COMMENT:An effective campaign against smoking could save the lives of more than 6,000 people who die in Ireland each year from tobacco-related illnesses
THE WORLD Health Organisation (WHO) has stated that unless urgent action is taken, by 2030 there will be more than eight million deaths a year caused by tobacco, with 80 per cent of them occurring in developing countries.
Tobacco is the leading cause of preventable death. In Ireland, more than 6,000 people die every year from tobacco- related diseases. Some 30 per cent of all cancers, including 90 per cent of lung cancers, are caused by smoking.
Tobacco is a unique product in that we know, from research conducted by the Office of Tobacco Control (OTC), that eight out of 10 Irish smokers start in their teenage years and, we also know, that once addicted by the drug nicotine, it is very difficult to quit. This is why it is so important that we work to ensure that young people do not start smoking in the first instance.
Research shows that if young people don’t start smoking in their teenage years, they are far more likely to enjoy a healthy life free of tobacco addiction.
There is no doubt that over the past few years we have made some progress in the ongoing struggle against the tobacco epidemic.
WHO described Ireland as “the tipping point” for the rest of the world to follow in terms of the introduction of the smoke-free at work legislation. This resulted in improved health for all workers from the dangers of second-hand smoke.
The recent focus of the work of the OTC has been on the retail environment, and the protection of young people in particular. The research published by the office last month shows that practically all tobacco advertising and display has been removed from shops and supermarkets.
This is a most welcome development and its effect will be seen over time. Indeed, research commissioned by the OTC has demonstrated that young people’s recall of in-store tobacco advertising is already beginning to fade since the introduction of the tobacco advertising ban in July this year.
However, and worryingly, the same research demonstrates that one-third of retailers and licensed vending machine operators are still prepared to sell tobacco to minors. While there has been a steady improvement over the past three years, this is still not acceptable. We must, as a society, ensure that children cannot access tobacco from our local shops.
In terms of overall population smoking rates, the 2007 HSE Slán survey demonstrates a smoking prevalence rate of 29 per cent with the highest reported rates – at 37 per cent – among the most disadvantaged in society.
These rates are very high by international standards and are, in fact, several percentage points higher than our neighbours in the UK and a long way off the more advanced tobacco control states. For example, Canada, which has had a focused goal-driven tobacco control policy for many years, is now reporting smoking prevalence rates of 18 per cent and falling. Clearly, we have much work to do in Ireland.
I welcome the plan by the national Cardiovascular Health Policy Group (Department of Health and Children, 2009) to set targets to reduce smoking prevalence. To achieve these targets and the objectives set out in the policy document, Towards A Tobacco-Free Society, commitment at a political and administrative level is imperative.
Of particular interest to me is helping smokers quit. We must ensure that a comprehensive smoking cessation service is available to all who need it. GPs are uniquely placed in the community to intervene with their patients to advise them to quit.
However, the latest Department of Health and Children Slán survey reports that only one in three smokers who attended a GP in the Republic in the past 12 months were advised to quit. Other studies have shown the potential the community pharmacist has in advising their clients to stop smoking.
Quitting smoking saves lives and has immediate and long-term benefits including improved health, reduced risk of coronary heart disease, cancers and improved lung function.
While it is important to acknowledge the progress made, it is imperative that we do not become complacent in relation to tobacco control. Meanwhile, the cycle of teen initiation into smoking continues apace, with an estimated 50 teenagers starting smoking every day in Ireland.
Finally, I believe it is critically important that we, as a society, in establishing our public health priorities, take cognisance of the advice of Dr Margaret Chan, WHO director general, when she says: “Reversing this entirely preventable epidemic must now rank as a top priority for public health and for political leaders in every country in the world.”
I believe now is the time to revisit and reinvigorate our national tobacco control policy by implementing the WHO “MPower” policies and taking encouragement from and following the example of those states that are successfully reducing smoking levels and reducing teenage initiation into tobacco.
BREAKING THE HABIT: WHAT WORKS
On the positive side, we know what works in tobacco control and we can learn from the experience of other states that are successfully driving down smoking rates. The WHO “MPower” package identifies the six most effective evidence-based tobacco control policies:
- Monitor tobacco use and prevention policies.
- Protect people from tobacco smoke.
- Offer help to quit tobacco use.
- Warn about the dangers of tobacco.
- Enforce bans on tobacco advertising, promotion and sponsorship.
- Raise taxes on tobacco.
Norma Cronin is chairwoman of the Office of Tobacco Control
For support and advice in quitting phone the National Smokers Quitline at 1850-201203
