SMOKING COSTS the Irish economy at least €l million a day in lost productivity, according to Minister of State for Health Róisín Shortall.

She has warned it will cost the health service more than €23 billion over the next decade if there is no progress in cutting the numbers who smoke, now 29 per cent of the population. “That would pay the entire cost of running our health services for almost two years,” she told the Dáil.

Ms Shortall was introducing legislation to allow graphic pictorial as well as text warnings on cigarette packets, illustrating the health consequences of smoking. The Minister, who has responsibility for primary care, said premature deaths from tobacco use here “are far greater than the combined death toll from car accidents, fires, heroin, cocaine, murder and suicide”.

She said smoking was the “greatest single cause of preventable illness and premature death in Ireland”, killing more than 5,700 people a year.

When implemented, the Public Health (Tobacco) (Amendment) Bill gives the Minister authority to introduce regulations making it obligatory for cigarette and tobacco packets to carry one of 14 images illustrating the health consequences of smoking.

Ms Shortall said: “The brand imagery of the tobacco package is the foundation upon which all other marketing is built”. It played an even greater role in countries like Ireland where “traditional forms of advertising, promotion and sponsorship are restricted”.

A World Health Organisation report showed that in Australia, when graphic health warnings were introduced, more than half of smokers believed “they had an increased risk of dying from a smoking-related illness, with 38 per cent feeling motivated to quit”. International research showed “smokers are more likely to remember a health consequence of smoking, when smoking, if they have seen a picture”.

More than 50 per cent of Canadian smokers said warnings “compelled them to smoke less around other people” and 31 per cent of ex-smokers in a further study said photographic and text warnings had motivated them to quit.

The Minister said it was “critical” health warnings on tobacco packages “counteract the promotion of these products”. With the pictures, smokers are “potentially exposed to the warnings 7,300 times a year”. She stressed full colour-picture based health warnings on tobacco products were far more effective than text only.

“Pictorial health warnings on tobacco products make them less attractive and target smokers by providing them with information on tobacco-related health risks.”

Research showed the chosen photos had different impacts depending on age group and sex. A picture of a wizened apple particularly affected women aged 18 to 35 who could see the skin damage caused, while impotency was found to particularly affect younger male smokers.

Ireland is in the top rank internationally for its comprehensive range of legislation, but despite this and the widespread knowledge of the harm caused, 29 per cent of the population smokes – “a prevalence rate that has remained stubbornly high”, Ms Shortall said.

She highlighted concern about children smoking, pointing out that 75 per cent of all smokers in Ireland started before turning 18 years old, while half of smokers started before the age of 16. In the four years after the smoking ban was introduced in 2002, the numbers of boys and girls consuming tobacco products dropped, but the number was smaller among girls.

The ban on point-of-sale displays and advertising has resulted in a significant drop – 60 per cent – in the proportion of children who recalled seeing retail tobacco displays. “It is no coincidence that one of the world’s largest tobacco manufacturers has now initiated legal proceedings in the High Court” challenging the 2009 legislation that banned such displays, the Minister said.