27 September 2006
Minister of State at the Department of Health and Children (Mr. S. Power): I apologise for being late which was due to questions in the other House taking longer than anticipated. I thank Senators for this opportunity to address the House on the 2005 Annual Report of the Office of Tobacco Control...
Dr. Henry: I welcome the Minister of State. Like all those in Washington who congratulated him, I applaud the marvellous effort by the Department of Health and Children, the then Minister for Health and Children, all those involved from ASH, the Irish Heart Foundation, Irish Cancer Society and all the institutions which pushed to get the legislation brought forward. I am utterly disgusted to hear it is being challenged by the tobacco industry in the courts. That has to be expected because it is what is being done internationally.
While the report is encouraging there are some serious issues that need to be addressed. That the rate of smoking is down to 24% from 31% in 1998 is encouraging. However, it is worrying that the number of women who smoke is the same as the number of men. Some years ago I was amazed to see in some parts of England, particularly east London, that the incidence of death from breast cancer in women was superseded by the incidence of death from lung cancer. Unfortunately the incidence of lung cancer in women is increasing here. It is probable that we will have to address the issue from a gender point of view. This is an area we have to deal with because we constantly hear about women drinking more and emulating men by drinking one for one with them. It appears we have reached a situation where women are achieving in smoking what men are trying to get rid of. Men start to smoke earlier than women and smoke more but they manage to give up more easily and earlier. That three quarters of smokers want to quit means we have a receptive audience. Therefore, it is important to see how we can address this issue.
Other Senators have raised the issue of affordability. Internationally that is an important consideration in getting people to stop smoking. I regret that in the 2006 budget there was no increase in tax on tobacco products and I hope this is remedied in the 2007 budget. It is a good idea that the Minister is bringing forward legislation on the sale of cigarettes in packets of fewer than 20. Behind the checkouts in many supermarkets are rows and rows of packets of cigarettes. Access is very important and it is all too easy. I see people asking for a packet of cigarettes as well as whatever they have put into the shopping basket. Perhaps the Minister of State would consider access and the position of cigarette products in supermarkets. This is extremely important in trying to reduce consumption.
While we have not addressed the issue of advertising here it is important. It is interesting to note that 60% of those who smoke Marlboro Light are female, as pointed out in the report, that nearly 70% of those who smoke Silk Cut Blue are female and 64% of those who smoke Silk Cut Purple are female while John Player and Benson and Hedges are favoured by male smokers. How are these products being projected at those who are smoking them? There must be a subtle difference in the advertising. The word "light" was included to appeal to women to give the impression that it was not as harmful as ordinary cigarettes. There is a class action in the United States where a judge has said it was a misleading form of advertising to call any brand "light" as so-called light brands were just as harmful as the regular brands.
The Minister pointed out that Dr. Shane Allwright's report showed huge changes in those who work in bars in particular. The improvement was astonishing. It also shows the dangers of passive smoking. A good leaflet has been produced on passive smoking entitled Let's Clear the Air and Create a Healthier Environment for Everyone, but I wonder whether it is getting enough circulation.
I re-read the 1996 report by the Economic and Social Research Institute, Women and Health Care in Ireland by Miriam Wiley and Barry Merriman, on tobacco and substance abuse. We will probably find that the trends are much the same, only better, because the incidence of smoking has reduced. Rural women smoke less than urban women. This report points out that Connacht-Ulster has the lowest level of smoking with only 20% of the target population smoking whereas in the Dublin area, the figure is 25%. It is interesting to note how particular factors affected whether a woman smoked in the various categories of women by occupation, education and social class.
We must not just base our help on gender but must break the figures down and help particular groups. For example, half of women in non-manual jobs but only 40% of women in manual jobs never smoked. The people least likely to smoke are women in higher professional class jobs, only 16% of whom smoked. As these figures are somewhat out of date, the numbers should have improved. However, there is a significant difference between the groups. Improved figures depend on education. Only 40% of women with primary education only never smoked whereas almost 70% of women with university education never smoked. Some 38% of women with medical cards smoke and these are the people who are most likely to have financial troubles.
I found the United States study very interesting. It showed that a woman in the lower socio-economic class was 3.7 times more likely to smoke during pregnancy. We have a serious problem with women smoking during pregnancy despite the fact it is well known and publicised that smoking seriously affects the foetus. Women who smoke have a higher incidence of miscarriage, stillbirth and of low birth weight children and when their children are born they are more at risk of sudden death. Cot death is tragic for any family.
It is important to remember that it is not just the woman's smoking that has an effect, but also that of the man or any other people in the house. Having a child in a smoky atmosphere is bad because children's defence mechanisms are much less developed than at a later date. Even when children pass the babyhood stage and the risk of sudden infant death, smoking can precipitate respiratory infections like bronchitis and pneumonia. Children of smokers are also much more likely to get chronic middle ear disease which is the commonest cause of deafness in children. Lung growth is also slower and these children will have less healthy lungs. Children with asthma are much more likely to suffer severe attacks if they are exposed to passive smoking. They will also have frequent coughs and sore throats and miss time from school. Smoking is, therefore, a serious issue for children.
It is extraordinary that studies in both Spain and Sweden show that far more pregnant than non-pregnant women gave up smoking. Unfortunately, we have not managed to get this message through to women. Large numbers of women here who smoke do not give up smoking during pregnancy as anyone who passes by our maternity hospitals will see by the numbers of women in late pregnancy standing outside dragging on their fags. We had to close down the little smoking rooms when the legislation was introduced. Those rooms used to be thick with smoke from the cigarettes of women smoking during late pregnancy, sometimes encouraged by visitors.
Senator Glynn mentioned the situation in psychiatric hospitals where significant smoking takes place. I remember a time when patients were given cigarettes more or less as a reward for good behaviour. It is good there has been such an improvement in that area.
Has the Minister of State reconsidered the situation in prisons? We must remember that all those who do not smoke, whether prison officers or other prisoners, are subject to passive smoke while prisoners are smoking. Attempts have been made to segregate smokers from non-smokers within cells, but do we need to reconsider the situation? I understand the prison is the person's home while he or she is there. On the other hand, if three-quarters of those who smoke want to give up smoking, it might be worthwhile addressing the issue again.
I congratulate the Minister of State on this report. It is great there has been support from all sides of the House for bringing it forward. We cannot forget the debate on the ban where it was implied that human life as we knew it would never be the same after the introduction of the ban. That has been proved totally wrong. The ban has done nothing except improve the situation for everyone in the country.
Ms Feeney: I welcome the Minister of State to the House and am pleased to have the opportunity to debate this comprehensive report from the Office of Tobacco Control.
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