With some 5,200 Irish people dying each year as a direct result of diseases caused by smoking, no one can argue against the zeal of Minister for Health James Reilly in his aim to reduce the prevalence of smoking here to less than 5 per cent by 2025.
Smoking causes cancer;
it is a major cause of cardiovascular disease, leading to heart attacks and strokes; blockages due to smoking in peripheral vessels lead to limb amputations; and it causes chronic obstructive airways disease
in the lungs of many smokers.
Specific goal
Nonetheless, to reduce smoking prevalence from its current level above 20 per cent to 5 per cent in just 12 years is a big ask. Can the Minister's specific proposals achieve this ambitious goal?
Tobacco Free Ireland recommends introducing legislation to prohibit smoking within the campuses of primary schools, secondary schools and childcare facilities, as well as the promotion of tobacco-free campuses for third-level institutions. With the necessary political will, these are achievable aims.
There is no doubt that increasing the cost of tobacco products is an effective way
to reduce smoking prevalence. Proposals to increase tobacco excise duty in the next five budgets will help. But we need to know by how much it will increase and we also need to know if Minister for Finance Michael Noonan has signed up to the proposals. As smoking rates decline his overall tax take from this source is likely to drop.
And our recent track record in increasing duty on the old reliables is hardly impressive.
Industry fight
The tobacco industry will fight these proposals tooth and nail. No one should be under any illusion about the huge resources they will throw at negating or diluting Reilly's plans. Inevitably the industry's actions may delay their implementation.
An undoubted weakness in yesterday's announcement is the absence of a detailed action plan with clear timelines. As the Irish Cancer Society pointed out, the ambitious plan requires dedicated funding. Will this be forthcoming at a time of unyielding fiscal rectitude?
With smoking rates higher among those in disadvantaged areas, the plan needs to develop some innovative ways of tackling tobacco addiction among people in the lowest socioeconomic groups.
The Minister may meet some societal objection to his plan to “denormalise” tobacco use. Although the arguments are complex, being overly reliant on stigmatising smoking as a control policy may not be helpful.
Everyone involved in healthcare will fervently wish the Minister success. But how many will be prepared to bet on him hitting his target rate remains to be seen.