Select Committee on Health díospóireacht -
Thursday, 10 Oct 2024

Public Health (Tobacco) (Amendment) Bill 2024: Committee Stage

An Cathaoirleach

We have received no apologies. The meeting is being convened to consider the Committee Stage of the Public Health (Tobacco) (Amendment) Bill 2024. The primary objective of the Bill is to increase the minimum age of sale of tobacco products to 21. The Bill also provides that current penalties for anyone convicted of selling tobacco products to people under the age of 18 will be extended to cover convictions relating to sales to people under the age of 21.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against any person or entity outside the Houses or an official either by name or in such a way as to make him or her identifiable. I also remind members they are only allowed to participate in this meeting if they are physically located on the Leinster House complex. In this regard, I ask all members prior to making their contributions to the meeting to confirm they are on the grounds of the Leinster House campus. I remind all members that should a division be called, they must physically come to the committee room in order to vote.

I welcome Minister for Health, Deputy Donnelly, to our meeting this afternoon. The Minister is accompanied by his officials. Does he wish to make his opening statement?

Minister for Health (Deputy Stephen Donnelly)

I do not have an opening statement prepared. I thank the committee for facilitating today. I was keen for us to accelerate this legislation on the off-chance that the election is not in March of next year. It has the potential to save an awful lot of lives over many, many years. I thank colleagues for facilitating the session today.

An Cathaoirleach

I will get straight into it. Two amendments have been ruled out of order and this has been communicated to the Deputy.

Sections 1 to 10, inclusive, agreed to.

An Cathaoirleach

Amendments Nos. 1 and 3 in the name of Deputy Cullinane have been ruled out of order as they are in conflict with the principle of the Bill.

Amendment No. 1 not moved.

NEW SECTION

Deputy David Cullinane

I move amendment No. 2:

In page 6, between lines 18 and 19, to insert the following:

“Report on De-Nicotinisation and Smoking Cessation Supports

11. The Minister shall, within 6 months of the passing of this Act, conduct a review, to be laid before the Houses of the Oireachtas within 12 months of the passing of this Act, to examine and propose measures regarding gradual reductions in the nicotine content of tobacco products, expanding smoking cessation supports, and a targeted campaign for the reduction in smoking rates among young people.”.

Amendments Nos. 1 and 2 have been ruled out of order so I will speak to what I was hoping to achieve with them. I will chiefly speak to amendment No. 2, which is in order.

The purpose of amendment No. 1, in particular, as well as amendment No. 3, is that before the provisions of the Act are brought into law, the Minister of the day would carry out a review of the international evidence of the raising of the age for purchasing tobacco products. I know there is evidence and the Minister would have taken this into account in progressing the Bill. We did not have pre-legislative scrutiny. This Bill come in very late and there was not a huge lead in. We were dealing with the issue of vaping, as the Minister knows, and we were dealing with two Bills in that space. On this particular Bill, I was conscious that we would look at all of the issues, including any unintended consequences or issues that may have arisen in other countries that have moved in this space.

I want to speak to amendment No. 2, which is in order. It requires that a report would be laid before the House no later than 12 months after the passing of the Act. That is to examine a range of other areas, including measures like gradual reductions in the nicotine content in tobacco products. Obviously, this Bill will affect somebody who is 19, 20 or 21 years of age, whenever this comes into effect. It will essentially raise the age of purchase to 21. They can still smoke. Even when this Bill is brought in, many other people will still smoke.

Other countries have looked at reducing the nicotine content as one of the ways in which we can reduce the harmful effects of smoking. It is very similar to what we are hearing about salt content in food. Should have incentives through tax? Should we have binding requirements on manufacturers to reduce salt content in food and so on? It is a similar sort of process. We can then look at expanding other smoking cessation supports and a targeted campaign for the reduction in smoking rates among young people.

Amendments Nos. 1 and 3 are ruled out of order. Amendment No. 2 is what it is. I will not be pushing it to a vote if the Minister does not support it and I will not be opposing the Bill on Committee Stage. This will probably be my last contribution on this but I want to get the Minister's own sense of the logic of amendments Nos. 1 and 3 is and to know whether he is minded to support amendment No. 2, which is in order.

An Cathaoirleach

Does anyone else wish to come in on this?

Deputy Stephen Donnelly

I thank Deputy Cullinane. I agree with the broad thrust of what the amendments do, which is in part to say, let us continue with the targeted research and also to explore other ways we can reduce harm. One of the specific ways the Deputy has looked at is the reduction of nicotine content or "denicotinisation", which is a new word to me.

Deputy David Cullinane

It is hard to say. The Minister has pronounced it well.

Deputy Stephen Donnelly

I agree with the thrust of what Deputy Cullinane is trying to achieve. I am not going to accept the amendments, not because I do not agree with what he is saying, but because we can go broader than this. I got a briefing from the Department in response to the Deputy's amendments. There are two points to make. One is we are doing the research all the time. The research is ongoing, be it through the HRB, the Department or academic partnerships. Second, the experts made the interesting point that we can look at reducing the nicotine content because that is the addictive substance but much of the harm comes from things like tar, added chemicals and other areas. They say yes to the broad idea but let us be broader. Let us do the kind of research the Deputy is discussing on filters, added chemicals, tar content and nicotine content. That is the product.

From a policy perspective, let us keep looking at the research on things like a smoke-free generation, tobacco companies paying for associated health costs and other things. I agree with what Deputy Cullinane is proposing but we can expand on that rather than through an amendment to the Bill.

Deputy Róisín Shortall

Apologies for being late, but I was speaking on the statements on mental health and it was an unfortunate clash.

Regarding smoking cessation supports, over the last two years this committee has dealt a lot with vaping and smoking. We urge the Minister to accelerate the production of the legislation to deal with the flavours and disposable vapes which we called for at this committee over two years ago. We hope that we will see that but I am concerned that we will not at this stage in the game.

What is the Minister's thinking on a situation, which we will hopefully have in the near future, where disposable and flavoured vapes will be outlawed?

There will be strict rules on the number of vape flavours available. Why, then, is the Minister seeking to impose a tax on vapes? Presumably, if the new legislation is produced quickly, as promised, we will have a situation whereby we will be dealing with the very widespread issue of vaping by children. However, one would assume that the nicotine-flavoured vapes are predominantly used by adults in an attempt to cease smoking. What is the Minister's rationale for putting a tax on those vapes?

Deputy Stephen Donnelly

On 10 September, I brought a memorandum to the Cabinet on the proposed vaping legislation. I now have Government approval to draft the Bill. A comprehensive heads of Bill document is in place. My officials, including the two officials with me today, have put a lot of work into that. It was more complex than I originally envisaged. When we are restricting packaging and colouring, there is quite a bit of complexity to it. We are pushing that as hard as we can. I asked for a big push from the Department to get the memorandum forward in order that, regardless of elections, the Bill would be drafted. That is happening.

The taxation on vapes is a measure that came from the tax side. It is a taxation measure from the Minister, Deputy Chambers, rather than from the Department of Health. As the Deputy said, there is a legitimate public health role for vaping in smoking cessation. We all know people who now vape rather than smoke. They will say that if vapes did not exist, they would still be smoking. The best evidence we have at this time is that there is clear clinical evidence of damage done to children and teenagers from vaping. There is emerging evidence of associated damage to adults. Certainly, when I talk to respiratory consultants in the HSE who are treating people, they are very clear that there is a link. Therefore, while vaping is a legitimate smoking cessation tool, there is also harm associated with it. Vapes are addictive and there is a lot of nicotine in them. Ideally, we want to move to a situation where people are not trapped in addiction by these products, whether cigarettes or vapes. We know from price elasticity on cigarettes that it is one of the measures that is effective in discouraging smoking.

Deputy Róisín Shortall

We are getting mixed messages on this issue, at the very least, and also mixed objectives. The Minister said there is emerging evidence of harm to adults from vaping. I have not seen that evidence. It would be interesting to see it. However, such evidence is relative. Is it indicating that vaping is more dangerous than smoking to adult smokers?

Deputy Stephen Donnelly

No. It is the opposite.

Deputy Róisín Shortall

If vaping is less dangerous than smoking, we should be encouraging people to vape in an attempt to get off cigarettes. We have talked about the importance of ensuring nicotine chewing gum remains affordable because it is an important tool in giving up cigarettes. Why would the Minister for Finance interfere in what is, in essence, a public health matter? It sounds a bit like the Government is trying to screw smokers in any way it can, rather than looking at what is the actual objective in this regard.

Deputy Stephen Donnelly

The official advice from the HSE for smokers is not to take up vaping but to use nicotine replacement therapy, NRT. As the Deputy is aware, we have made those products free. The initial indications are positive in terms of the impact that is having. What the Minister, Deputy Chambers, did by way of taxation is consistent with our public health position, which is not to move people from smoking to vaping but to move them off smoking through NRT, which we have made free.

Deputy Róisín Shortall

Does the Minister see no role for vaping in smoking cessation? I have never previously heard this theory. Is that what he is saying?

Deputy Stephen Donnelly

The HSE view, and, obviously, it knows what it is talking about from a clinical perspective, is that the way to help people give up smoking is through smoking cessation programmes, NRT, etc. Speaking personally, I know people who have moved from cigarettes to vapes. I believe them when they say that if vapes did not exist, they would be smoking. In the UK, there is a focus on vaping as an alternative to smoking. I do not think our position is incongruous. Most of us know former smokers who now vape. The clinical evidence we have is that smoking is far more damaging than vaping to an adult. That may changes over years. Vaping is still relatively new.

Deputy Róisín Shortall

That is fine but why is the Minister discouraging vaping for smokers if, as he said, smoking is far more damaging than vaping?

Deputy Stephen Donnelly

The HSE's position is not based around smoking versus vaping; it is about smoking versus not smoking through NRT.

Deputy Róisín Shortall

That does not make sense in the real world. Is any other country taking this approach? It would be great if nobody smoked but the reality, unfortunately, is that lots of people still smoke and it does them damage. The Minister is saying that we know anecdotally that smokers who use vaping as a means of ceasing smoking, or at least reducing it, find it very beneficial. Is that something to be encouraged or is it not? The fiscal policy seems to be discouraging it. It is hard for the Minister to hear what I am saying when his officials are talking to him.

Deputy Stephen Donnelly

No, I heard and understand the Deputy's point. The public health view is not to encourage people to move from smoking to vaping.

Deputy Róisín Shortall

That is in an ideal world. Presumably, the public health view is not really to move from smoking to nicotine replacement; it is to stop smoking.

Deputy Stephen Donnelly

That is its view.

Deputy Róisín Shortall

However, that is not easy to do.

Deputy Stephen Donnelly

I hear what the Deputy is saying. However, the public health position is to encourage smokers to move to not smoking by using NRT. The advice from the officials is that this is the approach, rather than vaping being an interim tool.

Deputy Róisín Shortall

That is overly purist. I do not understand that approach.

An Cathaoirleach

I ask that we confine discussion to the amendment that is before us.

Deputy David Cullinane

I agree that this is a purist position. I understand the logic of it but I agree we have to live in the real world. When we were discussing the Bill within my party, I spoke to former smokers who said that, without vaping, they would still be smoking. That is particularly relevant in the context of Bills being brought forward that deal specifically with vaping. The public health view seems to be a strange position. It is a purist position. There probably is a public health rationale for it but we have to live in the real world. It is important when framing Bills like this that there be input from the people who live in the real world, including politicians, the public and stakeholders. I referred to international evidence but it is also important to seek opinions from stakeholders, including smokers and the organisations that want everyone to stop smoking. I have never smoked. I do not like smoking and I do not want anybody to smoke. However, I live in the real world in which there are people who smoke. Vaping is a very important smoking cessation support. We have to move on the other issues to do with vaping, in which the upcoming Bill, dealing with flavours, is an important part.

An issue I forgot to raise in the context of amendment No. 2, which is also relevant to amendments Nos. 1 and 3, is the need to ensure, as much as possible, that we are moving in the same direction on these issues on an all-island basis, both North and South. Another point is that the figures we have show that approximately 17% of smoking products are acquired through illicit trade. That is very worrying. There is a concern that if we ban the sale of particular products for a certain section of the population, it could drive more trade underground and increase the problem. Has the Department done studies on that in the preparation of this Bill?

An Cathaoirleach

Does the Minister want to respond to Deputy Cullinane now or should I bring in another speaker?

Deputy Stephen Donnelly

I do not mind.

Deputy Neasa Hourigan

I have a very quick comment on the point about living in the real world. In the lifetime of the Government, we have seen, for the first time in 25 years, an increase in young people starting to smoke and vape.

We are talking about nicotine replacement therapy or treatment as a temporary issue, but that is not what we are talking about when we talk about vaping. We are talking about permanent addiction. I know we are trying to ban advertising to children and flavouring, but ultimately we cannot place vaping and NRT in the same category without qualifying that. I do not think it is unreasonable for a State to try to dissuade people from the permanent addiction space.

Deputy David Cullinane

It is not a case of either-or.

Deputy Neasa Hourigan

It is not a question for the Minister.

Deputy Stephen Donnelly

I think the point-----

Deputy Bernard J. Durkan

To make it short, it appears that there is different advice in the UK. If the intention is to achieve the same objective, why do we have different advice from that in the UK? This has been raised with all of us from time to time. I am a former smoker, who smoked for 27 years. I stopped by going cold turkey - just like that - but I know people who did not stop and who still continue to smoke. I also know people who vape and hanker back to smoking as well when they get a chance. The expert advice available in the UK differs from here.

Deputy Stephen Donnelly

Yes, it is different. The advice I have is that the UK and New Zealand have vaping as part of their smoking cessation policy, but that no other country does.

The WHO is taking an increasingly hard line on vaping. My understanding is that is for two reasons: the first of which chimes with Deputy Hourigan's point that it is still highly addictive. The second is that the evidence is still emerging. I have spoken to respiratory consultants in Ireland who are very concerned, not just about teenagers but about adults. They say that vaping could end up being more dangerous than we currently understand it to be.

Deputy Durkan is correct about the view of the UK, which New Zealand also has. Interestingly, those two countries also went for a smoke-free generation policy. Interestingly, New Zealand pulled back when the new government came in, and it remains to be seen whether the Labour Government in the UK will go there. That links into Deputy Cullinane's point on the North-South situation. It is something that Robin Swann and I discussed when he was health Minister in Northern Ireland and now Mike Nesbitt and I and the officials are discussing, which is that, ideally, we would have one approach on the island. That would be better for the reasons we understand, such as arbitrage and all of that. It remains to be seen where the British Labour Party will go with this. It may be the case that Northern Ireland is given discretion to do it in a different way. My preference is that it would be the same approach North and South.

Several of us discussed on Second Stage the merits of moving to a smoke-free generation policy. We asked why we should not go the way the previous UK Government went, and where the New Zealand Government went, although it has pulled back from it. That is something we need to keep under active consideration. For all the reasons that we understand, it will be up to a future health Minister to take a look at that.

Deputy David Cullinane

If that were the case, it would be all the more reason to consider amendment No. 2 and all that it calls for to be of value and assist any future Minister in that regard.

Deputy Stephen Donnelly

Yes, I agree with that, with the caveat that it is happening anyway, and there are a lot of different bits to it.

Deputy Róisín Shortall

My reason for raising this matter here today is that it is the only opportunity to hear from the Minister about his thinking. This measure will come in with the Finance Bill on Wednesday, as it is a provision of that Bill.

Deputy Stephen Donnelly

Yes.

Deputy Róisín Shortall

Is there any chance the Minister could send us a note on the rationale for it?

Deputy Stephen Donnelly

Yes, of course. Absolutely.

Amendment put and declared lost.

Section 11 agreed to.

Amendment No. 3 not moved.

Title agreed to.

Bill reported without amendment.

An Cathaoirleach

I thank the Minister for Health, Deputy Donnelly, and his officials for attending today's meeting, and for the work that has been done on this matter.