Great progress has been made but almost a quarter of the population still smoke, writes Dr Michael Boland, chairman of the Office of Tobacco Control
The last year has seen the successful bedding-in of the smoke-free workplace legislation. However, despite this success, we have much work to do if we are to create a tobacco-free society in Ireland. In particular, we need to reduce even more significantly the prevalence of smoking in Irish society and deter young people from becoming addicted in the first place.
The numbers of people smoking here has been on the decline for a number of years now. The Slán Health and Lifestyle survey in 1998 showed 31 per cent of the adult population smoked; by 2002 this had reduced to 27 per cent. The Office of Tobacco Control's (OTC's) own monthly tracking survey, which we've been running for over two years now, indicates that during 2004 prevalence was 24 per cent and declining. This fall represents around 200,000 fewer smokers in Ireland or about one million life years saved.
The drop in the prevalence figures are a tribute to the many smokers who have succeeded in breaking free of this addiction.
Eight out of 10 smokers want to quit and in the past many tried repeatedly but failed, mainly because they were unsupported. The development of better supports for people who want to quit has now improved the success rate considerably. In particular, those who use nicotine replacement therapy are twice as likely to succeed. The investment in smoking cessation services by the health service and the invaluable role played by the voluntary agencies have also contributed to this success.
However, we should be careful not to be lulled into a false sense of security. While great progress has been made through our comprehensive tobacco control programme, much work remains to be done as almost one-quarter of our population is still addicted to this deadly product. This results in the loss of loved ones to more than 6,000 families each year, through smoking-related illnesses.
It is important to remind ourselves that smoking is not just a behaviour, but also an addiction. Smokers have, at least, as high a rate of relapse and addiction-
related mortality as do heroin addicts, and need the same level of support in fighting their addiction.
This must go beyond brief counselling and substitution therapy to more formal support and counselling. Indeed, the OTC's own Irish Women and Tobacco report suggests strongly that women need intensive, organised and prolonged support if they are to quit smoking, and that the nature of this support may be different from that needed by men.
Based on current trends, with lung cancer increasing by 3 per cent a year among women, support programmes need to be put in place so that this disease will not become a predominantly female disease by 2020.
Given the obvious difficulties people addicted to tobacco experience in quitting, it is imperative that we do all we can to deter people - particularly young people - from becoming addicted in the first place.
There is no doubt that the sustained public debate on smoking has raised young people's awareness of the dangers of experimenting with this highly addictive product. The debate has also resulted in the ending of tobacco advertising in the print media, better enforcement of the law and the introduction of higher prices for cigarettes - all of which have been decisive in achieving lower levels of prevalence. However, further action is needed if we are to continue with the downward trend in terms of the number of people smoking.
We know from a considerable body of international evidence that the single most effective measure in deterring young people and children from ever becoming addicted is real and significant price increases - without which cigarettes become more affordable. Government has introduced such increases over recent years, with the exception of last year. In line with the National Health Strategy and the Government policy document, Towards a Tobacco Free Society, we will be strongly advising Government to again increase tobacco taxes in next December's budget.
The country's retailers and the tobacco industry also have a major responsibility in ensuring that more young people do not become addicted to tobacco. The law prohibits retailers from selling tobacco products to under-18s but we know that it happens - far too often, indeed. Now that the smoke-free workplace legislation is well embedded, the OTC will be very much directing its attention to this issue. The tobacco industry must also act responsibly in regard to young people and we need to see an end to the point-of-sale tobacco advertising in our shops and an end to the glamorisation of tobacco.
• OTC , Clane, Co Kildare. Tel: 045 892015 or visit www.otc.ie