"That the Bill be now read a Second Time."
This Bill may well be one of the shortest Bills introduced in the present session of Dáil Éireann but it is, in my view despite its brevity, an important piece of health legislation.
The purpose of this Bill is to provide for the control, by statutory regulation, of the advertising and sales promotion of tobacco products and of sponsorship by the tobacco industry.
The legislation will enable the Minister for Health to prohibit particular kinds of advertising and sponsorship, to restrict expenditure in these areas, and to control the form and content of tobacco advertising. It also provides for the furnishing, to the Minister for Health, of information necessary for the purposes of the Bill. All this is contained in the key section, section 2. The other four sections of the Bill contain the short title, definitions and provision for expenses and penalties.
I shall endeavour to outline for Deputies the general background against which this legislation is being introduced, the need for it and the general lines along which I propose to proceed with its implementation.
Deputies are aware that throughout the modern world Governments everywhere are increasingly concerned with the rising cost of health services on the one hand and the fact, on the other, that increasing expenditure is not matched by a corresponding improvement in general health and well-being.
This contrast clearly arises from the pattern of modern living and points us in the direction of emphasising prevention as strongly as cure. For this reason our health policy increasingly seeks to build up and develop the preventive function side by side with the curative one. An essential element of this policy is to support those in the community who are anxious to maintain good health when they have it, and to procure acceptance of the view that each of us has a personal responsibility to act in a way that will maintain, as far as possible, sound physical and mental health.
In the current year we have undertaken a number of campaigns designed to emphasise the preventive approach and support those who are anxious to maintain and improve their own health. These include a national hygiene campaign, a national fitness campaign, and, currently, a campaign designed to impress upon people the need for moderation in the consumption of alcohol—the first step in a determined attempt to reduce the impact of excessive drinking on the health and welfare of the individual members of the community.
In attempting to implement such a positive health policy, we immediately come up against the problem of cigarette smoking and the widespread, intensive, glamorous advertising of tobacco products. A positive campaign to promote good health can only be of doubtful value in an environment saturated with the advertising of tobacco and alcohol—advertising which continues to grow in volume and sophistication.
The World Health Organisation has been particularly concerned with the menace of cigarette smoking in recent years. As far back as 1975, it stated in a report that "smoking related diseases are such important causes of disability and premature death in developed countries that the control of cigarette smoking could do more to improve health and prolong life in these countries than any other single action in the whole field of preventive medicine".
In May of this year, the 31st World Health Assembly called for higher taxes to be levelled on cigarette sales and for restrictions to be imposed on tobacco promotion in the mass media. The Assembly blamed tobacco smoking as a major cause of chronic bronchitis, emphysema and lung cancer and as a major risk factor in heart attacks, some pregnancy related disorders and other serious health problems.
The Assembly also called on member states to strengthen health education programmes about smoking as part of general health education and urged comprehensive measures to control smoking by increasing taxation on cigarette sales and restricting, as far as possible, all forms of publicity for promotion of smoking. It underlines also the rights of non-smokers "to enjoy an atmosphere unpolluted by tobacco smoke" and asked the World Health Organisation itself to co-operate with member states upon request in developing measures to control smoking publicity in the media.
There is no need, however, for me to rely on any international authority to justify this legislation. Our own domestic situation clearly demands that we act.
The need for action can clearly be understood if we look at our own figures for deaths and illness which can be directly attributed to cigarette smoking.
In 1975, there were 1,191 deaths from lung cancer and associated conditions. At a conservative estimate, 70 per cent of these deaths are attributable to smoking and we can take it, therefore, that at least 800 of those deaths were caused by smoking.
But smoking is also a major factor in relation to two other important diseases. Chronic bronchitis and emphysema caused 250 deaths in 1975 in the active age group, 35 to 64, and it is calculated that at least 175 of these were attributable to smoking. Coronary heart disease caused 9,795 deaths in the same year. There are a number of factors associated with such deaths but it is accepted that cigarette smoking is a major causative factor and over 1,000 of these deaths can be attributed to it.
Let us clearly accept, therefore, that in 1975 at least 2,000 Irish men and women died because they smoked. And there is no reason, unfortunately, to believe that the number will be any less for 1978.
The number of deaths caused by smoking related diseases, however, is only part of the total picture. Large numbers of those who are hospital patients require treatment for diseases which are, to a greater or lesser extent, associated with smoking. It has been estimated, for example, that as a direct result of smoking, over 6,500 people between 25 and 74 required hospital treatment in 1977 and that they spent over 100,000 bed-days in hospital in that year.
The hospital admission figures are, of course, only the tip of the iceberg. There are no reliable statistics about the number of persons who have to consult their general practitioner because of illnesses which are attributable to smoking. In the absence of detailed statistics, it is necessary to estimate the extent to which such illness requires the services of general practitioners. One estimate suggests that, in the general medical services, over 70,000 calls on general practitioners are the direct result of smoking.
Smoking related diseases cause deaths, long hospital stays and illness requiring consultation with general practitioners. The cost of treating these diseases has, conservatively, been put at about £15 million a year. There are other costs which it is more difficult to estimate. It has, for example, been calculated that the total number of working days lost through tobacco associated illnesses would cost up to £30 million per annum. These figures are difficult to calculate exactly and we are continuing our efforts to estimate them more precisely. It is, however, clear beyond any dispute, that in dealing with the cost of smoking related diseases, we are dealing with a very substantial cost, not only in the direct charge to our health services, but in the social and other costs which of necessity arise through the illness of those who smoke.
While the economic cost is something which we must take into account, it cannot reflect the amount of anguish, sorrow and hardship which smoking related deaths and illness give rise to for so many people.
One can state calmly, factually and without emotion, that in our modern community cigarette smoking is responsible for a considerable amount of illness and a large number of deaths. For the Government to permit the advertising of tobacco products to continue uncontrolled on a widespread scale in this situation would be simply irresponsible.
I would now like to outline for the House how I propose to proceed with the implementation of this legislation when it has been enacted. First of all, to ensure that the Oireachtas is fully informed of what is happening, it is provided in subsection (3) of section 2 of the Bill that regulations made under the legislation shall be laid before each House of the Oireachtas as soon as practical after they have been made and such regulations may be annulled by a resolution of either House. I intend also to try to reach agreement with the tobacco manufacturers about the content of the regulations. It is my intention to consult with them and give them an opportunity of putting forward their views upon the detailed provisions of the regulations before they are made.
The controls which it is intended to impose upon the advertising of tobacco products here might, in certain circumstances, operate to the disadvantage of the Irish tobacco industry in competition against imported products. More liberal codes are operated in other countries and this could create a situation in which persuasive advertising of foreign brands would appear in foreign publications on sale here, particularly those which come from the United Kingdom. I intend to ensure that the Irish industry will not be placed at any disadvantage in this way. I believe that those concerned in the UK will respect the statutory standards imposed here but if some do not, measures will have to be taken to deal with such a situation.
The aspects of this legislation, perhaps, which have attracted most comment and interest among the general public, certainly among those interested in sporting and athletic activities, are the provisions dealing with sponsorship. I would like to make it clear that it is not my intention to interfere with existing sponsorships to any great extent for the present. I realise that precipitate action in this area might cause serious problems for sporting bodies and organisations generally. Accordingly, it would be my intention to begin by controlling the volume of sponsorship and preventing the undertaking of new sponsorships except in very special circumstances. I will also go carefully into the extent of the sales promotion of tobacco products engaged in during the event sponsored.
The regulations also will provide for the control of the total amount spent on advertising and the nature and content of such advertising. The advertising of tobacco products in cinemas will be phased out almost immediately. All forms of outdoor poster and sign advertising will be phased out by the end of next year.
Deputies will have noted that CIE has already taken the initiative in restricting, prior to phasing out, tobacco advertising. I shall be asking them to consider increasing the availability of non-smoking areas on trains and buses and to intensify the efforts they are already making to persuade their customers that they should observe these non-smoking areas.
Those who travel abroad will have noticed that Aer Lingus in common with other European airlines have now provided non-smoking areas in their planes and passengers are specifically requested not to smoke in those areas and this request is normally complied with.
Aer Rianta have, I am also glad to say, recently provided no smoking zones in the arrival and departure lounges of our airports. I shall be writing to hoteliers and restaurant owners asking them to ensure that in their dining rooms, non-smoking areas are made available for those persons who do not smoke and who do not wish to have smoking thrust upon them.
Health boards will be asked to ensure that smoking will not be permitted in the hospital wards and to make it clear to visitors that they should not smoke in the wards. I shall be asking other Departments to co-operate in restricting areas in which smoking may take place and in ensuring, as far as possible, that the norm should be that in the majority of offices smoking will not in future be acceptable.
I hope those who smoke and who wish to continue to smoke will not feel that they are being unduly discriminated against. I am not entitled, and I have no wish to interfere with the right of any citizen to decide whether or not he or she will smoke. I have, however, a duty to consider also the rights of those who have decided that they do not wish to smoke and who regard an environment free from smoke as something to which they have a right.
As I said at the outset, I regard this Bill as an important piece of legislation. While it is limited and specific in its intent, its existence and its passage by the Houses of the Oireachtas will be evidence of a more general change in our approach to the health problems with which we are faced. It will, in my view, make clear the Government's intention to take positive action to protect the health of our people when it lies in their power to do so.
The passage of the legislation will enable all those engaged in the administration of our health services to talk with conviction and credibility, especially to young people, about preventive medicine and positive health, and will place us among the leading European nations in the spreading international effort to prevent death and illness from smoking related diseases. It is in this spirit that I commend it to Deputies for a Second Reading.
I shall listen carefully to the views of Deputies on these proposals and consider any suggestions they may wish to make for their improvement or for the better regulation of the situation generally.