The Minister of State's speech was full of surprises. Do cigarettes burn at 600° centigrade or Fahrenheit? Think of what that would do if you had a cigarette between your lips. A person would be well on their way to the burns unit at St. James's hospital. I do not doubt that cigarettes get extremely hot because I have seen the effects of cigarette burns on people and they can be unpleasant.

People do not appreciate the addictive properties of smoking. I have, like the Minister of State, Deputy Moffatt and Senator Henry, seen people dying, on oxygen, suffering from lung cancer, amputees and they are still smoking, even though they know they are making the quality of their lives a lot worse. They subject themselves to severe medical intervention, none of which is pleasant, but still they continue to smoke. It is in this that we have to question the attitude of the tobacco companies. They have known this for years. In the Minister of State's speech we have seen the steps they have taken to hide the effects of tobacco and how they have added carcinogenic chemicals to their tobacco products. This was hidden from the public. If someone in the food manufacturing chain tried to do this they would be out of business in the morning. Yet as legislators, doctors and the general public we stand for this and condone it. This is public health damage on a massive scale and no one seems to be raising their voices against it. We are allowing young people and the general public to be poisoned by these companies yet there is not a cheep out of us. As a Government, we are prepared to take the money raised in taxes over the years but I suggest it has now reached the stage that we are not getting enough money in taxes to pay for the ill health that tobacco causes.

Whatever about imposing punitive taxes, we must look at how tobacco companies push their products, their advertisements, what they include in the tobacco, the chemicals they add and their manufacturing processes. We should also look at how they target their advertising at vulnerable people. They persist in doing this. They appear to go for glamour advertising occasions, with motor racing being the biggest. I am not an addict of tobacco but a reformed or post smoker. If you turn on any sporting programme on a Saturday afternoon, especially motor racing, you will see that it is dominated by tobacco advertising. Huge amounts of money are involved. One Government acting alone cannot do anything about this issue because the motor racing circus moves around the world. However, we could start in Europe if the European Commission came forward with a proposal to ban tobacco advertising.

We will have to deal with another problem if we are to ban the sale of tobacco. Tobacco is a cash crop whose production is labour intensive. The people who produce and harvest tobacco are poor. If we take away their livelihood they will have to be provided with an alternative cash crop. We must consider this problem because we cannot take away the basis of their livelihood without replacing it with something else.

I welcome this report produced by the Oireachtas Joint Committee on Health and Children. I am honoured to be a member of the committee. I congratulate its rapporteur, Deputy Alan Shatter, on the hard work he put into it. I regard this report as being part of the educational process as well as an indication as to what legislation we should enact to prevent the horrific side effects of tobacco smoking. The more we discuss this, the more it is put out in the public domain, the more we educate people about the dangers of smoking. We must get them to see that they are harming themselves and the general people in whose company they are. Statistics show that the unborn child is affected by the smoking habit of its mother and that the blood supply to the placenta and to the child in the womb is reduced. This has a knock-on effect and health implications for future generations.

Apart from the educational results of this report and the basis it provides for future legislation, this Government should initiate legislate against tobacco companies as a matter of urgency. One fact that has come out of this report - not just this report but other reports as well - is that tobacco companies hid the effects of their actions from the people they were selling to. If a car manufacturer was caught doing the same thing he or she would be out of business and be faced with punitive damages.

Dr. Henry: I am grateful to have the opportunity to comment on this comprehensive report which the committee has brought forward. However, the Minister of State did not say and the report does not mention whether Ireland is involved in the World Health Organisation's Framework Convention on Tobacco Control. When Dr. Gro Harlem Brundtland became Director General of the World Health Organisation, she decided to address what she described as the "pandemic" of tobacco-related diseases and pointed out forcefully that only intergovernmental initiatives would bring this to fruition. As Senator Fitzpatrick pointed out, the livelihoods of those producing this drug must also be taken into account. It is bizarre that EU subsidies are being given to tobacco producers in Greece while a large amount of money is spent on trying to reduce tobacco consumption in other parts of the EU. This document is inclined to focus on the Irish initiative, which is not all that is needed. We must look at the effect this is having on world health while noting the effect on commerce and how we will deal with that.

It is interesting, as the Minister said, that 80 per cent of smokers want to stop. It is important to prevent them starting. Tobacco is addictive, as even the tobacco firms have now been obliged to admit, and it seems to be extraordinarily difficult for people to give up cigarettes. Mercifully, I have never been a cigarette smoker myself so I do not have to go through the pangs of giving it up - it has been described as being more difficult to give up than heroin. We have a serious problem with children smoking. The report is excellent on advertising and I commend the former Commissioner Flynn for his efforts in this area. Advertising, without a shadow of a doubt, is aimed at children and the sooner tobacco advertising is banned, the better.

The report suggests the introduction of better legislation and more environmental health officers to police the sale of cigarettes to children. I always thought this was a good idea. However, some months ago in the New England Journal of Medicine, I read a report dealing with two contiguous health board areas in New England. One area rigorously enforced the legislation on selling cigarettes to children while the other did not. Unfortunately, the results were not much different - children appeared to be able to acquire cigarettes if they were looking for them, no matter what happened.

Price is important in cutting cigarette consumption by children and people on lower incomes. It is ridiculous that cigarettes are £1.20 cheaper per pack of 20 in the Republic than in Northern Ireland. Many millions of pounds in tobacco tax are collected by the Department of Finance and it is probably worthwhile to let people smoke. Smokers die about ten years younger on average so they do not collect their pensions. However, they cost a great deal in health care before they die, particularly in the past two years when a fortune can be spent cutting off bits of their legs, taking out bits of their lungs and doing heart bypasses. During their lives, they visit their general practitioners more frequently than non-smokers. Now that we know more about passive smoking, we must also take into account that it has a serious effect on those who work with them. The committee has done a good job in dealing with smoking in public places and the workplace. Those who have to work with smokers suffer everything from sore eyes to chest and upper respiratory tract infections. The jury is out on whether smoking causes cancer but certainly, given the amount of smoke inhaled by barmen, perhaps they would have a case. When smoking was permitted on buses, bus conductors won cases because of the effect on their lives.

This is a difficult problem with which to deal. However, it is cheering that 45% of people smoked 25 years ago while that figure has now decreased to 30%. The sad thing is that the number of women smoking has increased while the number of men smoking has decreased. It is difficult to deal with the problem of young women smoking. They have an image of smoking as glamorous, are under peer pressure and they worry about their weight - we know that people think if one smokes one will not put on weight. We are becoming fatter as a nation and they have good reason to worry about this, but it would be better if they decided to eat less and take more exercise. Perhaps it would be better to focus on the scientific facts that one is more likely to become old and wrinkled-looking earlier if one is a smoker and that one's skin thins. We are focusing on more serious diseases when perhaps focusing on the more cosmetic results would be better. I have asked people without a cigarette in their hand how much they smoke and they ask me how I know they smoke? I reply that I know at once because I can smell it from their clothes a mile away. People do not find it attractive when they are told that. Perhaps it is hard-hearted but we should be more unpleasant when we urge people to cut down, especially young women.

We also have the problem that those who are most likely to take notice of us are those that are the least likely to smoke; only 10% of university graduates smoke but 40% of the unemployed do. The fact that there are fewer unemployed should be useful as the number of smokers should decrease. There is a hard core of about 30% in both sexes, among the unemployed and unskilled manual labourers, who are the really heavy smokers and are least likely to get good health care. The message we are preaching is often to those who do not smoke. We must become more focused and ask community groups and those involved with the unemployed what they think are the best initiatives. The education of doctors would do no harm either. The Irish College of General Practitioners, the IMO and other organisations have urged doctors to be more proactive in trying to get their patients to stop smoking. This report states that only 36% of patients who were smokers said their GP had mentioned to them that it would be a good idea to stop. At least we were better than England, where the figure was 29%. General practitioners say they are pushed for time and cannot discuss this with their patients. I tell people they really should stop smoking which is not very useful. More help would be better.

I will finish by referring to the serious problem with young women smoking. The incidence of lung cancer in women is increasing. As I have said before, in the Tower Hamlets health authority in London last year, the death rate of lung cancer in women was higher than that from breast cancer, which is an incredible statistic. Women also seem to do particularly badly if they get lung cancer. The influence of smoking in relation to heart disease among women is also serious and affects them at an earlier age. I do not think many women are taking much notice of this. There is also the effect of smoking on women during pregnancy. If it is difficult enough to stop when one is not pregnant and it must not be any easier to stop when one is. A large number of women who smoke do not manage to give it up when they are pregnant although they are aware that on average children born to smokers are 200 g. lighter than children born to women who do not smoke at the same gestation period. It is a significant weight difference and could be up to 8% of the baby's weight. We must make a big effort regarding pregnant women in particular.

I work in the Rotunda Hospital where smoking is not allowed on general wards or out-patients' areas and it is extraordinarily depressing to see the number of people outside the doors dragging on fags. One would be asphyxiated in one of the small rooms where people can smoke. It is extraordinary to see pregnant women smoking who may be in hospital for a condition which might not affect their baby as seriously as their smoking. It is difficult to do anything about it but a greater effort must be made. Many of these women are from the more deprived socio-economic areas of the city, but it is in these areas that greater efforts must be made.

Unfortunately, there is a higher incidence of cot death in families where the mother or father, or both, smokes. There is a need to bring home to parents the great importance of keeping babies away from cigarette smoke. Small children have a higher incidence of respiratory disease if they come from families where there are smokers.

The number of smokers in Ireland will be reduced but the shameful point is that the tobacco companies will not lose because they are already doing unbelievable damage in Eastern Europe. I saw an advertisement beside the pyramids for Camel cigarettes, which nobody would agree is subtle. The companies will not lose but we must be determined that we will win given the increased prosperity and the possibility of better targeting of campaigns.

Smokers are often unemployed or from lower socio-economic groups and many of them, particularly women, work in the home. They might benefit greatly from doing part-time work given that women who work full-time are the least likely to smoke. The additional social benefits of increased child care and improved working facilities might lead to a lower incidence of cigarette smoking in ten years. We should not have a policy of despair because the level has been already reduced from 45% to 30%. There is a need now for much better targeting, particularly of women and those in lower socio-economic groups.

Mr. Glynn: Cuirim fáilte roimh an t-Aire Stáit. It is difficult to know where to begin on this topic but, as the Minister of State said, tobacco is the leading preventable cause of premature death in Ireland and the developed world generally. I wish to add the rider that it is legal and the conclusion, therefore, must be that tobacco companies are legal drug pushers. I am honoured to be a member of the Joint Committee on Health and Children which was addressed by representatives of the various tobacco companies, one of whom, Mr. Ian Birks, was a master at stonewalling. If the evidence that tobacco is harmful to health jumped up and bit him on the nose, he would still deny it.

The evidence on tobacco and health is robust and conclusive. Tobacco is addictive and it kills. The tobacco industry has promoted the argument that there is a need for more research into whether tobacco is a cause of disease or is addictive. This must be the joke of the century and it is a diversionary tactic. We know enough and now is the time to act.

We have all seen the glamorous advertisements to which Senator Fitzpatrick referred at major sporting and international events which promote various tobacco products. I remember when I was a young man working across the water seeing an advertisement, before such advertising on television was banned, featuring an individual walking along a strand at night. He looked a forlorn figure but then he took out a packet of cigarettes and lit one. The caption was "You're never alone with a Strand". It was a totally dishonest, misleading and untruthful glamorisation of a seriously addictive and health harming substance. More recently, there were advertisements featuring an individual in an obviously melancholic mood who finds a wonderful mood altering cigar. The caption was "Happiness is a cigar called Hamlet".

As pointed out by the Minister of State, by Deputy Shatter in his report, Senator Fitzpatrick and others, younger age groups are being specifically targeted. This fact of life is demonstrated in the statistics to which speakers referred. I do not intend to be sexist, but there is a high incidence of smoking among teenage women. People will try to do many things to get off the hook in relation to their addiction. They say that they have switched to a different brand which is not as heavy or rough or that they are cutting down and they are now smoking filter tipped cigarettes instead of untipped cigarettes. They may also say that they have moved down another rung of the ladder and are smoking smaller tipped cigarettes. However, in other areas involving addictive substances, there is the concept of denial and delusion. There is obviously denial on the part of individuals that they are addicted to a substance and they are deluding themselves because, as everybody knows, a delusion is a false belief that cannot be corrected by appeals to reason.

The Minister of State made an interesting reference to the temperature of a lit cigarette. One of the most well known forms of torture, which has been glamorised in Bond films and books, is a cigarette burn. Undoubtedly, a cigarette burn has much more serious implications than an ordinary burn from a fire or a scald injury. This has been medically established.

Senator Fitzpatrick referred to the huge amount of taxes collected by governments from tobacco companies. What is spent on people who are addicted to tobacco? I worked in the health services for many years and I concur with Senator Fitzpatrick's comments. People who are staring death in the face would still have a drag from a cigarette. I have often given patients oxygen or put them on nebulisers and when I removed it the first thing they asked for was a cigarette. An acquaintance of mine had a triple bypass 20 years ago because of cigarettes, yet recently this man needed an additional bypass. When discharged from hospital, he began to smoke cigarettes again, even though he knew they were harmful and had already caused him major problems.

The tobacco companies have three main planks for rebutting the evidence which exists on to the harmful effects of smoking. They say that smoking is voluntary. Of course, it is voluntary. People who shoot heroin into their veins do it voluntarily but they do so because they are addicted to the drug. The attitude of the tobacco companies is that smoking is voluntary and not addictive. Of course, it is addictive. As Senators Fitzpatrick and Henry and the Minister of State will know, those who attend their doctors and are advised about the serious implications of the continued use of tobacco, ignore this advice and continue to smoke. I am sure Senators Henry and Fitzpatrick will recall two people who came in to address the joint committee. They were not able to walk, one was in a wheelchair as a result of the use of tobacco. Tobacco companies deny that smoking injures health. If it jumped up and bit them on the nose they would give the same answer.

Tobacco is a global problem. The world tobacco trade is controlled by a small number of supranational companies. Public health interests must organise globally to meet the challenge. I commend the Minister, Deputy Cowen, for what he is doing. I hope the price of the packet of cigarettes will be increased in the budget because we must try to deter people from injuring their health. We must welcome the World Health Organisation's initiative to develop a legally binding treaty that is the framework convention on tobacco control. We call on Commissioner Byrne to prioritise the fight against tobacco and to build capacity to do this at EU level. We call on the Government to renew its commitment to fight tobacco and to build the necessary capacity to do this. This must have Community and all-party support.

I wish to comment on the concept of tobacco smoking. How does someone who does not smoke and who goes into a smoky atmosphere breath when they leave that atmosphere? I say they do so with great difficulty. Throughout the years, tobacco companies have made every effort to entice people to smoke by way of glamorised advertisements. They even reduced the packets to five cigarettes and people stupidly thought they were facilitating them. They were - they wanted to make absolutely sure that if people had not the price of a packet of ten cigarettes, they would have the price of a packet of five.

I am pleased to have been involved in producing this report and I commend the rapporteur, Deputy Shatter. There is only one way to greet cigarettes - that is with the thumbs down.

Dr. M. Hayes: I am extremely grateful to the committee for producing the report. It is an excellent and comprehensive document and I congratulate the rapporteur, Deputy Shatter. I am grateful to the Minister of State for the technical information on the growth of tobacco. However, I would have been more content if he had told us what the Government intends to do in terms of a concerted plan to deal with smoking.

There is no question that the health case against smoking has been made. It is beyond doubt that it is the single biggest killer and the single biggest contributor to ill-health and misery among people. However, it is deeply ingrained in the culture and it is very difficult to get an attitudinal and cultural change. For professional reasons I am more aware of the figures for the United Kingdom than for Ireland. In the United Kingdom, there are 2,000 tobacco-related deaths per week. If anything else was killing 2,000 people per week there would be riots on the streets. I am not arguing for the legalisation of cannabis. People are extremely concerned about drugs, and rightly so, but there are other drugs, such as tobacco and alcohol, which are deeply ingrained in our culture. We worry about BSE, salmonella etc. whose impact on health and killing capacity is infinitesimal compared to tobacco.

Smoking must be tackled on several levels. The main target must be the cigarette manufacturers. I am pleased that advertising will be banned and I commend the Minister for this. However, there is a need to take a slightly wider view of this issue. Formula 1 racing in Britain will be allowed to advertise for cigarette companies for God knows how long more - perhaps for as long as some of them contribute to Labour Party funds. We must not keep an eye on direct advertising only, but also subliminal advertising. This glamorises smoking and makes it appear an exciting and interesting activity.

Another way to deal with this problem, which has been fairly well proven throughout the world, is by way of pricing. I hope the Minister for Finance will reflect this in the budget. There is an effect in Northern Ireland because the number of cigarettes being smuggled across the Border at present is enormous. The cheap price of cigarettes here is contributing to ill-health and tobacco consumption there. It should also be made easier for people to sue tobacco firms, to take class actions. Health authorities should be more ready to take massive actions against tobacco firms for the costs related to tobacco-induced diseases. In the United States tobacco firms have paid out billions of dollars.

If this activity is glamorous for some people and addictive for others, it is not necessarily the answer to have a complete prohibition on it. Prohibition has not worked with other substances. There must be some means of addressing this issue.

Senator Henry was correct in identifying the two most at risk groups as young women and people living in deprived areas. People living in deprived areas often smoke to relieve tension and stress. This must be part of an attack on poverty generally - in dealing with the root causes of poverty and mutual deprivation, one might well be removing a considerable constituency from smoking or, at least, making them more receptive to a particular message. There should be an enhanced education programme in schools and youth clubs which would relate to young people. Sometimes young people should be spoken to by other young people.

There are strong arguments for comprehensive community health programmes to help people, especially women, young girls and children, to deal with their own health problems and to see the effects of smoking on them and their unborn children. Since addiction is part of the problem and a very clear strategy of tobacco firms is to secure addiction at an early age, there should be a great concentration on methods of detoxification. Great concentration is placed on putting in place detoxification programmes in respect of other drugs. Why not establish detoxification centres for those suffering from nicotine addiction?

Our entire society must make an enormous effort to recognise smoking as a dangerous and filthy occupation. I do not smoke but I am extremely aware that I am in more danger from toxic fumes from passive smoking than I would otherwise be. If we start applying the health and safety legislation to people such as barmen, those involved in the entertainment industry, etc., the situation would be transformed. It is wrong that people are required to earn their living in polluted environments which are a danger to their health.

There are many aspects to this problem and a number of treatments are required. I commend the report and I congratulate the Minister for Health and Children, Deputy Cowen, on the stand he has taken. I support my colleagues in asking for the early production of a national programme to counter smoking. This should be linked to European Union and World Health Organisation programmes so that the problem is tackled on as many fronts as possible. I return, however, to my point that the place where we will hurt tobacco companies most is in their pockets.

Mr. D. Kiely: I welcome the Minister of State and I thank him for his interesting and broad-minded contribution which, perhaps, differed a great deal from the views expressed by Senator Jackman. I am not a member of the Joint Committee on Health and Children but I have read the report and it is an interesting and worthwhile document which requires further debate.

The problem of smoking is quite serious. We constantly hear news reports about the number of deaths on our roads but no announcements are made about the fact that three times as many people die from tobacco-related problems on a daily basis. There is a need to take this situation in hand.

The Minister of State indicated that the Minister, shortly after his appointment, established a review group which is to produce a report entitled Towards a Tobacco Free Society. I look forward to the publication of that report because I would like to see the recommendations it contains. I would also like to see the legislation the Minister introduced in respect of this area being fully implemented because people seem to completely ignore its provisions.

People who smoke seem to believe they have a God given right to light up wherever they please, without taking account of the feelings of others. If you inform them that you are sitting in a non-smoking area because you do not like smoking, they look at you in surprise and say that it is their God given right to smoke. At this point I usually inform them that it is not their God given right to force me to inhale their smoke or to interfere with my health. There is a need to introduce further regulations to stop people from behaving in this way.

The public transport authorities must take a stricter approach in respect of smoking. For example, people specifically travel in non-smoking carriages on trains to avoid inhaling toxic fumes. However, others often smoke in the corridor outside and make the excuse that they are not smoking in the carriage. As a result, the people in the non-smoking carriage are obliged to inhale the fumes. All forms of public transport should be made non-smoking, as should the Houses of the Oireachtas.

Studies and research into smoking show that tobacco companies focus primarily on young people. They do this because they want to hook young people on to smoking and they achieve their goal by running attractive advertisements which show a cowboy on horseback smoking a Marlboro. Sports advertising is used in a similar way. The first thing these companies try to do is trap young people by encouraging them to smoke. Once that happens, they are usually hooked for life and research shows that 80% of them cannot stop smoking.

Previous speakers referred to the number of young women who are taking up smoking. These women believe smoking to be the "in" thing and they think they will look fashionable if they walk around with a cigarette in their hand. Nothing could be further from the truth because it is terrible to see a young girl leaving school and lighting a cigarette. We should educate these girls and inform them they are fooling themselves if they think smoking is attractive. Parents have a major role to play in discouraging young people from smoking. The Government and the Minister must put in place television advertising campaigns and encourage the production of television programmes which show the seriousness of this problem. In addition, educational programmes should be put in place in our schools to warn children about the dangers of smoking.

Many members of the public are not aware that 50% of those who smoke die prematurely. That is a frightening statistic. There are many health clinics in operation throughout the country and people are seeking to keep fit by using herbal remedies and eating food which contains no contaminants. However, I have often seen people who immediately light up a cigarette after eating a meal which contains the proper vitamins to keep them healthy.

As already stated, smoking should be banned on all forms of public transport, in the Houses of the Oireachtas and in all public buildings. We should show people an good example. A number of weeks ago, Deputy Shatter stated that two thirds of football stadia should be smoke-free zones and I fully agree with his comments. Sports grounds should be sectioned off so that smokers and non-smokers can enjoy the games they are watching in comfort. I attended a county football recently and the man beside me started smoking. The smoke did not bother me very much but, as the Minister of State indicated, more damage is done by the toxic fumes one inhales from passive smoking. I am alarmed that a person who inhales smoke at second hand will incur greater harm than the person actually smoking the cigarette. That is frightening and people should be made more conscious of the dangers of passive smoking.

At the end of his contribution, the Minister of State said the Minister for Health and Children, Deputy Cowen, has advised the tobacco industry and the media industry of his intention to introduce an effective prohibition on tobacco advertising with effect from July 2000. I look forward to it and I am delighted that the Minister has given this commitment. This is a step in the right direction. The Minister should stop taking out advertising campaigns on the seriousness of the risks of tobacco smoking. On top of that he should implement the law where there are now non-smoking areas in restaurants and so on, because people just seem to ignore them. There were large non-smoking signs in our own restaurant but until recently, people would come in and immediately light up. They felt no responsibility for those around them until the signs on the walls were made bigger and stated that areas were non-smoking. Eventually the penny dropped and the Captain had to tell these people where the non-smoking areas were, and rightly so. Some of the people who think they have a God given right to smoke should look around them.

Much research and statistics on this subject are produced in America. When one goes into a restaurant in America, the first thing one will be asked is whether a smoking or non-smoking area is required. That right at least is given, even though many people in America are smokers. When one goes into a public building the right of the citizen in respected. Slowly but surely, this will be the case here. I welcome the Minister to the House and thank him for his initiatives. I look forward to an in-depth study of the report published recently.

The Seanad adjourned at 6.50 p.m. until 10.30 a.m. on Wednesday, 24 November 1999.

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