Ireland still performs well below most other EU member states when it comes to climate action. But when it comes to public health, we have a standout example of an effective public health campaign that saved lives: the anti-smoking campaign.
On March 29th 2004, Ireland became the first country in the world to ban indoor smoking at bars, restaurants and places of work. It was a remarkable political achievement for then-Minister for Health Micheál Martin, whose political skills were critical to getting the ban over the line. Martin established an Office of Tobacco Control within the Department of Health and ensured it had the resources and political backing to take on the tobacco industry.
Supporting the ban was an unprecedented alliance of civil society organisations, trade unions and health professionals. Restrictions on the advertising and sale of tobacco have been accompanied by strict enforcement by environmental health officers, with fines of €3,000 for noncompliance. Additionally, hefty excise duties on tobacco raised the cost of smoking. Since 2009, there has been a complete ban on tobacco advertising.
By any metric, the measures have worked. According to the HSE, there are 800,000 fewer smokers today, with smoking rates down from 27 per cent in 2004 to 18 per cent in 2023, largely attributable to the ban and the shift in social norms. Luke Clancy is a professor of respiratory medicine and was one of the leading campaigners for the smoking ban. He claims that it has saved 1,500 lives a year since its introduction. But the HSE is not finished yet: its vision is an Ireland free from the harms caused by smoking.
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In 2004, policymakers feared a public backlash and widespread noncompliance. The hospitality industry warned of big drops in revenue. The support of trade union Mandate, which represented bar workers, for the campaign against tobacco swung public support in favour of the restrictions.
So, what can we learn from the tobacco control measures? Firstly, presenting climate policies as protective of public health creates the possibility of different motivations, new alliances and new policy instruments. This can help bypass the criticisms of “nanny state”, especially they are proven to work.
Climate change is fundamentally a health issue. It will maim and kill and bring about human suffering and illness on an unprecedented scale, affecting those with underlying health conditions the most, just like smoking. Policies that only tinker with incremental changes at the margins give the fossil fuel industry more time to rebrand itself and fight back with pseudo-solutions. An office of fossil fuel control (OFFC) in the Department of Health should be leading the fight against fossil fuel products, using regulation, litigation, subsidies and behaviour-modification strategies in the interest of public health.
Let’s make meat-free menus, public transport and renewable energy services the cheaper default
Nudge architecture, or choice architecture, is the practice of designing how choices are presented to influence decision-making. This has proven successful in deterring people from taking up smoking: taxes have raised costs and bans have made people think twice before engaging in damaging behaviours. The HSE acknowledges that for people on low incomes, a smoking habit is hugely expensive, so it has specific outreach programmes for disadvantaged communities. While governments should of course target fossil fuel supply and distribution, we should not underestimate the potential for tapping into loss aversion and social proof as proven ways to reshape the system from within.
To start with, the OFFC could introduce measures to deter high-carbon behaviours that risk public health. Fossil fuel products could contain graphic warnings to raise public awareness. This could be extended to air travel tickets and red meat products. Let’s make meat-free menus, public transport and renewable energy services the cheaper default, not the exception. Make car parking in towns and city centres inconvenient and expensive in comparison to park-and-ride, public transport and active travel. Data centres place a huge drain on power, so there is a very strong argument to ban developing any more of them.
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Taxes and pricing can play a role too, such as frequent flyer levies and advertising bans that draw attention to high-carbon lifestyles. Public health messaging could highlight the health impacts of climate change and the benefits of clean air, renewable energy, green jobs and sustainable transport as well as addressing misinformation and building support for climate action. Perhaps, just like the HSE’s Quit smoking cessation programme, the Government could stop subsidising fossil fuels and instead provide hands-on practical support to individuals and communities while investing in realistic, affordable alternatives.
More strategically, we need to support litigation against big fossil fuel companies and make them liable for continuing to poison the Earth decades after they knew about the effects of greenhouse gases on the atmosphere.
