The health effects: Smoking rate falls from 29% to 22% in 10 years
The pioneering move has ‘denormalised’ smoking and saved thousands of lives, but statistics suggest the battle is far from over
Ten years after Ireland became the first country to ban smoking in all workplaces, the measure is popular and widely complied with, and it has made pubs, restaurants and lots of other places more pleasant. But multiple studies suggest the ban’s real success has been its health benefits. Research published in 2007 found it had given non-smoking bar workers, who were now exposed to less second-hand smoke, healthier hearts and lungs.
A subsequent study in the southwest concluded that, in the year after smoking was banned, there was a 12 per cent drop in the number of patients admitted to hospital with acute coronary syndromes. Further research, published in 2012, linked the ban to a decline in admissions with acute pulmonary disease for certain age groups and an overall reduction in admissions for asthma.
Last year the online science journal Plos One estimated that, had smoking not been banned, an additional 3,726 people would have died, primarily from passive smoking. It added that although tax increases, health warnings and advertising bans “may have resulted in synergistic health improvements”, their effects were “small and gradual” in comparison with the impact of the ban.
Dr Ross Morgan, a consultant respiratory physician at Beaumont Hospital in Dublin and chairman of the anti-smoking lobby group Ash Ireland, says the accumulated research shows that the ban has been an astounding success. “The headline findings are that comprehensive smoke-free bans introduced in Ireland and elsewhere bring with them really positive outcomes in terms of heart disease, including acute heart attacks, strokes and respiratory illnesses.”
The ban also had a big part to play in “denormalising” smoking in Ireland, Morgan says. “It has reduced people’s exposure to smoking and thereby reduced people’s tolerance to second-hand smoke. Nowadays nobody would dream of lighting up beside you in a restaurant, because people are not going to tolerate it.”
Dr Marie Laffoy, community oncology adviser at the National Cancer Control Programme, agrees that the ban has been a success but stresses that “the battle against smoking is ongoing”. “Smoking is associated with 85 per cent of all lung cancer, for which the outlook is very bleak, and around a third of all other cancers,” she says, adding, “You’ll hardly find a disease that smoking doesn’t make worse.”
The ban has been part of a suite of anti-tobacco measures over the past decade, including quit-smoking campaigns, price increases, the banning of the 10-pack, restrictions on advertising and health warnings on tobacco products.
In March 2004 just under 29 per cent of the population aged 15 and over smoked, according to the HSE. That had fallen to 21.5 per cent by the end of last year. Other statistics paint a slightly different picture. Eurobarometer polls suggest that although the proportion of Irish people who reported smoking fell from 32 per cent to 29 per cent between 2002 and 2006, the percentage smoking in 2012 was still 29 per cent.
Health Behaviour in School-aged Children Ireland, a series of studies at NUI Galway, has shown a downward trend in the number of 10- to 17-year-olds who smoke, from 21 per cent in 1998 to 12 per cent in 2010. It also found that 21 per cent of 15- to 17-year-olds classed themselves as smokers in 2010. The latest HSE figures, from last December, say that 13.3 per cent of that age group smoke.
And what about tobacco sales? The number of cigarettes sold rose in the Republic in the two years after the ban, according to Revenue; it has been dropping ever since: 5.3 billion cigarettes were sold in 2004; 3.8 billion were sold in 2012.
But sales of rolling tobacco have risen, and the industry says there has also been a jump in cigarette sales that avoid duty, whether that means counterfeit packs or tobacco that has been produced abroad and then brought into Ireland, either legally or by smugglers.