It is one of the most effective public health measures ever in this country. To what do I refer?
The smoking ban, introduced in workplaces in Ireland 15 years ago today.
It’s easy to forget the life of second-hand smoke, pre the ban. But you only have to travel to a country where none is in place to remember the awfulness of sitting and passively inhaling someone else’s smoke to the point of nausea, and coming home after a night-out smelling like an old ashtray.
If this is the nanny state in peak action, I’m all for it. In fact, how could then Health Minister, Micheál Martin, not have done it, given the declaration by the World Health Organization’s International Agency for Research on Cancer that environmental tobacco smoke included more than 50 known carcinogens and that passive smokers were in serious and constant danger.
To worldwide attention, and huge opposition at home, the Fianna Fáil leader introduced the ban, the first of its kind anywhere. Overnight, ashtrays were removed from pubs, restaurants, and clubs.
I remember, in covering the story at the time, the squealing outrage of many publicans and bar patrons. Unsurprisingly, there was also an exceptionally well-organised political lobbying operation mounted by the tobacco industry.
By the end of it, we knew more about the ventilation of buildings than builders and architects did.
TDs, including those from Martin’s own party, howled about people being deprived of the enjoyment of a fag to accompany their pint. One even spoke of how “heroin addicts get methadone” and moaned about smokers be subject to this “short, sharp action”.
There were even complaints about how TDs would have to go out onto the plinth in Leinster House and smoke in the rain, hail, or snow, to get their tobacco fix.
It didn’t help that they saw the Health Minister as far too clean-living for their liking, and that if he was coming after the fags now, what would be next?
As it happens, we set quite the example back then, and similar bans were later introduced in other countries. We are among the best for tobacco control initiatives, including the ban on self-service vending machines in pubs (2009), and the ban on smoking in cars when children are present (2016).
Plain cigarette packaging began to hit the shelves here at the beginning of last year, after we became the fourth country to introduce them. The new boxes are the same plain neutral colour and have more prominent health warnings.
They also feature graphic photographs of the illnesses and diseases that people develop as a result of smoking.
All forms of branding — trademarks, logos, colours, and graphics — have been removed from tobacco packs, with a uniform, standardised typeface.
I’ve been lucky enough never to have smoked, but I could still have told you from a line-up of cigarette boxes which brand was which. Because smoking has been so denormalised, children who live in a house that has no smoker can be unaware of the habit and certainly would not be able to name a well-known tobacco brand.
A study in 2013 estimated that 4,000 lives had been saved by the ban. Immediately after it was introduced, there was a 13% decrease in all types of death, a 26% reduction in ischemic heart disease, a 32%
reduction in stroke, and a 38% reduction in chronic obstructive pulmonary disease, according to a Brunel University London study.
The authors of the study attributed the decreases in the amount of deaths to reductions in passive smoking. Those results were almost a decade after the ban was introduced, so thousands of more lives have been saved in the five years since.
A review, published in The Lancet, of 11 international studies showed that smoking bans, including our own, have resulted in sharp falls in the numbers of children being admitted to hospital with asthma attacks and the number of babies born before full-term.
The smoking rate in Ireland before the ban was 30% and is now 20%. The Government’s Tobacco Free Ireland initiative aims to have fewer than 5% of people smoking by 2025.
Disappointingly, we are unlikely to achieve that, but we continue the fight, including the eighth consecutive budget excise duty hike announced by Finance Minister Paschal Donohoe.
There’s no end to the positive statistics, but whatever else Mr Martin does in his political life, this brave action will top the list, at least in terms of saving lives and increasing life expectancy.
The tobacco industry remains lurking on the sidelines, still incredibly well-funded, still looking for any possible niche to increase smoking levels, particularly targeting the less-well-off, be that in Western societies, like our own, or generally poorer countries, where laws do not exist to protect the population.
Vaping does look to be considerably less harmful than smoking, but given the black arts that the tobacco industry is famed for, it is difficult not to suspect that it will somehow use vaping to get more people smoking.
Just recently, British American Tobacco announced that it is to restart its sports sponsorship for the first time in over a decade.
But it is pushing its vaping, rather than tobacco, products through Formula One.
As Ash Ireland, a group that advocates for reduced tobacco use, pointed out, in the past such a tie-up had exposed millions of people to cigarette brands and their products, due to Formula One’s “considerable appeal among youth and young adults”.
Elsewhere, Philip Morris International (PMI) has committed an incredible $1bn in funding for the Foundation for a Smoke Free World, an entity entirely funded by PMI.
Last month, Ash Ireland joined almost 300 organisations and experts from around the world in welcoming the World Health Organization decision not to partner with the foundation.
There is so much money to be made, regardless of the risk to human health, that the tobacco companies will never give up.
That means that our politicians and public health advocates, who have done a pretty good job in this regard so far, must adopt the same approach.