I should like to express my thanks to the Deputies who contributed to the debate for their detached and objective approach to this Bill. I hoped that the Bill would be supported by members of all three parties and, if that were the pattern, then we could have in this House a really serious deliberative assembly in which people could say what they thought on essential non-controversial issues. In the Labour Party we differ as to the merits of the Bill. Some are for it and some are opposed to it. I should like to thank Deputy Cooney and Deputy Harte for their support of the Bill, and I hope that this will encourage Deputies in future to cross the party boundaries on issues of this kind.
I should like also to thank the officials in the Department of Health who supplied me with an enormous amount of very helpful material. That is the way it should be. There should be some assistance to private Deputies in a matter of this kind to enable them to put forward the most convincing case possible.
I was very disappointed in the Minister's attitude to the Bill. As Deputy O'Donovan said, it is really a very innocuous Bill. It proposes to do very little. The proposals are minor. Ideally they should go very much further but the Minister is not even prepared to support the proposals even as far as they go. I am quite astonished at his attitude. He admitted himself that the notice on the cartons is of minor importance. In the past he described it as a futile gesture and I am driven to the reluctant conclusion that Deputy Fitzpatrick is not right in his assumption that the Minister is behind this drive to do something about this serious issue, for one reason or another, but mainly because, I believe, of financial considerations. I am driven to that conclusion because I do not think the Minister is a stupid man. He must know the case made since 1938. I was wrong last week when I said 1954; that was the first time I personally became involved. In fact, the first work was done on this subject in 1938 and that showed that there is a direct relationship between cigarette smoking and early and preventible death. The work started in 1938 has continued and has been supported and the findings ratified by subsequent research all over the world.
We have advanced, I suppose, in that the Minister says he proposes to reject the Bill. His predecessor, Deputy MacEntee, was more extreme; he said, as far as I remember, that he did not wish to use Deputy Browne's terrorist mechanism. The Bill was precisely the same as the Bill before the House and, since the Minister merely proposes to reject it, I suppose we have advanced slightly.
I do not think the Minister is a stupid man and I can only conclude that there is a motive behind his refusal to tackle this problem seriously. It is a very serious problem. We are lagging behind, as we do in so many cases, all the other civilised countries in regard to this particular problem. The United States started as far back as 1964. Canada, New Zealand, Britain and other countries have started to do something about it. This is our first serious attempt to deal with the matter.
As Deputy O'Donovan said, it is absurd to prevent television advertising while permitting the continued use of radio, magazines and, presumably, newspapers for this purpose. From international literature, in particular from the literature issued by the College of Physicians in England, by the general support for the anti-smoking campaign in America and by the work of the World Health Organisation, I think I have shown conclusively that cigarette smoking is a lethal habit. It kills in one of three ways, each of which is dreadful and painful. It can result in lung cancer, coronary heart disease, bronchitis and emphysema. I cannot understand the attitude of mind of a Minister for Health who, as the present Minister has done, dismisses this continuing increase in the incidence of these diseases in Ireland. Between the years 1950 and 1968 there was an increase in the incidence of lung cancer from 300 to 970, an increase from 400 to 1,450 in respect of chronic bronchitis and an increase from 1,700 to 5,900 in the incidence of coronary heart disease. In spite of the increases in these avoidable diseases in so far as cigarette smoking is concerned the Minister can dismiss the matter by saying, as is reported at column 1904 of the Official Report for the 16th February, 1972:
We have to look at tobacco, dangerous as it may be, dangerous as the Report of the Royal College of Physicians has said it is, as a drug which is liable to reduce the life of those who indulge in it quite definitely, but at least it has no hallucinogenic effects of note and does not cause abject misery to the family of the person who is a consistent smoker. One has to look at it in a balanced way particularly in regard to adults who smoke cigarettes.
Is it the position that the Minister is incapable of using his imagination? Has he ever seen anyone crippled from any of these diseases. Surely he must have had experience of people suffering from serious heart disease, bronchitis, emphysema or lung cancer. How can he say that these diseases do not cause abject misery to the families of the victims? The last lung cancer victim whom I watched die was a Deputy of this House. During the months before his death he realised that he would not be cured. His wife and family were aware, too, that he would die within a short time. They were a family who cared deeply for one another. For all those months could the Minister say that the condition of that patient did not cause abject misery to his family? This man who had been about 15 stone in weight was reduced to about six stones towards the end and when I went to visit him during the last few weeks of his life, I found that his wife had sat in St. Luke's Hospital during those weeks and waited out those days and hours until he died. That is merely the case of one heavy smoker whom I knew. This misery goes on all the time. It is the Minister's job to do something about it. Having listened to him, one of the most shameful findings is his callous indifference to his responsibilities. He has wonderful power at his disposal but yet he does nothing about this problem.
The Minister should be ashamed of himself. I can only assume that he is too stupid—I choose the word carefully but I have no wish to be offensive —to understand the implications of these reports which all of us agree can be believed now without any question of doubt: or else, he is too insensitive to understand the full implications, but I find that hard to believe. Frequently the Minister anathemises drug pushers here but in this case it appears that he is on the side of the pushers in that he does not wish the tobacco manufacturers to suffer and considers that the Government cannot afford to suffer the loss of revenue that would be associated with the discontinuance of cigarette smoking.
There must be a serious programme of dealing with this problem. Unfortunately, Deputy O'Donovan's point about revenue is correct if I put forward a statement by a Conservative Minister for Health in 1966. He said:
Smokers, mainly cigarette smokers, contribute £1,000 million yearly to the Exchequer. Nobody knows better than the Government that they simply cannot afford to lose so much.
It is not exclusive to the Conservative Party because in 1969 a Labour Minister for Health said much the same thing. He said:
The introduction of a meaningful differential tax on cigarettes would be bound to have a seriously detrimental effect on total revenue from tobacco. The capacity of tobacco duty to produce revenue would be ended.
Perhaps one cannot help referring to them as two likeable rogues because at least they had the audacity and moral courage to admit they were prepared to carry a number of these preventable deaths on their consciences. They were prepared to square this kind of behaviour with their bizarre moral attitudes. When it came to attempting to help people who suffer from the disability of finding it difficult to give up cigarette smoking they put the revenue first and the lives, welfare and the health, and what the Minister called the abject misery of the families, came a bad second. That is the motivating factor and it applies not only to those two Ministers but to our present Minister for Health.
The Minister makes no attempt to get away from the fact that he accepts these terrible findings. In his article in an advertisement in Woman's Choice of 9th March, 1971, he said :
The association between smoking and lung cancer, chronic bronchitis, coronary artery diseases and peptic ulcers is indisputable.
In his speech the Minister made some peculiar references, which I did not understand, to the greater seriousness of what he calls the drug problem—I presume he means the drug addiction problem—and his preoccupation with whether a drug is hallucinogenic. I do not think it matters very much whether it is or is not hallucinogenic. Even though he attempts to separate what he calls the drug habit and cigarette smoking, in his Departmental leaflet he states:
Smoking, like any other drug habit, becomes very hard to give up. It creates the craving which only 40 cigarettes a day will satisfy.
This is what the Minister believes will happen to the person who smokes. Smoking is like any other drug habit but about the other drug habits, LSD, amphetamines, heroin, pot, hash and the others the Minister comes here with the most punitive type of legislation. Not only will he not allow people to use these drugs—there is no question of their exercising their independent rights as individuals to decide whether they will kill or poison themselves by using these drugs—the Minister lays down regulations that they will not be permitted to use them. In relation to the hard drugs I share his views but not in relation to the others.
The Minister is adamant that if people insist on using the hard dangerous drugs more than likely they will end up in jail, and this applies particularly to the pushers. The Minister is quite authoritarian in these circumstances; he is very conscious of his responsibilities as Minister for Health in protecting people from the emotional needs which lead them to take drugs, whether heroin, opium or other drugs. With regard to a relatively small problem in our society the Minister is prepared to take drastic action but with an enormous national problem involving great unhappiness, sickness and death, effectively he has refused to act.
The Minister says that tobacco is a drug which reduces the span of life of those who indulge in it. That is true about nearly all the diseases that from time to time have been dealt with by successive Ministers for Health. That is their job. If there is a condition in society which is preventable or which, if not prevented or avoided, reduces the span of life of people, attempts are taken to deal with it. Why does the Minister make an exception in this instance? What is his justification? Is he content to see people killing themselves by permitting them to go on with this habit? Is this not the same as suicide? What is the morality of all of this?
The Minister is fortunate that there is a difference between organic dependence on addiction to a drug like heroin or morphia, on which the body eventually becomes dependent so that it is impossible to give the drug up, and cigarette smoking. It is possible to give up cigarettes and people can be helped in this way. However, the Minister is refusing to give them this help and this I consider totally disgraceful on his part.
At column 1904, Volume 258, of the Official Report dated 16th February, 1972, the Minister states:
Perhaps I next should say a little more about the difficulties to be faced in trying to persuade adults to give up cigarettes.
The Minister refers to the Report of the Royal College of Physicians. It is not impossible to give up cigarettes; it is not impossible to persuade adults to do this. There are a number of adults in this House who have said they have already done that, and I suppose the classic example of the fallacy of the Minister's statement that it is impossible to stop adults smoking is seen in relation to the medical profession. Among the medical profession there has been a dramatic drop in smoking since 1951 on. There are more non-smokers among doctors than among the general public and only half as many cigarette smokers. Thirty doctors smoke cigarettes as against 61 others. Between 1951 and 1965 50 per cent of British doctors who used to smoke stopped smoking when the evidence of risk of cigarette smoking was first recognised by most doctors. These results were the same throughout Canada, New Zealand and the United States.
Another interesting fact is that not only doctors were able to give up smoking, contrary to the Minister's belief on the subject—because doctors are no different from anybody else; they have just the same weaknesses and disabilities, likes and dislikes, as any other member of society—but also the non-medical staff at Edinburgh University, professional, clerical, skilled working class, who simply were more aware of the risks. That is a very important point. Deputy O'Donovan made the case, and to some extent differed with Deputy Barry, as to why some people can stop smoking and other people cannot stop smoking. The general finding is that it is a matter of the level of education of individuals. Doctors obviously, for various reasons, must have access to literature on the subject and they also watch people dying from this disease, which is educative in a very positive way. Other people working in this milieu in which this kind of information is available were also impressed by the statistics and the facts available and were able to control their cigarette smoking.
Therefore, the Minister is quite wrong if he genuinely believes—and I am afraid he does not genuinely believe —that it is impossible to control this problem or to improve the situation in regard to it significantly. I do not believe that, but let us assume that he does; then I can tell him he is wrong in his belief. He is also wrong in relation to the graph he quoted of the pattern indicating reduction in consumption in the United States in 1961 and 1968. He used it to show that it is very difficult to persuade adults to give up smoking. At column 1905 of the same volume he said:
The general consumption of tobacco in the United States, for example, has shown spasmodic falls and then appears to have slowly risen again. It appears to have risen recently after the ending of advertising of cigarettes showing again that the advertising of cigarettes, as claimed by some of the tobacco companies, is almost more a method of selling rival brands of cigarettes than it is of increasing the consumption of cigarettes.
What the Minister said it not true, because the facts are that since the mid-sixties one in three of men and one in four of women in the United States who were smoking in 1966 had stopped smoking in July, 1970. Therefore, the Minister either has not read the report of the College of Physicians which he has quoted or, if he has read it, has quoted it selectively in order to mislead the House and in order to justify his failure to take any positive action in regard to this matter.
As I said in introducing this Bill, I was astonished at the decision of the United States Government to act on the Surgeon-General's report in 1964, because of their enormous vested interest in the tobacco company. It is to their credit in the United States that they were the first to try to do something positive in relation to this problem. What they have done has had the effect of reducing the incidence of cigarette smoking to some extent in the United States.
Everybody knows this is an enormous vested interest. The British have just been slightly worse than the Minister and our Department of Health. We have been talking about this now for nearly 20 years. Our Department of Health has been the worst; the British has been the next worst; other countries have been infinitely better. The British had the farcical position of watching £52 million being spent on advertising sales promotion of cigarettes while a miserable £100,000 was spent on counteracting it, pretending they were doing something. It was a squandering of the £100,000 just as the money the Minister is spending is being squandered, with the same dishonest pretence that he is seriously concerned about this problem in spending a fiddling £27,000 against the enormous expenditure here. I am sure it is enormous, although I have not got the present figures, because when I asked for them recently from the Minister's Department I was told the Minister did not have them. He is not sufficiently interested to find out the size of the advertising programme against which he is working. He has not even taken the trouble to find out how much greater it is than the £27,000, or whatever it is, that he is spending. That money is completely wasted. There must be many ways in which it could be better spent.
What the Minister is doing is putting this notice on the carton. In reply to a Parliamentary question he told me that this was a futile gesture. What he is agreeing to do here is what he has described as a futile gesture. Faced with these tragic figures, tragic in their human implications, the Minister rejects this Bill of ours and says instead that he will carry out this device of putting a notice on the carton of which he assures us no one will take any notice. This is his total contribution to dealing with the problem of the very powerful advertising campaigns of the tobacco pushers on whose side he has aligned himself.
On 19th February, 1970, the Minister said:
I have considered this suggestion previously and have rejected it— essentially because I am satisfied that it would have little or no practical effect.
So we are simply wasting public money. I suspect that the reason why the cartons will carry this notice is that we have an export trade in cigarettes and our cigarettes will not be allowed into England unless they carry this notice. It is as simple and as cynical as that. There is no other reason for doing it. The Minister has no sense of true responsibility as Minister for Health and he does not care enough to do anything about it. We are suppressing our television advertisements because they are complicated and expensive to make. They are not making them in England and they will not bother to make them here. The notice will be carried on the cartons because our cigarettes will not be allowed into a number of countries, including England, unless they carry it.
There is no doubt in the world that it is difficult to persuade adults or children to give up cigarette smoking, but there are many adults who, given the information, given the education, have found it possible to give up cigarettes. Why will the Minister not adapt his programme to a policy based on the factors which so moved doctors, and the workers in Edinburgh University I mentioned, and various other people like Deputy Fitzpatrick, Deputy Barry and others who, because of their level of education and their level of intelligence and their level of self-control—I ask the pardon of the Labour Party—were able to give up this habit which is very difficult to give up. I had that problem myself. I completely concede that it is a very difficult habit to give up. My complaint is that we are not giving the help they deserve to the people who are anxious to give up the habit of cigarette smoking.
The Minister replied to one point raised by Deputy Cooney. The Minister does not seem to know what is on television. He does not seem to know his own service very well. Deputy Cooney suggested that pop idols and pop singers should be used in an anticigarette smoking campaign on television. The Minister came back with a suggestion about Mr. Mitchell, who is an announcer. The Minister's Department are already using people like Dickie Rock in their advertising programme. Because of the Minister's obvious lack of enthusiasm, and lack of conviction that this would be anything other than a futile gesture—that is, putting the notice on the cartons— Deputy Cooney made a number of suggestions with regard to the size, the layout and the content of the notice, whether we should try to frighten people or should try to reason with them, and the various methods used by advertisers when they are faced with trying to sell anything. Should we change the colour of the print and the size of the print? These are all very important factors. The Minister made no attempt to deal with that point which was put forward by Deputy Cooney.
I have seen most of the literature supplied by the Department and it has been directed predominantly at children. I share with other Deputies the conviction that it is not sufficient to talk to children only. Adults must also be helped. We have continuous information topped by the most recent findings of the Irish Cancer Society that among the sector of the community upon which the Minister and his Department have concentrated over the past ten years, to the extent they have concentrated at all, the children, the rate of smoking is increasing in spite of the propaganda by the Minister's Department over the past ten to 15 years. These findings were made by public-spirited medical officers of health in Westmeath and Cork mainly and they have shown that smoking starts at the age of seven years and increases rapidly thereafter. Not only does it start at the age of seven years but the rate of smoking among boys and girls is very much higher now than when the Minister started his campaign to stop children smoking. Surely the Minister should learn something from these facts and figures.
