Anti – smoking policies in Ireland

Dr Siobhan Jennings, Consultant in Public Health Medicine

Health Service Executive and representative for Irish Cardiac Society

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TOBACCO USE IS A RISK FACTOR FOR SIX OF THE EIGHT LEADING CAUSES OF DEATH IN THE WORLD

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Monitoring tobacco use and prevention in Ireland

1. SLAN survey 1998, 2002 and 2006

2. HBSC survey in children 2002 and 2006

3. Office for Tobacco Control (OTC) monthly telephone

survey

SLAN 07 Smoking ratesSLAN 07 Smoking rates

Overall smoking prevalence 29% in SLAN 07 male (31%), female (27%)

Health Behaviour in School-aged Children Study (BOYS)

Health Behaviour in School-aged Children Study (GIRLS)

Protect people from tobacco smoke

Milestones in tobacco control in Ireland

• 1964 Voluntary Advertising Ban • 1988 Ban on sale to < 16yr olds, raised to < 18 yrs in 2001

• 1990s Health strategy (also CHD strategy), Quitline, health warning on tobacco products, restrictions on advertising

• 2000 ‘Towards a Tobacco Free Society’ , Ban on all print advertising, end of sponsorship, OTC and RIFTFS

• 2003 Report on health effects of environmental tobacco smoke

• 2004 Legislation ‘Smoking ban’

• 2006 Packets of cigs < 20 banned.

• 2009 Point of sale ban on display of cigs and advertising Two hospitals banned smoking on campus

Protect people from tobacco smoke March 2004 Legislation prohibiting smoking in workplaces ‘Smoking Ban’

Evaluation (Office for Tobacco Control)

High compliance

2005 93% in hotels, 99% in restaurants, 90% in licensed premises / pubs

2008 97% workplaces compliant

Hugh public support

96% believed smoking ban ‘was successful’(89% of smokers)

98% believed that workplaces were morehealthy (94% of smokers)

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Office of Tobacco Control, Monthly telephone survey of trend in prevalence in smoking in Ireland, 2003 - 2008

Impact of a national smoking ban on the rate of admissions to hospital with acute coronary syndromes – CHAIR Registry, Ireland (population ~550,000)

Smoking ban in 2004… 11% decrease in following year

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Acknowledgement Edmond Cronin 1, Patricia Kearney 2, Peter Kearney 1, Pat Sullivan 3 1 Cork University Hospital, 2 University College Cork, and 3 Mallow General Hospital, Ireland

Ban on smoking in public places, 2008

Malta

Offer help to quit tobacco use Benefits for those who quit smoking

• Within 20 minutes Blood pressure and pulse drop

• Within 8 hours Carbon monoxide levels return to normal

• Within 24 hours Risk of heart attack decreases

• Within 72 hours Lung capacity increases

• After 1 year Risk of sudden death from heart attack is almost cut in half

• After 5 years Lung cancer death rate for the average smoker decreases

• Within 10 years Risk of sudden heart attack and strokes becomes almost the same as a non smoker, risk of cancer drops significantly

Source: Burnside, G., Spiers, A., Winckles, W. Help Smokers Quit Kit. Ulster Cancer Foundation, Northern Ireland.

Offer help to quit tobacco use

1. National telephone Quitline (trained counsellors)

2.www.giveupsmoking.ie launched May 2009 information, personal quit plan

3. Smoking cessation services

4. NRT therapies

Offer help to quit tobacco use

1. National telephone Quitline (trained counsellors)

2.www.giveupsmoking.ie launched May 2009 information, personal quit plan

3. Smoking cessation services

4. NRT therapies

Warn about dangers of tobacco

Social marketing campaigns – ‘Break the habit for good: NICO’ – ttaarrggeettiinngg yyoouutthh in

2000

–– DDaannggeerrss ooff SSeeccoonndd HHaanndd SSmmookkee in 2004 – ‘Every cigarette is doing you damage’ in 2003/04 – ‘Beauty of Quitting’ in 2007 - ttaarrggeettiinngg yyoouunngg

wwoommeenn – Promotion of Quitline – Campaigns ttaarrggeettiinngg ppaarreennttss – EU campaigns - ‘Feel free to say No’

Expenditure on social marketing campaigns warning of dangers of tobacco

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HSE Expenditure on Anti-smoking campaigns (€ )

Expenditure

€ 625k in 2009 = € 0.15c per head (Recommended € 2 - 3 per head)

Consideration being given to photo warning on cigarette packs in Ireland

Enforce advertising and sponsorship bans

Tobacco product display prior to Ban in 2009

Tobacco product display in back lit panels in stores

Display Till Covers

Advertising on beer mats

Enforce bans on advertising, promotion and sponsorship

• From July 2009 New Legislation to protect minors

– Point of sale ban on advertising or display of tobacco products

– Introduction of closed container/dispensers to store tobacco products

– Tighter control on location and operation of vending machines

– Register of retailers who sell tobacco

Raise taxes on tobacco

Trend in the price of a pack of 20 cigarettes, the Tax Take and Tax Exclusive Price in Ireland

IIrreellaanndd hhaass tthhee hhiigghheesstt ttaaxx ttaakkee oonn cciiggaarreetttteess iinn EEUU ((ttaaxx == >>7700%% ))

22000099 • € 95.8m smuggled tobacco seized in 2009 ($50m from single seizure in

October) - 70% increase on 2008 seizures

• Finance Bill in 2010 - increase in fines by a factor of 10

Summary • Ireland

– 2nd on WHO Tobacco Control Scales – Many elements of MPOWER – Became complacent?? – Point of sale advertising ban in 2009 (expected to

pay dividends in medium term)

• Reflections – Sustained nature of tobacco control – Multi level activity needed – Benefits of collaboration and sharing internationally – Leadership within EU - MPOWER standards in ALL

countries