Anti-Smoking policies in Ireland. Jennings S. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).

1. Anti – smoking policies in
Ireland
Dr Siobhan Jennings,
Consultant in Public Health Medicine
Health Service Executive and
representative for Irish Cardiac Society

2. M
P
O
W
E
R

3. TOBACCO USE IS A RISK FACTOR FOR SIX OF THE EIGHT LEADING
CAUSES OF DEATH IN THE WORLD
Source: MPOWER: a Policy Package to Reverse the Tobacco Epidemic

5. M
P
O
W
E
R

6. 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

7. SLAN 07 Smoking rates
Overall smoking prevalence 29% in SLAN 07
male (31%), female (27%)

8. Health Behaviour in School-aged Children
Study (BOYS)

9. Health Behaviour in School-aged Children
Study (GIRLS)

10. Protect people from tobacco smoke

11. 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

12. 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 more
healthy (94% of smokers)

13. SLAN 07

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

15. 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
1400
1215
1200
1079 1072
No. of ACS patients
1000
800
600
400
200
0
29.03.03- 29.03.04- 29.03.05­
28.03.04 28.03.05 28.03.06
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

17. Ban on smoking in public places, 2008
Malta

19. 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.

20. 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

22. 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

23. Warn about dangers of tobacco
Social marketing campaigns
– ‘Break the habit for good: NICO’ – targeting youth in
2000
– Dangers of Second Hand Smoke in 2004
– ‘Every cigarette is doing you damage’ in 2003/04
– ‘Beauty of Quitting’ in 2007 - targeting young
women
– Promotion of Quitline
– Campaigns targeting parents
– EU campaigns - ‘Feel free to say No’

25. Expenditure on social marketing campaigns warning of
dangers of tobacco
HSE Expenditure on Anti-smoking
campaigns (€ )
1,200,000
1,000,000
800,000
600,000
Expenditure
400,000
200,000
0
2006 2007 2008 2009
€ 625k in 2009 = € 0.15c per head
(Recommended € 2 - 3 per head)

26. Consideration being given to photo warning on cigarette
packs in Ireland

27. Enforce advertising and sponsorship
bans
Tobacco product display prior to Ban in 2009

28. Tobacco product display in back lit panels
in stores

29. Display Till Covers

30. Advertising on beer mats

31. 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

32. Raise taxes on tobacco

33. Trend in the price of a pack of 20 cigarettes, the Tax
Take and Tax Exclusive Price in Ireland
Ireland has the highest tax take on cigarettes in EU (tax = >70% )

34. 2009
• € 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

35. 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