Third-hand smoke: the next battle

Ten years ago next Saturday (March 29th), Ireland became the first country in the world to introduce a workplace smoking ban. The move was positively received for the most part and the percentage of the population smoking has fallen from 29 per cent to 22 per cent over the past 10 years. However, anti-smoking campaigners believe more can be done to create an almost entirely smoke-free culture.

These campaigners – including the Royal College of Physicians of Ireland (RCPI) and the Irish Cancer Society – welcome the Department of Health's wide-ranging Tobacco Free Ireland document as a positive and far-reaching approach towards creating zero tolerance for smoking.

Dr Pat Doorley is the chairman of the RCPI's policy group on tobacco. "The smoking ban has saved an estimated 3,400 lives over the 10 years and the Tobacco Free Ireland policy is very ambitious – but achievable – with its target to reduce smokers to 5 per cent by 2025," he says.

“Taxation is the single most effective measure to decrease smoking as certain groups, such as young people and those from lower socio-economic groups, are price sensitive. These are also the smoking groups we need to target most. We need to tackle smuggling of cigarettes with more surveillance at ports and points of sale.”

The draft bill on plain packaging for cigarettes, which is currently going through the Dáil, is also widely welcomed.

“In countries like Australia, which is a world leader in Tobacco Free policy, many studies have found that smokers prefer coloured packs with bright attractive logos.

“Smokers also pay more attention to warnings on plain packaging and children will perceive the dangers of smoking more with plain packaging,” says Doorley.

Keeping cigarette smoking out of sight is another area that medical experts are adamant to improve on. “The HSE has a smoke-free campus policy and virtually all hospitals are smoke free now. We’d like to see all outdoor areas in creches, school yards and universities smoke free.”

The RCPI also encourages all healthcare professionals to discourage cigarette smoking at every opportunity and to give people lots of support to help them quit.

The Irish Cancer Society suggests that information about quit lines could be printed on new plain packaging.

“We also have to watch the marketing tactics of the tobacco industry – especially on social media as they try to get around plain packaging. Also, we would like to see an action plan on foot of the Tobacco Free Ireland policy,” says Kathleen O’Meara, head of advocacy and communications at the Irish Cancer Society.

The so-called de-normalisation of smoking is the key message healthcare professionals want the younger generation to pick up on.

Paediatric respiratory consultant Dr Des Cox says that more awareness is needed about the dangers of second-hand and third-hand smoking.

Second-hand smoking is defined as smoke from a lit cigarette or the smoker’s exhaled tobacco smoke. Third-hand smoke is defined as the smoke left in a room or a car after a smoker has left the space.

Children exposed to smoke are known to be at higher risk of recurrent chest conditions such as bronchiolitis and croup.

“There is a recent study which points to children in a smoking household being at a greater risk for heart disease and chronic obstructive pulmonary disease in adulthood,” according to Cox.

Ban extension
The RCPI is very keen to see the smoking ban extended to include smoking in cars where children are present. One New Zealand study found the air quality in a car in which someone smoked – even with the window partially down – was equivalent to that of a smoky pub.

The RCPI is beginning to highlight the dangers of third-hand smoke.

“There is emerging data on the dangers of third-hand smoke but really there is no safe level of tobacco smoke, if you consider the 4,000 chemicals it contains, 200 of which are carcinogenic. Children simply shouldn’t be exposed to it at all,” says Cox.