Time to change tack in battle on smoking?

Some months ago the Department of Health accepted that the smoking ban has not had any real impact in reducing the number of people who smoke in Ireland.

Despite all the furore and millions spent on education and advertising, just as many Irish people as ever are happily puffing their way to an early grave. Some, by smoking around their children, are leaving a legacy that will make their sons or daughters hostages to the tobacco companies all of their lives. The ban was introduced just over eight years ago and still huge numbers of Irish people jeopardise their health and their children’s health by continuing to exercise their right to smoke.

The scale of the habit and the cost of supporting it, not to mention its almost inevitable consequences for the national health budget, is bewilderingly vast.

Two years ago, Irish people bought 4.3bn cigarettes from legitimate, tax-paying tobacco companies. In a country of 4.85m people that is as startling as it is daft. Even more eye-opening is the fact that figure represents a 200m fall on the previous year because of the escalation in sales of smuggled cigarettes.

Last week’s seizure of just under 40m cigarettes in Dublin Port suggests this is one of the very few sales graphs on an upward trajectory. That haul had a value of around €15m and had it reached the streets the contraband would have represented a loss of around €13m to the exchequer. These cigarettes are at least as harmful as properly branded ones so the State is hit with a double whammy — a multimillion-euro loss in excise duties and eventually a health bill to cope with the inevitable sicknesses, some lethal, others just debilitating, caused by smoking these cigarettes.

Yesterday, James Reilly, the health minister, said he would like to extend the smoking ban to all areas where children might be influenced by their parents’ smoking. The motivations are entirely admirable but the practicalities involved are daunting. A beach patrol to confront errant parents? Instruct the traffic corps to arrest adults caught smoking in cars with children? This level of policing seems neither possible or desirable.

There may be another way.

The State’s health service is a kind of insurance policy — insurance that you will get treated for your illnesses no matter what your resources are. All insurance companies charge an excess fee to their customers — a small, usually set, figure — so maybe it’s time to consider charging smokers an excess before they can avail of public or private health services to deal with smoking-related illnesses?

The furore would be no greater than that which preceded the 2004 ban but the results couldn’t be any worse.