Annex 3: Health Committee visit to Dublin
7-9 November 2005
The Committee met:
Dr Shane Allwright and Ms Marie Killeen, Office of Tobacco Control
Mr Tadg O'Sullivan, Chief Executive, Vintners' Federation of Ireland
Mr John Power, Chief Executive, and Mrs Anne O'Carroll, Irish
Hotels Federation
Mr Henry O'Neill, Chief Executive, Restaurants Association of
Ireland
Professor Luke Clancy, ASH Ireland
Mr Eamon Corcoran, Principal, and Mrs Siobhan McEvoy, Chief Environmental
Health Officer, Department of Health and Children
Mr Seamus Cramer, Irish Prison Service
Mr Bernard Harbor, IMPACT and Mr John Douglas, MANDATE
Timetable of the Irish smoking ban
November 1999
- The Oireachtas Joint Committee published a report on Health
and Smoking.
March 2002
- Public Health (Tobacco) Act passed by the Dáil Éireann.
May 2002
- Enactment of section 2 of the Public Health (Tobacco) Act which
established the Office of Tobacco Control (OTC) as a statutory
body.
November 2002 - The Irish
Government proposes a ban in restaurants and pubs where food is
served.
January 2003 - A report
jointly commissioned by the OTC and the Health and Safety Authority,
"The Health Effects of Environmental Tobacco Smoke in
the Workplace", highlights effects of passive smoking and
calls for a ban on smoking in all workplaces, including bars.
30 January 2003 - Irish
Government announces ban. It was opposed by the Vintners' Federation
of Ireland (VFI), which describes it as 'unworkable, untenable
and unenforceable', arguing that ventilation was effective, a
claim which was challenged by Environmental Health Officers. The
ban was supported by unions: MANDATE called for bar workers to
be protected, stating that 150 died in Ireland every year from
ill-health caused by passive smoking.
March 2004 - Ban introduced,
but with exemptions for prisons, Garda Station detention areas,
nursing homes, hospices, religious order homes, central mental
hospital, psychiatric hospitals, residential areas within third
level education institutions, hotel, guesthouse and B&B bedrooms.
December 2004 - In a national
poll conducted by RTÉ, Ireland's public service broadcaster,
the smoking ban is voted the high point of 2004.
March 2005 - Bertie Ahern
claims ban has been a great success with few problems of compliance
and forecasts of collapse in pub trade have not been borne out.
A survey carried out by the trades unions says 90% of Dublin bar
workers approve of ban. According to the Irish Central Statistical
Office, bar sales declined by 5.3% in the full year after the
ban was introduced - but it was claimed that this was only slightly
above the decline in the bar trade (4% per year) which began in
2001. A journalist noted:
'Bars have facilitated them [smokers] in a variety
of ways, often providing outside tables, gas heaters and ashtrays,
and sometimes building on patios and lean-to shelters. This in
turn has added a new dimension to social intercourse as the open-air
smokers discuss the ban and other topics.'
October 2005
- The OTC's Annual Report declared that bar retail sales by volume
had increased during the most recent three-month period (year-on-year)
following four years of decline. The number of people employed
in the bar sector also jumped by 1,400 to 23,200. Compliance with
the ban was high. The VFI, in contrast, replied that according
to the Central Statistics Office 7,600 jobs were lost in the hospitality
sector the first year after the ban which meant a net loss of
6,200 jobs since the ban began. The VFI also claimed that as many
as 200 pubs, mainly in rural areas, have gone out of business
since the smoking ban was introduced in March last year.
A study funded by OTC found a significant reduction
in bar workers exposure to secondhand smoke following the ban
(salivary cotinine concentrations dropped by 80% which was far
greater than the fall in Northern Ireland bar staff). There is
some evidence that home exposure declined after the ban.
The Office of Tobacco Control (Dr Shane Allwright
and Ms Marie Killeen)
The idea of banning smoking in public places grew
out of two Dáil
inquiries, in 1999 and 2001, and was enshrined in the Public Health
(Tobacco) Act of March 2002. This legislation prohibited smoking
in public places and workplaces and created the Office of Tobacco
Control as an independent statutory agency to advise on and co-ordinate
the enforcement of the ban.
A joint scientific committee comprising representatives
from the Office of Tobacco Control and the Health and Safety Authority,
as well as independent scientists, produced a report on secondhand
smoke in January 2003, which found that SHS is a Category A carcinogen
as well as a causal factor in several other serious diseases.
It also found that ventilation and voluntary arrangements were
ineffective in controlling SHS in public places.
The primary aim of the legislation was to protect
third parties (especially workers) from the harmful effects of
SHS. It was based on strong scientific foundations, from within
the Republic of Ireland and from abroad. There was clear and committed
political leadership behind the ban and a broad base of public
support.
High levels of public support for a ban on smoking
were found. 67% of those surveyed (including 40% of smokers) supported
the legislation before its introduction, and research conducted
by the Department of Health and Children found 82% supported the
ban once it was in force. In addition, it was voted the high point
of 2004 in a national poll conducted by RTÉ. A survey carried
out one year after the ban's introduction found that 98% of respondents
believed workplaces were healthier; 96% believed the law had been
a success; and 93% thought it was a good idea.
Compliance has also been very high. In more than
45,000 inspections, the National Tobacco Control Inspection Programme
found that 93% of hotels, 99% of restaurants, 90% of licensed
premises and 97% of other premises were compliant, while 92% of
premises inspected by the Health and Safety Authority complied
with the ban. There were very few prosecutions for breaching the
legislation (13 to the end of 2004; approximately 50 to date).
There was little or no substantial adverse effect
on the economy. Restaurants and hotels reported no negative impact;
representatives of the bar trade claimed that sales had fallen
by 15-25%, but data from the Central Statistical Office pointed
to a much shallower decline, which may have been attributable
to pre-existing trends. There was a small decline (2.4%) in the
number of people employed in the bar trade, but this decline has
halted and the figures are now increasing.
The factors contributing to the success of the smoking
ban were:
- A comprehensive and intelligible
law with few exemptions;
- Well-prepared and adequately resourced implementation;
- Sustained and committed political leadership;
- Support of a broad base of interested parties;
- Active information campaign to build public awareness;
- Public confidence that the legislation was workable.
The Vintners' Federation of Ireland (Mr Tadg O'Sullivan,
Chief Executive)
The Vintners' Federation of Ireland (VFI) was created
in 1973 by the merger of smaller associations, to represent the
interests of individual publicans. It currently has around 6,000
members.
The VFI accepted that cigarette smoke could be unpleasant
and uncomfortable for non-smokers and workers, but said that it
simply didn't know if it was harmful to health, and believed there
to be no conclusive scientific evidence. However, if smoking is
so harmful, why is it allowed at all? It did not believe that
legislation was the appropriate way to tackle the problem.
The statistics used to support a ban on smoking were
not wholly reliable; in particular, the number of deaths among
bar staff attributable to SHS exposure had been hugely exaggerated.
The consumption of tobacco and alcohol in the home
has increased significantly as a result of the ban; health experts
have suggested that there may be a link with the increased number
of domestic fires.
There had been major adverse effects for the licensed
trade. Volume on-sales, having risen from 1990 to 2000, fell slightly
between 2001 and 2003, but then fell significantly in 2004 [the
year the ban was introduced]. There were significant job losses
in the hospitality industry in 2004, despite a growth in jobs
in the broader economy. Rural areas have seen significant numbers
of pub closures—as many as 500 in the Republic of Ireland
as a whole. The VFI believes that the ban on smoking has been
a major contributory factor. The VFI also contested the OTC's
use of data from the Central Statistical Office, particularly
the claim that employment in the hospitality sector had risen
to 23,000, when, it is clear, there are well over 50,000 people
employed in the sector. The VFI says the OTC figures are therefore
false.
The VFI was of the opinion that, far from the ban
on smoking being simple, it had been the subject of considerable
confusion and had been interpreted differently by different people,
especially Environmental Health Officers.
The Irish Hotels Federation (Mr John Power, Chief
Executive, and Mrs Anne O'Carroll)
The Irish Hotels Federation (IHF) represents hotel
and guest house owners. It was founded in 1937 and represents
approximately 1,000 establishments, employing 57,000 people.
The IHF accepted the health arguments in favour of
a ban on health and safety grounds. There was a duty of care on
the part of employers in the hospitality industry with regard
to workers, and this extended to protection from the harmful effects
of SHS.
The introduction of the ban on smoking in public
had generated considerable positive media coverage, and the hospitality
industry in general had benefited from this.
There were no alternatives. There was a lack of conclusive
evidence on the efficacy of ventilation, despite the work of Dr
Andrew Geens in this field.
The Restaurants Association of Ireland (Mr Henry
O'Neill)
The Restaurants Association of Ireland (RAI) is the
recognised representative of the restaurant trade. It was formed
in 1970 and represents more than 600 restaurants of all kinds.
The RAI supported the introduction of smoke-free
legislation. It had concerns over the enforcement of the ban,
whether the responsibility for infractions would lie with the
smoker or the proprietor and which sectors would be exempt, and
was the only organisation to request a meeting with the Minister
of Health.
A survey carried out by the RAI found that 68% of
patrons favoured a ban, and 70% of members agreed. The organisation
therefore gave its official backing to the legislation.
The RAI found that there was no downturn in business
after the introduction of the ban; indeed, if anything, there
had been an increase in trade. There had been complete compliance
and no prosecutions for infringing the ban. A partial ban of the
kind proposed for England and Wales would have been unworkable.
ASH Ireland (Professor Luke Clancy)
ASH Ireland is a campaign group which was established
in 1992 as a joint venture by the Irish Cancer Society and the
Irish Heart Foundation. It aims to reduce the prevalence of smoking
and educate the public about the dangers of smoking.
The ban on smoking in public places was not a consumer
protection issue, a smoking cessation measure or an issue of tobacco
control. It was a measure for the protection of workers in the
workplace, based on human rights.
The ban had been important in effecting a significant
cultural change with regard to the public's view of smoking and
the harmful effects of SHS.
More comprehensive research was needed on the effects
of a ban on smoking in public, particularly on the economic impact.
It was hoped that the UK would conduct such research if it introduced
smoke-free legislation.
Department of Health and Children (Mr Eamon Corcoran,
Principal, and Mrs Siobhan McEvoy, Chief Environmental Health
Officer)
The Department clarified a number of outstanding
issues for the Committee.
The definition of a 'workplace' in the context of
a ban on smoking was the same as that to which health and safety
legislation applies - the ban on smoking was promoted largely
as a health and safety and worker protection issue. It was necessary
because ventilation was deemed "ineffective" to counter
the harmful effects of SHS. It was felt to be important to engage
with the trades unions in promoting the ban as a matter of workers'
rights.
Figures from the Central Statistical Office demonstrated
that bar sales declined by 4.4% in 2004, but this was part of
a trend which had begun in 2002. Cigarette sales, by contrast,
fell 8.7% in 2004 after a fall of only 3.4% the previous year.
There had been closures of rural pubs, although it
was not known how many. This should be seen as part of trend.
Many family-owned rural pubs operate on very small margins and
may close when a new generation inherits.
The impact of the ban overall on smoking is somewhat
unclear; however, the prevalence of smoking among the young remains
a problem. No evidence has been found to support a theory that
the ban has led to higher levels of smoking in the home; nor is
there any evidence of cross-border trade with Northern Ireland
increasing. Although there had been some decline in bar trade,
this could in part be attributable to anxieties about changes
in the licensing system; currently, pub licences may be sold,
often for substantial sums, but there are fears that deregulation
may reduce their value significantly.
The Irish model for a smoking ban was "coherent
and enforceable", and compliance has been extremely high.
The model proposed for England was not one which would have been
adopted in Ireland.
The Irish Prison Service (Mr Seamus Cramer)
There are currently 3,200 prisoners in custody, of
whom 100-120 are women. Smoking prevalence is extremely high;
between 80 and 85% of male prisoners smoke, while the rate among
women is virtually 100%.
The current policy is that prisoners are only allowed
to smoke in their cells or in outside areas. However, a more detailed
smoking policy for prisons is currently at a draft stage.
The Department of Health does not believe that the
European Convention on Human Rights applies to prisoners' right
to smoke.
The Irish experience demonstrated the importance
of local-level enforcement and pragmatism in allowing exemptions.
IMPACT and MANDATE (Mr Bernard Harbor and Mr John
Douglas)
IMPACT is the Irish Municipal, Public and Civil Trade
Union. It is Ireland's leading public sector trades union and
has 54,000 members in health, local authorities, the civil service,
education, community and voluntary organisations, semi-state companies
and aviation. MANDATE was formed in 1994 by the amalgamation of
IDATU (the Irish Distributive and Administrative Trade Union)
and INUVGATA (the Irish National Union of Vintners, Grocers and
Allied Trades Assistants) and is a union of retail, bar and administrative
workers.
The trades unions in Ireland were intimately involved
in the evolution and the implementation of the ban on smoking.
They stressed the importance of strong political leadership combined
with broad political consensus; of a level playing field as a
result of the regulations; and of significant penalties for non-compliance.
The level of public support for the ban was high and increasing.
They also emphasised the importance of the presentation of the
smoking ban as an issue of protecting workers in the workplace.
A survey conducted for MANDATE one year after the
implementation of the ban suggested that 80% of their members
felt that their health had improved.
Conclusion
The ban on smoking in public places was regarded
by most of the people we met as a success. The main factors in
ensuring compliance and public support have been:
- An emphasis on the issue of
the protection of workers' health;
- Strong and committed public leadership;
- Broad political consensus and engagement with
interested parties;
- A positive campaign to inform and prepare public
opinion;
- Clear and simple regulations which are easily
intelligible;
- Limited exemptions based on pragmatic decisions;
- A robust regulatory framework with significant
penalties.
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