Smoking Ban - Made In Ireland

On March 29, 2004, the Irish government implemented a law banning smoking in the workplace. This was the first law of its kind in Europe and represented the culmination of many decades of antismoking legislation and campaigning.

As early as the 16th century, people in Ireland recognized the problems with tobacco consumption. One of the earliest references to these problems was by the priest and poet Brian Mac Giolla Phadraig, who, lamenting the decline of his native country, attributed it at least in part to "a stoc tobac 'na clab da lantseideadh" (tobacco pipe in jaw, at full blow). Despite this recognition, tobacco consumption increased in Ireland and was widespread among all classes of society. Insidiously, it became associated with alcohol consumption, and a common practice in Ireland from the 17th century to the 20th was to give out small pipes of tobacco (duidins) along with copious alcohol at wakes and weddings.

In the 1830s, the great temperance crusader Father Matthew railed against the evils of alcohol but did not attach the same importance to tobacco smoke, believing it to be a lesser evil. The use of cigarettes spread in Ireland, particularly after the First World War, and for some time, the harm caused by cigarette smoking fell below the radar of most health care professionals and the general public. Although articles addressing the health effects of smoking began to appear in medical journals by the early 20th century, it was not until 1952 that this issue was brought to the attention of the general public. In that year, Reader's Digest published an article entitled "Cancer by the Carton," outlining for the first time to a lay audience the health implications of tobacco use.

As early as 1964, the Department of Health and Children in Ireland adopted an integrated approach to the control of tobacco consumption, involving both statutory and voluntary controls on industry's behavior with respect to the environment, as well as health education. This approach evolved, leading to a series of laws prohibiting the advertising of tobacco products in the electronic media and placing restrictions on access to advertising in the print media. In addition, the level of spending on advertising and sponsorship by tobacco companies was controlled by law. Ireland also imposed a policy that kept prices on tobacco products high through a system of retail-price management and taxation; the country had one of the highest tobacco taxes in the European Union, and retailers were permitted to sell cigarettes for no less than 97 percent of the price set by the government. Multimedia educational campaigns were also introduced. A voluntary prohibition on smoking in the workplace was developed by the Health Promotion Unit of the Department of Health and Children with the support of the Irish Congress of Trade Unions, the Irish Business and Employers Confederation, the Irish Cancer Society, the Irish Heart Foundation, and the Health and Safety Authority. This code established, in the area of tobacco control, the consultative approach between industry and the trade unions that had proved so successful in economic development and that would be pivotal to the success of any legislation in the area of tobacco control.

The result of these measures was a reduction in the prevalence of smoking from 45 percent in the mid-1970s to about 28 percent in the early 1990s. However, there was still evidence of a major tobacco-related health crisis in Ireland. In 1994, Ireland ranked 12th among the 15 countries in the European Union with regard to life expectancy for women and 9th with regard to life expectancy for men. Heart disease and cancer were the principal causes of premature death, with coronary artery disease accounting for 1 in 4 deaths at all ages and stroke accounting for 1 in 10 deaths. Mortality from cancer in Ireland, particularly lung cancer, remained significantly above the average for the European Union. In 1989, the proportion of deaths in Ireland that were attributable to smoking was 21.2 percent. These data did not take into account the enormous morbidity also associated with cigarette smoking.

There were a number of weaknesses in the programs aimed at tobacco control. Public awareness of the problems and agreement about the need for tobacco control were perceived to be vital not only for better health among the population, but also for the support required to pass effective legislation. In 1999, the Oireachtas (Parliament) Joint Committee on Health and Children, composed of politicians from across the political spectrum, examined the issue of smoking and health. They sought the views of a wide range of groups, including representatives of the tobacco industry. The committee unanimously recommended a revised antismoking strategy. One of the most important outcomes of this process was the establishment of the Office of Tobacco Control. In 2001, a tobacco bill was introduced that gave the minister for health and children the power to create smoke-free working environments. This bill was signed into law in 2002, but there was still disagreement about how widely these restrictions should be applied. The same year, the Office of Tobacco Control, together with the Health and Safety Authority, commissioned a pivotal report on the evidence of deleterious effects of secondhand smoke. The conclusions of this report were so damning that when it was released in January 2003, Minister for Health and Children Micheal Martin announced that he