Irish puff away as Europeans act on smoking addiction

Iceland may go and make cigarettes available by prescription only. In Ireland, the state will allow you to smoke yourself to death, but not to take your own life

WHICH is more dangerous: You continuing to be able to randomly kill people with impunity — or the state stepping in to stop you?

That is the dilemma currently gripping Iceland as the country’s parliament debates a radical move to make cigarettes available on prescription only — and even then, just in extreme cases.

Now, considering Iceland has been using most of Europe as a giant ash-tray for the smoke from its volcanoes for the past year, the idea that it is taking the lead against tobacco pollution is more than a tad ironic.

But lawmakers in Reykjavik are raising intriguing questions about the acceptable limits of personal freedom versus the desirable reach of government intervention.

In Ireland, the state is quite happy to let you kill yourself — and others via passive smoking — with a slow-motion addiction to nicotine, but will not let you kill yourself in a voluntary, dignified, sudden exit via euthanasia if you are terminally ill.

While in Iceland the authorities are rolling out a zero-tolerance regime that will ban smoking in all public places, including pavements and parks, and in cars where children are present, but health campaigners are determined to go further by pushing through the prescription law to try and kill the habit for good.

And in one of those lovely Nordic twists of logic, after relentlessly pushing up the prices of cigarettes because the World Health Organisation calculates every 10% rise in charges leads to a 6% drop in consumption, prescription fags will actually be much cheaper because they will be seen as being for desperate people on the edge of society.

“Under our plan, smokers who are given prescriptions will be diagnosed as addicts, and we don’t think the government should tax addicts,” Thorarinn Gudnason, president of the Icelandic Society of Cardiology, who helped draw up the proposed laws, explained.

Gudnason says 20% of all deaths in Iceland are linked to tobacco and cites a study showing that after a smoking ban was brought in for pubs and restaurants in 2007 there was a 21% reduction in acute coronary syndrome (heart attacks and near heart attacks) among non-smoking men.

And prescriptions will not be handed out to anyone who asks, but only for those who repeatedly fail to succeed on rigorous quit programmes.

Finland is aiming to be even tougher by making smoking completely illegal within 30 years — I wonder what effect that will have on the country’s notoriously high alcoholism and suicide rates?

Swedish surgeons also now refuse to operate on smokers until they give up, because of the damaging effect smoking has on the recovery process.

But why ban, say heroin, and not nicotine, just because one can kill you quicker?

One country heading in the opposite direction to the ban-loving northern Europeans is Portugal, which decriminalised the personal use of all drugs, including Class-A ones like heroin and cocaine, 10 years ago.

Lisbon took action because the country had 100,000 heroin addicts and the highest rate of HIV infection from syringe sharing in the EU.

A study by the Washington DC-based think-tank, The Cato Institute, found the move had some startling results, with the number of heroin-related deaths halved by 2009.

And while more teenagers are now smoking marijuana in Portugal, youth heroin use has fallen. By redirecting resources away from prosecuting and jailing addicts and from rehab programmes, the number of people in drug treatment is now up by 147%.

Intolerant Iceland, on the other hand, already has the lowest smoking rate in Europe with the number of those lighting up dropping from 30% of the population in 1991 to just 15% now.

And given that it is the most isolated country in Europe, with strenuous customs controls, it is probably the one place where cigarettes could be realistically banned.

It is hard to envisage any Irish administration being as bold as either the Icelandic or Portuguese governments have been in their opposite approaches to similar situations.

Health concerns driven by either the chilly Arctic logic of prohibition in Reykjavik, or by the sunny, libertarian approach seen in Lisbon would never hold much water on our rain-drenched group of islands.

The British government sacked its own drugs czar, the wonderfully named Prof David Nutt, last year because he refused to talk down to people about drugs and would not pander to the usual, largely meaningless, “war on drugs” rhetoric that everyone turns off to.

Instead, he argued people were less likely to indulge with harmful substances if they were given the real facts about them, and attacked what he called the “artificial” separation of tobacco and alcohol from illegal drugs as being counter-productive to the general well-being message that should be promoted.

The then Labour government fired him as chairman of the Advisory Council on the Misuse of Drugs after he argued that cannabis, ecstasy and LSD were less harmful than heavy smoking and drinking.

Prof Nutt also enraged his political masters by pointing out that as ecstasy use caused 30 deaths a year in Britain it was less harmful than horse-riding, which causes 100 deaths a year.

The scientific community and many drugs experts rallied to the support of Prof Nutt, who is head of psychopharmacology at the University of Bristol, but the powers that be wanted him shut down.

In short, we are as likely to mirror Portuguese permissiveness here as we are to get their weather this summer.

It’s always down to cold, hard cash in poor, broke Ireland and the fact smokers ‘cough-up’ €1,477,600,000 a year to the state in taxes and duties for the freedom to smoke themselves to death is the killer issue — but unfortunately, ministers don’t seem to have realised that the cost to the health service caused by tobacco-related illness is actually well above that at more than €2bn a year as 6,000 Irish people die annually from the habit.

The Icelandic approach smacks of social engineering of the kind which can often lead to totalitarianism, the Portuguese stance suggests enlightened realism, and the Irish position, well, it just reeks of the usual, stale, fag-butt end of indifference.