Deadly consequences of smoking must be tackled by tobacco control strategy
ANALYSIS:EVERY DAY in Ireland, 16 people die as a result of smoking. One in two smokers will die prematurely and as a direct result of being a smoker. Smoking kills more people every year in Ireland than road incidents, suicides, drugs, farm accidents and Aids combined. There is no doubt that smoking is a major public health issue and a huge cost to the exchequer.
Second-hand smoke is also highly dangerous and moves to protect non-smokers and children from the toxins and carcinogens in second-hand smoke have widespread public support and we welcome them. We were pleased to see the unusual level of unanimous support in Seanad Éireann for the Private Members’ Bill published by Senators Crown, Van Turnhout and Daly to ban smoking in cars where children are present.
And we also welcome the intention of the Minister for Health to ban smoking in public places where children are likely to be present, and which is also being promoted by local authorities.
There can be no question that these measures are necessary. Our smoking rate, at 29 per cent, is high, particularly compared to the UK who have brought it down to 21 per cent. We still have a distance to go to achieve the smoke-free society that many governments have committed us to and which is possible to achieve.
Smoking places a huge health and economic burden on the State. The negative health effects of smoking are well established. Smoking causes one in three cancers and nine in 10 lung cancers. It costs the State €2 billion a year to provide health services to smokers and €1 million a day in productivity is lost because of smoking.
We know non-smokers are also dying because of second-hand smoke. The evidence is clear; there is no safe level of exposure to second-hand smoke. Second-hand smoke has been associated with cancer, heart disease, middle-ear infections and respiratory problems including asthma and bronchitis in both smokers and non-smokers. Second-hand smoke levels outdoors can reach the same level of concentration as levels indoors. The activity of smoking is not “normal”. Cigarettes are the only consumer products which when used correctly kill the user. One in two smokers will die from a smoking-related illness. Visiting a public space is a normal activity. Engaging in a life-threatening activity while there is not.
Children learn from and copy the behaviour of adults. Children whose parents smoke are twice as likely to begin smoking than children whose parents do not. We know that the earlier children begin smoking, the more likely they are to continue through their adult life. Smoking around children increases their chances of developing a lifelong addiction from which half of users will die.
Smokers and non-smokers are entitled to make choices about their health. Smoking is not just a behavioural habit, it is an addiction. It is not enough to treat nicotine addiction as a lifestyle issue. The US surgeon general has said that smoking can be as addictive as heroin and users can have the same relationship with tobacco as those who are addicted to heroin. We need to start thinking of smoking in these terms and provide the same level of support to fight tobacco addiction in this country.
Last year, a European-wide study found that 75 per cent of Irish smokers want to quit. Many of those people need professional and ongoing support if they are to succeed but in many cases this support is not that easily available.
People from less affluent socioeconomic groups are more likely to smoke. More than half of disadvantaged women aged between 18 and 29 years of age smoke, which is twice as high as the rate in non-disadvantaged groups.
The number of women dying from lung cancer now exceeds the number of women dying from breast cancer. Data from the National Cancer Registry shows that the number of lung cancers in women is increasing by 3 per cent a year. From being a predominantly male disease for the past 50 years, lung cancer is projected to be a predominantly female disease by 2025.
A ban on smoking in public spaces and cars needs to form part of a broader integrated tobacco control strategy. Tobacco prices need to remain high as price is the most effective barrier to smoking. Price increases encourage smokers to quit and are particularly successful at discouraging young people from starting to smoke. However, the illicit tobacco trade undermines efforts to reduce smoking as illicit tobacco is sold at a lower price. Spending on anti-smuggling operations needs to be increased to tackle the trade in illicit tobacco.
Mass media campaigns telling people about the dangers of smoking do work, particularly when combined with community-based services that support smokers to quit, but these services need to be widely available.
It is only by addressing smoking on every level, and by supporting people to make positive health choices, that we will be successful in reducing our smoking prevalence.
Kathleen O’Meara is head of advocacy and communications at the Irish Cancer Society. The society runs the National Smokers’ Quitline, phone 1850-201203 for free expert advice and support on how to quit