This review was written on March 18th 2005
Life expectancy in Ireland has been increasing
gradually during the last century, thanks to various social, public health and
medical measures. It has extended more rapidly in the last 25 years largely as
a result of the anti-smoking campaign which first started forty years ago at
the time of the first Royal College of Physicians and the Surgeon General’s
reports. Life expectancy will gather momentum because of the recent public smoking
ban in Ireland, followed as it will be by similar measures worldwide. Indeed,
it may mark the beginning of the end of cigarette smoking as a health hazard. The
trend will be further increased by changes in the production of cigarettes –
smaller cigarettes, reduced tobacco content and lower levels of tar and
nicotine.
The ban will have a powerful effect on the
culture of nations and on public health, particularly as most smokers in
Ireland are now in the younger age group who do not yet manifest the clinical
effects of the smoking diseases. Older persons, septuagenarians, octogenarians
and older, who are likely to be non-smokers or who had stopped smoking when at
an earlier age, will become an increasing proportion of our population. It is well established from
epidemiological studies that the healthy smoker who stops gradually reverts over
five to ten years to the same risk status as the non-smoker.
Budget 2015 - another 40c on a pack of fags. |
In terms of legislation, the Irish ban is
unique as a measure of social engineering. It was promulgated by a minister,
cabinet and a parliament for the common good with no obvious motive of political
gain or advantage. The exchequer will not necessarily be affected as the price
of cigarettes will almost certainly be subject to increasing taxation. The ban was
implemented after a widely conducted and controversial campaign involving every
stratum of Irish society. The commercial vested interests were harnessed most
powerfully to oppose the ban; but the Minister and his department adopted a
brilliant public relations strategy, receiving increasing and vital support
from a variety of organisations, including voluntary, statutory, health, social
and environmental bodies and members of the medical professions. In political
terms, it was the most altruistic piece of legislation in my memory and, in
terms of public benefit and approval, it is in the same realm as the banning of
plastic bags.
The success of this legislation contrasts with
some other aspects in our country. The neglect of education, civics and the
provision of better infrastructure for transport, cycling and healthy exercise,
are some of these, and our appalling planning policies at a time of great
prosperity and of waste as consumerism takes precedence over more pressing
social obligations.
Noel Gilmore, a former director of the Government Information Services, provides a fascinating account of a well organised public campaign which up to recently would not have been envisaged in our wildest dreams. The author writes well and is supported by detailed research into the origin and the progress of the campaign. It makes easy and sometimes amusing reading, and is a comfortable gossipy account but is none the worse for that. It is an important reminder of what can be done by our politicians for the common good. Let us be thankful for this rather rare example of our government’s genuine concern for Irish society.
Micheál Martin, Minister for Health, 2004. |
Some months after the ban was implemented I was invited by an old-standing colleague in Munich to attend a meeting on medical epidemiology and to address the audience from various European countries on Ireland’s success in banning smoking in public. The audience was suitably impressed by our government’s altruism but I thought it appropriate to add my own view that there was one factor which received no publicly in Ireland but which might have been in the mind of the minister for health and his cabinet colleagues. Talk was being heard at that time that some of the staff in our public houses were aware of the increasing information being published about the carcinogenic effect of passive smoking. Such workers were obviously exposed to a heavy atmosphere of cigarette smoke during their employment. Those inflicted by lung cancer, emphysema or coronary disease were likely in future to raise this matter when seeking compensation and would certainly succeed in their plea of risk exposure. I suspect that our minister for health must have some inkling of this potential hazard and that his altruistic act must have had a tinge of a political motive.
I find it remarkable, still, that the Irish were not just the first to ban smoking, but that Irish smokers and the general public recognised the sense and justice of the ban. It spelled disaster for the tobacco companies, because if smokers in Ireland had fought successfully against the ban it would have weakened the resolve in other countries. Instead, the Irish – the unruly, anarchic Irish – had put out the fags.
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