, it is time to broaden the debate on health from its almost exclusive and obsessive focus on health services to encompass a wider agenda.
The chorus of criticism, bordering on ridicule, that greeted the recent suggestion by Deputy Batt O'Keeffe, chairman of the Oireachtas Sub-Committee on Health and Smoking, that Ireland should consider a fat tax illustrates the challenge we face in this area. Specific proposals for taxes on food items would need careful consideration, as they might be socially regressive. Deputy O'Keeffe should be commended for initiating a debate on the important topic of obesity, which is now regarded by the World Health Organisation as a dominant global health issue.
I can speak from experience as a licensee operating a small hotel and licensed restaurant, while my family operates a bar. People are somewhat disappointed with Tadhg O'Sullivan's health grounds argument on behalf of the vintners. He was ill-advised to take on the World Health Organisation on the risks to public health of smoking in bars when discussing the detrimental effect that the tobacco ban would have on the licensed trade. The opposite may be the case and a positive line should be taken on this public health issue, though that might not be applauded by the vintners. We spend a lot on health services but preventative medicine and public health awareness and education in schools are also important.
From working in the retail trade I know that many young people, from college age down, are smoking. In my experience huge numbers of them are doing so. Public health education is very important. The Minister should consider producing a video to educate those in schools and colleges, given the level of addiction to alcohol and tobacco among young people. This should be done at national school level, where the temptation starts. This was discussed during the Private Members' debate on obesity, though the Minister will be hoping for results with the older generation of people who are hooked on smoking in bars.
The licensing laws introduced by the Minister for Justice, Equality and Law Reform may be difficult to implement and while the Garda have indicated they will not police this ban, it should be administered through the health boards. However, the ban can be self-policing and the reaction of the trade should be good, as people will be able to enjoy themselves in a smoke-free environment. It will distinguish Ireland as having taken the lead on a public health issue, particularly as every year 7,000 people, almost 150 people per week, die from illnesses solely attributed to smoking. People do not realise that.
The Minister is right to be decisive and to police this from the start. He is beginning to concentrate on public health and this gives the message that he wants to educate people about preventative health and extending their lifespans through diet, controlling their alcohol consumption and so on. I welcome the fact that the message is being given that smoking knocks years off one's life.
I was disappointed by the vested interests in this area, notably the hoteliers and restaurateurs. Some people, including politicians, were intimidated by statements that trade would be so damaged that pubs would have to close down. That is totally off the mark and if people took a positive attitude they would see that this move should open up a whole new market.
It is estimated that by 2030 almost 50% of the US population will meet the current criteria for clinical obesity. Ireland is not far behind the US in this area, with approximately one quarter of middle-aged men and women exceeding the clinical obesity threshold and clear evidence of an emerging epidemic of obesity in childhood and adolescence. As a society we must choose between taking measures to tackle this epidemic or simply watching it unfold. If, as seems likely, we take the latter option, we had better plan for major increases in resources for patients with obesity-related diabetes and kidney failure and we will need to match our US cousins in facilities for the surgical treatment of morbid obesity. Although our health and life expectancy have improved steadily over the past century, it is not an immutable law of nature that these favourable trends will continue in an environment designed to maximise calorie intake and restrict opportunities for exercise.
I believe in the promotion of public health and the Minister should spend some of his €10 billion budget promoting exercise and education in public health. The Government's obsession with spending can be seen from the Hanly, Brennan and Prospectus reports, as well as the health strategy document. I heard Mr. David Hanly at a debate on his report last week and I was disappointed by the lack of accurate costings, though that is a matter for another debate. If one is talking about investing in public health, a public health programme dealing with schools in every health board area is vital, as is advertising on the national airwaves. The Minister's work on dietary awareness and food promotion, restricting advertising, and public health awareness would pay off in five or ten years' time, when the State would save huge amounts of money.
The level of objections to the smoking ban arose from people being indoctrinated with the belief that it interfered with their privacy. However, we must look at public health in the context of the economy and preventative medicine is important in that regard.
Food advertising for children is geared towards the wrong kinds of food. As a retailer, I know that if one looks at the shopping baskets of those on lower incomes, they are full of Coke, crisps and other high fat products. That is down to education, because one rarely sees them buying fish or fruit products. Though those products are good value for money, they are seldom bought.
A parallel promotion could be done with the Department of Social and Family Affairs on getting good value for one's social welfare payments. A total of €10 billion has been allocated for social welfare payments. Analyses of spending are alarming as people purchase dear products with low food content which is bad from a dietary and public health point of view. The Minister should conduct a public health promotion through the social welfare system because it would not cost a fortune. A public health awareness campaign could be aimed at the lowest social class in terms of spending. The people concerned smoke excessively and purchase the worst food products, which generate significant profits for retailers, as none of them is in the top 20 products in terms of value for money. Advertisers and retailers are priming people because their stock comprises products that will cause significant health problems.
Following several decades of research, preventive strategies focused on alerting the population to the health problems of obesity and advising people to eat less and exercise more will not turn the tide of this epidemic. In the context of the obesity epidemic in childhood, it is estimated that in 1999 the food industry in the United Kingdom spent £300 million on creating advertisements designed to capture children's imaginations and specifically to encourage them to buy or ask for foods high in sugar, salt and fat – the three killers.
Dietary issues are not covered by the legislation but are related to public health. While the merits of fat, sugar or salt taxes may be debated, as a society, we need to consider measures to restrict our exposure to food which is damaging our health and that of our children. For instance, there is no reason Ireland should not emulate Sweden where advertising targeted at children under ten years of age is prohibited. The tightening of food labelling regulations might also be considered in order that people know how much saturated fat, salt and sugar is in their diet. The option of fiscal measures that would discourage the food industry from producing and aggressively marketing unhealthy products should also remain open. To adopt such measures is not a manifestation of the nanny state. The level of salt and sugar in people's diet is causing problems.
I am glad the Minister of State is listening attentively to public health concerns. I am a retailer and salute the Minister for Health and Children for taking a solid line on the anti-smoking ban. It is regrettable he had to make a number of derogations but, in a number of cases, for example, psychiatric hospitals, this was understandable. If he had wavered and back tracked on his decision, it would have been a disaster because he would have lost a great deal of respect among the public having taken a stand on such an important public health issue. It will be a few years before he is commended for his actions. However, he is in a position to tackle other public health issues relating to advertising, food labelling and so on.
The Minister has planned the use and promotion of public health labels at points of sale. As the reaction of the licensed trade has been not to accommodate the ban, it is important that the Minister should ensure licensees display signs relating to public health concerns in order that patrons will know establishments are adhering to the Government's public health policy. Whatever about the removal of ashtrays, public health signs should be visible in bars and restaurants. Does the Department intend to market the ban as a public health concern? This is one of many measures which it is considering. I hope licensees will take responsibility and actively pursue the ban in order that customers will be aware of what is expected of them.
Sponsorship of events by tobacco and alcohol companies is a matter for another day. However, the registration of tobacco products under the legislation by retailers is important. The great difficulty in many supermarkets is that people aged under 18 years work at check outs which creates problems in terms of the sale of tobacco products.
I compliment the Minister on introducing the legislation because this is public health issue No. 1. I hope he will introduce other public health measures that will be equally effective in the long-term and will be in the interest of the well-being of the public.
I thank all Members for their contributions. Deputy Perry's comments on public health were particularly interesting. While he went beyond the scope of the legislation, I agree with him that investment in public health generates a return for the Exchequer and the general well-being of the population. Significant amounts are spent on advertising by the food industry as it engages in public health propaganda campaigns. Investment by the State in this area is minuscule compared with investment by private companies, which often produce wrong and dangerous images about our eating and drinking habits.
With regard to the threat to public health from tobacco consumption, there is strong support in the House for this important initiative. Public health authorities in many countries have grappled with the problem of how to prevent persons from taking up smoking and to get smokers to break their addiction once it is established. I reminded Deputy Durkan that the phrase, "An Irish solution to an Irish problem", was coined by a former Minister for Health and Taoiseach. We have devised an Irish solution to an Irish problem on this issue. Ireland will be one of the first countries to give a firm lead in this area which is very much to be welcomed.
There is no single solution to deal with the tobacco epidemic. A comprehensive approach of the type undertaken by the Government through the Public Health (Tobacco) Act 2002, this amending legislation, education and information initiatives and 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 the population. The level of smoking stands at 25%, according to the most recent survey evidence. This is in stark contract to the level of 43% that prevailed in the 1970s. This welcome reduction translates into lives saved, serious illness prevented and avoidance of the pain and suffering involved in death brought on by tobacco related diseases such as lung cancer and emphysema.
Our success in improving the health status of the nation is linked to reducing further the level of tobacco usage and, especially, preventing younger persons from beginning the smoking habit. If the incidence use by young persons can be reduced, we can make considerable progress towards a tobacco free country. I am aware that much effort in promoting and supporting tobacco-free initiatives has and is being carried out by a range of groups and organisations.
The Joint Oireachtas Committee on Health and Children published two reports on health and smoking the conclusions of which left nobody in any doubt about the nature of the threat posed by tobacco consumption. The cardiovascular health strategy group report, Shaping Healthier Hearts, also made clear the importance of reducing smoking levels to reduce the incidence of heart disease which is one of the biggest 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 and encouraging the cessation of smoking. The positive health message is getting through to people. Smoking tobacco products and environmental tobacco are seen as significant risks to the health of smokers and non-smokers. The introduction of smoke-free indoor workplaces in 2004 will be another positive step in the smoke-free initiative we are undertaking. Many workplaces are already 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. I understand the difficulties smokers experience in trying to quit. Most smokers commence their addiction before adulthood and many 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 those trying to quit. 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 of Health and Children, the Irish Cancer Society and the health boards. Additional smoking cessation officers have also been recruited by the health boards.
Tobacco remains a significant burden to individuals, families and society through death, illness and medical costs. The positive measures being undertaken on a broad front in reducing tobacco usage will increase life expectancy and result in happier, healthier and better quality lives for many of our people.
Question put and agreed to.