Sub-Committee on Health and Smoking

The sub-committee met at 9.30 a.m.

DEPUTY BATT O'KEEFFE IN THE CHAIR.

Chairman: The Sub-Committee on Health and Smoking is now in public session. Today's meeting is the third of four scheduled meetings when evidence will be heard from a cross-section of interested parties. While witnesses have agreed to appear voluntarily before this sub-committee, evidence is being heard under oath under the provisions of the Oireachtas Witnesses Oath Act, 1924. I welcome to our first session this morning a delegation from the Department of Heath and Children. We have Tom Mooney, Deputy Secretary, Noel Usher, Principal Officer, Chris Fitzgerald, Principal Officer and Gearoid Ó Dufaigh, Assistant Principal.

Mr. Tom Mooney, Mr. Noel Usher, Mr. Chris Fitzgerald and Gearoid Ó Dufaigh were sworn in by the Clerk to the sub-committee.

Chairman: The delegation will make an opening statement which will be followed by questions from members. We are hoping this opening statement will be confined to 15 minutes. I would like to advise the witnesses that while Members of this sub-committee have absolute privilege this does not apply to witnesses appearing before it. I would like to bring to the attention of witnesses and Members the fact that under the provisions of section 10 of the Committees of the Houses of the Oireachtas (Compellability, Privileges and Immunities of Witnesses) Act, 1997 certain rights are granted to persons who are identified in the course of the committee's proceedings. So persons being invited before the committee are made aware of these rights and any persons identified in the course of proceedings who are not present may have to be made aware of these rights and provided with a transcript of the relevant part of the committee's proceedings if the committee considers it appropriate in the interests of justice. Notwithstanding this provision in the legislation I should remind Members of the long- standing parliamentary practice to the effect that Members should not comment on, criticise or make charges against a person outside of the House or an official either by name or in such a way as to make him or her identifiable. I now invite Mr. Mooney to make an opening statement.

Mr. Mooney: Thank you, Chairman. At the outset, my apologies, there was a gremlin in the works but a copy of my statement is on its way. Do you want me to wait or do you want me to -----

Chairman: Fire ahead.

Mr. Mooney: We will have it in a second. Thank you very much, Chairman. Our early concern was that towards the middle of the twentieth century some statistical data indicated that there was a correlation between cancer and smoking of tobacco products. Other studies reported that smokers do not live as long as non-smokers. Further scientific studies and reports in the early 1950s gave rise to a public awareness and concern over possible health damage from use of tobacco products. In 1964 the US Surgeon General released a report entitled "Smoking and Health" which concluded that cigarette smoking is causally related to lung cancer in men and to a lesser extent in women. Since then the dangers of smoking and its detrimental effect on human health have been clearly established in numerous scientific studies carried out by reputable medical and scientific bodies including the World Health Organisation, particularly over the last 30 years. Evidence has accumulated year on year of the enormous worldwide threat to human health from consumption of tobacco products. Furthermore studies carried out internationally in recent years have also confirmed that there is a significant risk to the health of the non-smoker from inhaling tobacco smoke referred to as passive smoking.

Just a brief look at the levels of smoking in Ireland, the results of the Survey on Lifestyle, Attitudes and Nutrition, the SLAN survey published on behalf of the Department in 1999 provides the most up to date baseline data on smoking prevalence in this country. These data showed that, on average, 31% of the population smoke and this is an increase on previous statistics of 29%, and the smoking prevalence for GMS patients was 36%. Overall, 49% of children reported that they had ever smoked a cigarette and by the age of 15-17 years a third of both boys and girls are current smokers and 40% of girls are smokers in social classes 5 and 6. Eighty per cent of all smokers became addicted to tobacco between the ages of 14-16 years. More young females than males are taken up the habit and they are less likely to quit once they have started. And 80% of smokers indicated that they had an intention to quit or that it was their wish to stop smoking.

Tobacco use and, in particular, cigarette smoking remains the leading cause of preventable illness in the country. Tobacco is a significant burden on individuals, families and society through death, illness and medical costs. Our success in improving the health status of the nation is linked to reducing the level of tobacco usage and, in particular, preventing young persons from starting to smoke. If the increase in tobacco use by young persons can be reversed we can make considerable progress towards a tobacco free society. The priorities of Government policy in this area are outlined in reports such as Towards a Tobacco Free Society, Building Healthier Hearts and the Health Promoting Strategy 2000-2005. The addictive nature of nicotine in tobacco products is a key element in people continuing to smoke. The real and horrific nature of that addiction, which was known to the tobacco industry for many years, is only now being fully understood by the public health agencies.

Putting in place programmes to curb that addiction are an essential feature of the anti-smoking initiative. There are a number of diseases, such as lung cancer, heart disease, emphysema and chronic bronchitis which are largely caused by tobacco consumption. About 7,000 deaths each year in Ireland are directly attributable to smoking-related diseases. Smoking is a major causative factor in about 90% of the 2000 deaths from lung cancer each year. Smoking increases the risk of other cancers such as cancers of the mouth and of the throat and smoking is a primary cause of cardiovascular disease which is the greatest single cause of mortality in Ireland. Most people who use tobacco begin as children. About 80% , as in the survey I quoted earlier, of adult smokers in Ireland begin their addiction before the age of 16 years. Because they start young, they have more difficulty quitting, are more likely to become heavy users and are more likely to develop a tobacco-related illness in adulthood. Smokers who start in adolescence and continue to smoke regularly have a 50% chance of dying of a tobacco-related illness.

Inhalation by non-smokers of environmental tobacco smoke, or ETS as it is known, or passive smoking is also a significant health hazard. ETS contains almost 4,000 chemicals, about 60 of which are known carcinogens. Young children exposed to ETS, particularly in the home, are at risk. Children exposed to ETS experience increased rates of bronchitis, pneumonia and ear infections, exacerbation of chronic respiratory symptoms such as asthma, reduced rate of lung growth and an increased risk of death from sudden infant death syndrome. Studies have shown that non-smokers who live with smokers have an increased risk of heart disease and the greater the exposure, the greater the risk. Other studies have shown that passive maternal smoking increases the risk of low birth weight babies.

On environmental controls, I should mention that there are an extensive range of these already in place. Smoking, for example, is prohibited in public access areas in all buildings used by the State, in public access areas in banks and building societies, in cinemas, theatres, concert halls, indoor sports centres, bingo and bridge halls, in pre-schools, crèches and day nurseries, schools and school yards, supermarkets, grocery shops and butchers' premises; on all buses and all DART and Arrow train services and taxis and hackney cabs; in hospitals, nursing homes and most health facilities, in doctors' and dentists' waiting rooms and retail pharmacies. And I think that generally the prohibition on smoking in these areas is well accepted and well respected with, I think, the occasional well-known difficulties relating to late night buses. Nevertheless there is a need for increased environmental controls on smoking and for better enforcement of these controls in order to protect persons from ETS.

In allocating funds each year to health agencies, we do not distinguish between the funds for tobacco related diseases and other costs and while there are a number of diseases such as lung cancer, emphysema, and heart disease associated with tobacco consumption, it is not always the causative factor. There are a range of factors which could be taken into account in attempting to accurately compute the cost of smoking related illness to the State and which could produce a variety of results. These could include costs of treating unborn infants, costs of maintaining those too ill to work from smoking, the cost of treating non-smokers made ill by passive smoking, and the cost of anti-smoking health initiatives. Figures ranging from £400 million to £1.6 billion have been suggested as possible costs to the State in dealing with tobacco related illnesses. Perhaps there is a need for a formal evaluation of the cost to the health services, or indeed society as a whole, of tobacco related illness and death. However, given the wide disparity in the estimates which I have just quoted there, if we are to proceed in such an undertaking we would want to agree the social and economic parameters before setting out on the exercise. And it should be noted that statistical data on deaths from cancer, heart disease and respiratory illnesses associated with tobacco consumption do not state tobacco as the cause of death.

With thousands of their Irish customers dying each year from consumption of their product, the Irish tobacco industry is reliant on recruiting new smokers each year if it is to remain a viable industry. Studies show that most adult smokers commence their addiction in adolescence and logically the industry needs access to young people to gain new smokers. Advertising and sponsorship by tobacco companies has been the main method of inducement of persons, and particularly young persons, to consume tobacco products. The industry is a market based one with a strong commitment to advertising. Now, existing legislation already provides that a general health warning is required on all packaging of tobacco products and on advertising. Since May 1990 tobacco packaging must carry an approved statement indicating the risk associated with the use of tobacco and to the health of persons. Currently we have nine different types of health warnings used to inform persons of the dangers to their health from smoking. The statement "tobacco seriously damages health" must appear on the front of all packets and the back of the cigarette packets must also carry a statement indicating risk to health. These are listed there. In the interests of brevity I won't go through them but they must appear on the back of packaging or rotating sequence.

Numerous anti-smoking campaigns and initiatives advising of the danger to health from smoking have been and are being carried out as part of the Department's health promotion policy and strategy. Health boards and non-governmental organisations such as the Irish Cancer Society and the Irish Heart Foundation actively participate in these programmes and initiatives. Relevant public awareness campaigns, coupled with strong legislative controls and appropriate fiscal measures, will help to reduce the number of people, particularly young people, who smoke.

Since 1986 the Department has restricted the spending by the industry on advertising and promotion of tobacco products. Advertisement sponsorship budgets for tobacco companies were capped by the Minister for Health and Children and in recent years reduced. The content of advertisements is also regulated and the media that could be used for tobacco advertisement was restricted. Cut price offers, gifts and sales promotion devices were prohibited. Ireland has for many years been the leading advocate of tobacco control and the measures introduced regarding advertising were subsequently adopted by other countries.

Up to July of last year the tobacco industry in Ireland was spending up to £8 million each year on advertising and sponsorship of their products. Major events sponsored by the industry included the Irish Open Golf Championship sponsored by Carrolls, the Tops of the Towns Variety Competition sponsored by Players and the Irish Masters Snooker Championship sponsored by Gallaghers. Numerous local events and activities around the country were also sponsored by tobacco companies. Despite denials by the industry, tobacco advertising is, in our view, effective in increasing consumption of tobacco products.

Finally, since July of last year advertising and sponsorship budgets were reduced to zero, effectively ending the ability of the tobacco industry to advertise and promote its products. Currently only limited instore and trade advertising is permissible and the new Tobacco and Public Health Bill will provide for the ending of this instore advertising as well. This a proud tradition of leadership in this area and we are determined that Ireland will continue in this role and particularly in our associations with the EU and the WHO.

I have already referred in general terms to our anti-smoking campaigns and initiatives, which incidentally, is by far the most important single-dimensional programme in our Health Promotion Unit's schedule and the following are some brief specific examples that we have then.

Break the Habit for Good is the most recent anti-smoking campaign. Break the Habit for Good was launched in December 1998 in association with the Irish Cancer Society and the health boards. The campaign takes a slightly different approach to previous campaigns and emphasises the positive effects which quitting smoking can have on the individual. The campaign involves national and local initiatives, which offers support to those people wishing to give up smoking. The budget for anti-smoking initiatives for 2000 was £1.276 million and £1.5 million in 2001. Initially the Break the Habit for Good campaign used radio and print advertising and developed an Advice Kit as a support for those who wanted to quit. The Break the Habit for Good campaign was aimed at the general population highlighting the positive effects which quitting smoking can have on the individual, e.g. they can live longer, save a fortune, save their money, and as young teenagers do not easily identify with issues such as "live longer" it has been found that the desired impact on young teenagers has not been attained.

NICO was developed in 2000 as part of the Break the Habit for Good campaign to target the growing number of young teenage girls, particularly in social class 5 and 6 who are smoking and who are starting to smoke. This anti-smoking campaign targets young females and emphasises the negative effects smoking can have on physical appearance, such as stained teeth and wrinkled skin or whatever and the storyline is there is nothing sexy about smoking. The media used are TV, radio, outdoor and newspaper advertising. Television is a proven useful resource in accessing young people. Strategically located outdoor sites - such as those adjacent to schools and colleges - complement the TV and radio ads.

On School Based Initiatives the broad based public awareness campaigns can be successful but the best prospect of reducing the number of people, especially young people, from stopping smoking or not starting is a targeted approach. In this regard, initiatives such as the Social, Personal and Health Education, known as the SPHE Programme, are particularly important. From September 2000 an SPHE Programme is offered at junior cycle level, to post primary schools nationwide through a partnership between our Department, regional health boards and the Department of Education and Science.

Social, personal and health education is a broad based health education programme which aims to enhance the self-esteem and decision-making skills of young people using experiential learning methodologies. The implementation of the programme will ensure that there is a co-ordinated approach between health boards and the Department of Education and Science at regional level in a way that has never formally existed before. The Department of Health and Children is fully committed to ensuring that this process is a success and that a secure place will be established for health education within the school system to complement the work that has already taken place in many health boards.

The Department of Health and Children also recognises the importance of the out of school setting for delivering health messages to young people. The Department has again teamed with the Department of Education and Science and with the National Youth Council of Ireland to provide a wide range of health promotion training for the youth sector through the National Youth Health Programme. This programme aims to promote the notion of a Health Promotion Youth Service, thereby ensuring that the messages young people receive in school are mirrored elsewhere. In March of last year the Minister for Health and Children launched a report Towards a Tobacco Free Society which all of us here were involved in and following on from that a number of recommendations have been implemented.

I will just quickly go through these, Chairman, as I'm conscious that the time is slipping by. The ending of tobacco advertising and sponsorship has been much in the news where we have set the budget for them at zero and advertising in the print media has been banned because we feel we have to stop the predatory marketing practices of the tobacco industry to ensure that today's children will not be the future victims of the tobacco epidemic. The Office of Tobacco Control will have an important role to play in monitoring the activities of the tobacco industry in this area and in commissioning research into the marketing practices of the industry, and I understand that you are meeting them immediately after us so I won't go into any details with them.

Following the ending of the sponsorship of events and activities by tobacco companies last year the Minister for Health and Children provided funding for sponsorship of the Irish Masters Snooker Tournament in 2001 of £200,000. A similar amount will be provided in 2002 and 2003. Health sponsorship of this prestigious international event will further highlight the healthy anti-smoking message and promote a tobacco-free society. The extensive television coverage of the event involving many well-known young snooker stars brought home to viewers, especially young people, the positive aspects of not taking up smoking and of quitting smoking. The message is consistent with Government approved health policy on tobacco and health.

On compliance, additional resources totalling £1 million pounds have been made available to the health boards this year to recruit additional staff to improve enforcement and compliance with the law in the area of tobacco control.

We have taken a significant step in making nicotine replacement therapy available to all people on medical cards who wish to give up smoking. And the age limit for the sale of tobacco products to young persons has recently been raised from 16 to 18 and the maximum fine for persons convicted of selling tobacco products to underage persons has been raised from £500 to £2,000 and this will act as a further deterrent to retailers.

The Minister has recently expressed his concerns over passive smoking and is considering initiating new measures under existing laws to provide for increased protection for persons from ETS. The new Tobacco Health and Promotion Bill will introduce a range of measures to further the recommendations contained in the report Towards a Tobacco Free Society which was launched by the Minister with Government approval last year. The Minister hopes, subject to clarifying some legal points, to publish this comprehensive Bill by the end of this month and these measures will include prohibiting the sale of cigarettes in packets of less than 20, ending of in-store advertising and promotions which are directed largely at underage persons and the registration of all tobacco retail outlets.

The Office of Tobacco Control, administratively set up last year to co-ordinate national tobacco control programmes, will be statutorily established under this new Bill, and a new tobacco research function is being established which will support the development of a tobacco-free society. The main aims of this initiative will be to promote and develop academic excellence in tobacco and health studies and advance public health largely through research into tobacco marketing. The Office of Tobacco Control will be closely involved with this initiative.

I referred to the different types of health warnings which are currently provided for in law to inform persons of the dangers to their health from smoking. A new European Union Directive was adopted by the European Parliament on 15 May this year on the sale, marketing and manufacturing of tobacco products. The directive sets out rules based on scientific advice on key issues such as additives, addictive substances, health warnings and misleading claims evidence. The new directive requires larger health warnings on tobacco products covering between 30% and 40% of the surface area. More precise information on additives, reductions in levels of carcinogenic materials and more precise and reliable methods of measuring ingredients levels will also be required. Transposition and implementation of the Directive by a national law will further advise and warn consumers and third parties of the dangers to health of smoking. Public health success in reducing tobacco use requires activity on all fronts. We believe that when we have these additional legislative measures in place and the office of tobacco control is placed on a statutory footing and with the additional resources being made available for health promotion activities and research and information activities, Ireland's reputation will be confirmed as in the vanguard at European level in the fight against tobacco. And finally I just might mention the initiative which the WHO is taking on a framework convention on tobacco with the object of introducing world-wide controls on the tobacco promotion and tobacco industry. This is something that we very much welcome, we have offered our full support and have taken our full part in the negotiation sessions that have taken place to date.

Chairman: Thank you very much Mr. Mooney. The cost to the health services, the figure from £400 million to £1.6 billion is a very wide figure.

Mr. Mooney: As I said there Chairman, it depends on the parameters which we bring into play. We can cost for example, you can get some magnitude of the cost at least by looking at the treatment of diseases which have been caused by smoking, what we spend on health promotion and enforcement agencies. What is far more difficult to cost are things like the social costs or the suffering, the out of work, the economic loss, the various social welfare payments that come in and as I said we think there is scope for such an exercise there but before we would launch on that I think we would need to agree on all the parameters and what is to be included or what's not to be included.

Chairman: Yes, I think one of the things we would be critical about is the fact that almost two years ago, this sub-committee's report was published and one of the things that was suggested in that report is that we would in fact look at the overall costs to the health service. I know a previous secretary general of the Department indicated that it would be in the region of £700 million. So that every time the Department of Health comes before us we get varying figures and I'd say we would all be in tandem that it is now time to define exactly what the costs are so that we know exactly what it is costing us every year and where we can go from there. What is the position in relation to the Department and the Government taking a case against tobacco companies? The Minister indicated some time ago that he referred this matter to the Attorney General. Is there any update on exactly what advices are coming back from the Attorney General in this area?

Mr. Mooney: I don't have any update on that, Chairman. You're quite correct in saying that we have asked for the advice of the Attorney General in this matter. The Attorney General has appointed Senior Counsel to look at the whole broad aspect of the thing. We know that they are working because we have briefed them and we have spoken to them but I can't say when they are likely to report to the Attorney General or what the interaction between the Attorney General...

Chairman: Would you contact the Attorney General after this meeting and request that the committee would be informed when exactly they are expecting this particular advice to be made available? And the final question I want to ask you is that you are saying that the 4,000 chemicals about 60 of which are carcinogenics in ETS (environmental tobacco smoke). Have the tobacco companies at this stage given an absolute clear cut indication of what the make-up of a cigarette is and the ingredients in that cigarette and can you confirm to me that in law they're obliged to do so?

Mr. Mooney: There are two things. One is that, in our view, they are obliged in law to do so and they have provided us with the ingredients and make up of the various products. I would say that the figure of 4,000 that you quote is not of products that are going to the cigarette in their manufacture, it is the gases and vapours which are given off when the thing is lit. But there is a much shorter list of ingredients to go into cigarettes, in the manufacture of cigarettes.

Chairman: Are you absolutely satisfied that the information that you have received in terms of the make up of cigarettes is correct?

Mr. Mooney: We cannot be certain of that. We have to assume, at this point, that the information which the tobacco companies have given us is correct. But, we will be taking, be seeking to take, broader powers in relation to, our powers to get the information from the tobacco companies and to insist on various research and that being carried out under the new Bill, which is coming forward. These are powers that we don't have at the moment. But we will...

Chairman: And will they be included in a new Bill?

Mr. Mooney: Yes, and we will be seeking - which will put us in the position of being able to, I suppose, to answer the question that you're asking, to verify the accuracy of the data and the information which is given to us, something that we're not in a position to do at the moment.

Deputy G. Mitchell: I thank Mr. Mooney and his colleagues for their presentation. Mr. Mooney, will you give the sub-committee an absolute assurance, as far as you can, that in the efforts which will be taken to tackle passive smoking, particularly in places like public houses, there will be no half measures, that the moves will be strong, stringent and applied? It is time that in public houses in particular, where people like myself, my family, my constituents and the general public are most threatened by passive smoking, strong action was taken. So in the measures you are taking, will you please confirm that will be the case?

We had Professor Luke Clancy yesterday. You know Professor Clancy is a noted authority in the area of respiratory problems. One of the things he told us is the budget for St. James's Hospital is something like £170 million, and he suggested that maybe as much as half of those admitted to the hospital were admitted because of smoking related illnesses. He also said that lung cancer is the single commonest fatal malignancy and that 90% of the cases are preventable. He went on to describe our approach to lung cancer as a country as mystifying. Can the Department explain to the sub-committee why it is that the average number of lung cancer deaths in Ireland is 2.4 times greater than breast cancer deaths but that according to Professor Clancy, who is the Medical Director of Peamount Hospital, no clear lung cancer strategy or clear allocation of money for lung cancer services in particular for the treatment of lung cancer exists? I would like a specific reply to that question.

Could the Department confirm that there is not one hospital consultant in the health services to deal specifically with smoking related diseases, smoking cessation or the health promotion of non-smoking? This is again according to Professor Luke Clancy in his submission to the committee yesterday. One of the things that appears to put people like yourselves and ourselves on the back foot is the success of the tobacco industry in marketing. What steps have been taken and have you commissioned any studies into establishing the principal methods used by the tobacco industry in creating a successful marketing campaign and how that might be counteracted? The Chairman has already raised the question of suing the tobacco industry. I presume we will be getting a further report from you on where that is at. According to page 70 of the Joint Committee Report of the National Anti-Smoking Strategy, the overall public health expenditure for 1998, when the report was written, was £3.18 billion and the State budget for health promotion for 1998 was £6.19 million, being 0.19% of the overall health expenditure. Now the proposed health expenditure for this year is over £5 billion. What is the actual figure for the expenditure on health promotion and what percentage of overall health budget does this represent for the coming year?

Mr Mooney: Chairman, on the actions to be taken, Deputy, in relation to environmental tobacco smoking and environmental control, well firstly, I suppose we have to await the passage of the Bill and we will vigorously impose whatever emerges from that. I think the Minister for Health and Children will be seeking to take wide powers in the Bill to enable them to ban tobacco smoke in a wide variety of areas. I think that we are particularly concerned about places such as employment and people in enclosed workspaces. You mentioned a particular instance of smoking in pubs, we in the Department of Health would be very keen to try to find a way of banning smoking in pubs, we have been talking to the Vintners' Associations, we recognise that these clean air systems and all the rest are an advancement but are still nowhere near enough and certainly I think that there are areas that we are very concerned about, like for example, pubs where food is prepared. We would also try to seek to ensure, if there is more than one room, or more than one place there, that at least one of them would be non-smoking. However -

Chairman: Our report suggests that you ban it in public houses.

Deputy G. Mitchell: The question was Mr. Mooney, can I go for a pint without smoking somebody else's cigarettes? That's all I want to be able to do and for my constituents to do and I think it's time we did it. I am a legislator and I am asking you to put that in the legislation.

Mr Mooney: I think that the legislation which the Minister will be bringing forward in the next month or so will make provision to take powers to do that sort of thing. At the moment we just do not have powers like that, other than by discussion and persuasion. By and large, that approach has worked very well, as I said in the statement, the environmental controls that we have in place are generally well respected by the public and we think that encouraging that sort of move is by far the more positive way to go, that in general the top-down, the directional approach, tends not to work in relation to smoking. It tends to be much more effective if you can build support from the ground up and gain wide community support, but we would agree fully with the Deputy if it was possible to ban smoking in pubs.

You also mentioned the fact in relation to half the patients in St James's, well if Doctor Clancy said that, I assume that he has the figures, and our own general feeling is that probably would be about right anyway.

You also mentioned the fact that there is no specific strategy in relation to lung cancer. That may be so, but there is the cancer strategy that was introduced by the Minister for Health dealing with cancer in the broader sense, and lung cancer would be dealt with as part of that. Lung cancer would be one of very many cancers and generally I think if we were to try to have a strategy in relation to all of them, it could be a very disparate sort of service, but certainly I think that the preventable nature of lung cancer is the sad point about it. The Deputy, I think, said 90%, some of the figures, 85-90%, it's in around there, there is general international agreement that that is the level of lung cancer which is caused by smoking so the tragedy of the thing is that it's a preventable cancer, and almost 85-90% can be prevented by smoking cessation, by not smoking.

You mentioned the fact that we said there is not one consultant to deal with smoking. Well, again, the consultants, I suppose deal with the tobacco related illnesses. The number and type of consultant is regulated by Comhairle na Oispidéal as a statutory body. I don't know how they might react to that but we do have though a Professor of Health Promotion in University College, Galway which we funded and which we would see as perhaps, I think, covering some of the area that Dr. Clancy may have had in mind in relation to that, but we can follow that forward.

On marketing, we are quite convinced that the marketing of cigarettes, although the advertising and promotion, although this is denied by the tobacco industry, we are quite convinced that this is a major determinant of the levels of smoking and, as I say, rather that spend too much time doing the type of studies that the Deputy was saying there, we have perhaps gone in with a fairly blunt instrument of wiping out their budgets and banning it in all of the media, including the print media, but one of the issues, under the auspices of Tobacco Control we are setting up this research institute and one of the issues that the research institute will dig into will be an academic and a much more focused research into the whole advertising and tobacco. This will be a dedicated agency which can devote itself to that sort of work and hopefully provide us then and you with the evidence to take action against them. Perhaps I might ask Mr. Fitzgerald to talk about the health promotion budgets at which the Deputy will ask questions ...

Mr. Fitzgerald: In relation to the health promotion budget, the budget for this year is approximately £6.9 million which you would be comparing to something in excess of £5 billion. So that is the figure I have to say for national spend that the health promotion unit, which I am responsible for, has available to it. It is an additional figure obviously which has been built up over the last number of years at health board level and we have been investing over the last five or six years at building up capacity at health board level to enable the health boards to take much greater ownership in terms of health promotion initiatives on the ground and we reckon there is approximately £6 million available to the health board and that is protected, ring-fenced, if you want, budgets that are available to the health boards so that would bring the total spend between what's available to us nationally and what the health boards have to something in the order of £12 or £13 million.

In addition to that under the cardiovascular health strategy which we have been rolling out over the last year and a half, considerable extra funding has also gone into health promotion initiatives in a very broad sense of that. In fact the emphasis within the cardiovascular health strategy falls largely on the prevention of heart disease rather than on the curative or treatment side of it. Under the cardiovascular strategy so far, for example, considerable extra resources have gone into smoking cessation services at health board level including the creation of new posts of smoking cessation officer. So all of the boards have taken on new people with a specific remit in relation to smoking cessation and the plans I know for 2001 will see a considerable growth in that sort of service being available at health board level. We have also invested through this in what we call a brief interventions programme which is a programme aimed to skill up general practitioners to be able to intervene in the context of normal consultations with their patients in the area of smoking cessation.

If I could mention something which is relevant to what Mr. Mooney was talking about a moment ago, under the cardiovascular health strategy there are proposals to increase considerably the number of consultant cardiologist posts and in fact there is a sub-committee of Comhairle na nOispidéal looking at that at the moment but the expectation is that there will be considerable growth in the number of consultant cardiologists posts coming under that and many of those will be what are described as non- interventionist cardiologists. So a very large part of their emphasis in fact will be on health promotion and on advice for patients in relation to lifestyle which would include smoking so whereas it is not coming in the context of cancer which is the issue under which Deputy Mitchell raised it, it will be coming in under the cardiovascular strategy as well.

Senator O'Meara: I thank the members for coming this morning and speaking to us on this very important matter. I would like to acknowledge the work that is being done. When one goes to other countries, particularly other European countries, one can see that we are encouraging generally a non-smoking environment in the workplace and so on. We only have to think of our own experiences over the past two decades in particular to see how things are changing but clearly we are not doing enough. The statistics speak for themselves - 31% on average of the population are smokers. You said there was an increase from 29%. Despite all the measures that are being taken, there has not been a decrease in the number of smokers. If anything, as you say, there has been an increase in the number of smokers. Now, possibly, the number would have increased even more if the measures that are being taken had not been taken, but we don't know that, in fact. What we do know is that the number is not going down, there are very serious statistics in relation to young people and, for instance, 36% of GMS patients are smokers; a third of those between the ages of 15 and 17, and those figures speak for themselves. We are clearly not adopting aggressive enough strategies. When you look at the experience of areas where aggressive strategies are being adopted you can see that there are results. We have evidence from California, Massachusetts and Florida which show that over a ten year period of an aggressive approach using legislative, educational and other measures the rate was brought down from 30% to 20% over ten years. So clearly, we have to examine the areas where it's working, and look at how we're going to adopt those strategies to make it work.

The second point I want to make is linked to that, this issue of the cost to the public health purse of smoking. I am shocked at the fact that we don't know the actual cost to the health system generally, of smoking. You say that perhaps there is a need for a formal evaluation of the costs; there is clearly a need. When Professor Luke Clancy says that lung cancer is the single commonest fatal malignancy of men and women and you referred yourself to cardiovascular disease linked to smoking; he says that we know that at least 90% of these deaths from lung cancer are preventable if we can eliminate smoking, when at the same time, only one in six cancers is curable. From a public health point of view, we are allowing a situation, we are simply basically standing by and allowing a situation where people are dying, or are in very bad health, as a result of something that we can do something about, in other words, smoking. I don't accept that we can't get a breakdown of the cost to the health service of smoking. For instance, every winter, there's a huge increase in the number of people who turn up at hospitals with respiratory illnesses, bronchitis, emphysema and other respiratory illnesses directly related to smoking. We were told during the smog era that there was a direct relationship between the smog problem and people turning up in hospital with increased asthma and so on. I don't accept that we can't be told how many beds are occupied with people with smoking-related illnesses; how many lung cancers are related to smoking, and therefore the ongoing cost of that, and indeed the other costs. I just don't accept that we can't get a breakdown. If the Department is not doing that, to me there is something very wrong.

The public must know the cost to the public purse of smoking, only then can we move into a situation saying, this is the cost to us of smoking, next question, what are we going to do about eliminating that? It seems to me, and I said this yesterday, and said it last week, that we are standing idly by and allowing a major health problem to continue in front of us. We express huge concerns about the issue, but the question is, why are we not getting the figures, and when will we get the figures? Thank you, Chairman.

Mr. Mooney: The first one, as to whether we are aggressive enough or not, I would agree with you; we would like to be in a position to be far more aggressive. But having said that, I'd like, I think as you acknowledge yourself, we would, short of the two or three places that you mentioned in the States, we would be very much in the van in relation to smoking controls and that. In fact, some people who come to visit, I'm sure you've experienced the same thing yourself, they do find it strange that smoking is so restricted here, and that the advertising, they suddenly don't see them on the streets and you see them when you go abroad and that. So, on the one hand I suppose we would claim that we are very much to the forefront of that, but we agree that more can be done, and this is I think the whole purpose of some of the initiatives which I outlined to you there, and the new legislation which is coming along, looking particularly at what is happening at EU level and at WHO level and that; and that we can piggyback, so to speak, on that as well. I had to skip through some of the things there in the interest of time, even though when the EU Directive was struck down in the European courts, we still forged ahead with our own legislation irrespective of that and we did try to do that. Now, you see, Deputy, I think even the way you phrased the question indicates some of the difficulties but that's not to say that we won't try to get - I mean, from the health services point of view I think we can get strong and very good estimates of what it is costing us. From the public purse point of view, though, which was the way you phrased it at the end, it's a very much different thing, as I said earlier there, in relation to things like social welfare payments, the lack of sick leave and all that sort of stuff and I think it's at that area you begin to get in, as I said, that if we were to do a comprehensive study of that we would need to set down clearly the sort of parameters that we need to do there but from our point of view ------

Senator O'Meara: From the health service point of view -----

Mr. Mooney: From the health service point of view, and particularly from the hospitals' point of view, it's quite, and that was the figure I think that the Chairman mentioned earlier, of the £700,000 which we had calculated at one stage but that would be a very incomplete and partial cost of smoking to society or even to the public purse but the research institute which I mentioned earlier that would be a key area of where they would be able to dedicate some expertise and research power into looking at that as well and that would be one of the issues which we would expect them, ask them to look at.

Senator O'Meara: Can you give us a breakdown of the costs to the health service?

Mr. Mooney: Yes, we will get that for you, Deputy. I think you mentioned also as well the numbers of bed days and that with smoking related diseases. We can do that, yes, but again bed days for smoking related diseases and bed days for smoking would be two different things.

Deputy Keaveney: I thank the Department for coming here today. Professor Clancy yesterday was talking about BSE, foot and mouth and when a couple of sheep were going to be ill the Border was closed and nothing could move. In terms of foot and mouth it could ruin an industry but it was not going to kill an individual whereas while we acknowledge that 7,000 people are killed each year from smoking yet we do not seem to have a fraction of a reaction in respect of it. You said that £8 million was spent by the industry on advertising to encourage you to smoke whereas your entire budget, and I assume that smoking is not the only thing you deal with when you talking about health promotion, is £6.9 million. Even with the £6 million from the health boards that is £13 million take out what other targets are there. It is quite scary when you hear 90% of lung cancer is preventable but nearly all people with lung cancer in Ireland are smokers. It is higher than the international average. I just wonder what your comment is in relation to Professor Clancy who yesterday said that it is a very inexpensive disease in Ireland, lung cancer, because people are just let die. There is nothing that they can do. I want to know if cardiovascular disease and lung cancer, we're talking about smoking not being sexy, is it not a sexy enough subject to be going in with all guns blazing? If we have a budget that is not even merely comparable to the advertising that the tobacco industry is doing, taking all the other advertising that happens through product placement, Bridget Jones' Diary and all the rest of the it, are we serious about our approach to this? Do you have a battle to get the right resources to deal with the subject or is there a priority within the Department for this particular issue?

In relation to the cost of smoking that we've been talking about, I do not know if we are going anywhere until GPs are all computerised and can all link in and tell you what is happening because even if we know what is going on at hospital level, a lot of the information that we want is at GP level and we are not anywhere near getting that information from GPs. I wonder what your reaction is - there has been a lot of talk that this new body that will be set up will be for research and more talks about talks which is very familiar in Northern terms. We have talked and we've been in Florida and we've watched the campaigns where the young people themselves were asked "why are you getting involved in smoking or why should you not get involved in smoking" and they did their own advertising campaign which I think cut to the quick and really got the message home to the right age group. As well as research, should we not be spending serious money on actually going out and getting young people to deliver the message themselves in terms of pilot projects through the media in a similar vein to Florida or we can invent our own?

We have a big campaign often about the right of the unborn and it's a big issue that's been debated at constitutional level but is the message getting through to mothers in terms of what is happening to their unborn child when they are talking about smoking? I did not realise the statistics in relation to sudden death syndrome even after a child is born. I think if that message was going stronger to mothers we mightn't have had... whether it's the scare tactic or what but if it's reality and if it is causing trouble to a child not yet born, I think the message should be harder hitting. Nicotine replacement therapy has been made available to medical card holders and that is really welcome but I think that everybody has given us the same message. Only 2% of people can give up cigarettes on their own. Should we not be giving nicotine replacement therapy to everybody because if it is a way of solving a problem we should be going down that road? I think another statistic that's startling is that 80% of smokers became addicted when they were under 16, when it was illegal to sell cigarettes to them. How many retailers have been prosecuted or fined in the past year or in the last year that we had statistics for because I would doubt that there was very many? In saying that I welcome the money that's been given to the health boards for targeting, but, as Deputy Mitchell said, unless we decide that it's a priority it won't be pursued. Just two more points, Chairman, I know I'm, I know I'm, we're talking about the clean air initiative but I want just to check ford the clean air initiative, what we were discussing another day here, mean recycling the air that already has smoke in it and can you actually get clean air going round a pub without serious cost implications? We were told that to take the smoke out of the atmosphere yes you have to put it outside and bring it in and the cost for heating up a premises again is phenomenal and in reality not very many places can afford to do that. And just my last question is, with 60 carcinogens what other product do we allow to be sold in Ireland for consumption that has the same ingredient? Sorry for the long list but I'm quite interested in this.

Chairman: Deputy Kenneally, I hope your shopping list isn't as long at that.

Deputy Kenneally: No, I was sticking to the usual, Chairman. I too would like to thank the representatives of the Department of Health for coming here this morning. It is disappointing that we seem to be getting indications that the tobacco companies are not going to come in before us because this is the fourth presentation we've had and there is a very common theme I think running through it. We're getting one particular message but obviously there are two sides to every story and I hope that we will have the opportunity of getting the other side of the story. And just to say something about the cost as well, if you take the middle figures of the range that you gave it would suggest to me that if you solved the smoking problem overnight, which I know we can't do, but you would wipe out the waiting list every place else in the Health Service with the money that is there at the moment. I think that puts it into context what it is costing us in terms of health and the burden on the Exchequer.

I wonder, one of the difficulties I think we have - this has come up from other contributions - a lot of the data that we are depending on is coming from abroad. While we're making a lot of effort and we probably are well ahead of many other European countries we don't seem to have done an awful lot of research and we don't seem to have an awful lot of data in Ireland to support whatever efforts we are making to curb smoking. I just wonder are there any ongoing efforts at the moment to, say, compile relevant statistics or what research is being undertaken at the moment to provide us perhaps with the ammunition that we need? In relation to, and this is following on from a question Cecilia asked as well, in relation to the make-up of what is in cigarettes. If somebody came into this country and wanted to put a product on the market and we didn't know or weren't sure of everything that was in it I'm quite sure we wouldn't allow it to be sold. To say that the tobacco companies have told us what's in it but we don't know if that is true or not, would suggest that perhaps it's a product that should be banned. Now I realise that it's almost impossible to do it but we certainly wouldn't be allowing a product to go on the market now, I would suggest, if we did not know the make-up of it. You said in your contribution, one line I have underlined here: "Appropriate fiscal measures will help to reduce the number of people who smoke" and I would accept that totally.

Another one of the contributors said that we now have more environmental health officers. That may be the case but I'm certainly not aware of it in my area, the South Eastern Health Board area. If they are they are certainly not making smoking a priority. Would it be that perhaps if these additional fiscal measures were provided you could have environmental health officers dedicated only to trying to curb smoking and doing nothing else? I feel the environmental controls that we have are not being implemented at the moment and we have to make smoking more socially unacceptable. I agree with you about that bottoms up approach. It is definitely the way to go but I don't think that smoking is very restricted in this country because we see it almost everywhere we go. You said in your contribution as well that when these new laws come in we will vigorously enforce the legislation. I would have to say that our record up to now has not been one of enforcement. Why do we think that just because new laws are put in place that we are going to enforce them? I think we are great in this country in many areas of bringing in a lot of very good measures and then not enforcing them. And the final thing, do people need a licence to sell cigarettes at present? I don't believe they do. You did mention the registration of all outlets. Does that mean they will need a licence to sell cigarettes? Will it mean as well that if we get implementation and if they are caught selling cigarettes to underage people that that licence will be revoked?

Mr. Mooney: Where will I start? At the end? They are the ones I can remember best. No. At the moment you don't need a licence to sell tobacco. There was a time when you did and in fact in many old shops you will still see the old sign over the door "licensed to sell tobacco". It was abolished in 1961. Now we are not convinced that ....we would like we think to have a licensing arrangement. We are not convinced though that it is necessary to go that route. The registration one then is a slightly different one and that would be where we would be putting an onus on the tobacco companies, the big suppliers, the Gallaghers, the Players, the Wills and that, that they would have to keep a register of the people they supply tobacco to. It is necessary to have some sort of sanction because the biggest sanction of all would be that a licence or a registration would be revoked rather than any level of fines that we could put in place. So, again, that is something that we would like, whether or not we get back, whether or not that would be seen as something that perhaps would be a sledgehammer in the context of legislation to have a licensing arrangement reimposed but certainly we would like to see some sort of registration system and that's what we are talking about there. You mention the aspect of enforcement. I think that I would have to concede that we are acutely aware ourselves that the area that we have been weakest in is the area of enforcement. Consequently this year for the first time we allocated dedicated money for the recruitment of EHOs to actually beef up our enforcement process. If you haven't seen them on the ground in the south-east, certainly the board had the specific money to do that.

The Office of Tobacco Control that you will be talking to later, in fact, one of the primary reasons for setting up that in your own, the committee's report on smoking here, you suggested that we would set up a separate unit within the Department of Health to do that. At the same time as you know, we were carrying out the tours of tobacco free society, our own report. While we would recognise the value of the recommendation you made, we felt that it wasn't going far enough because with the best will in the world, with the shortage of staff and all the rest in the Department, we get pulled around on to whatever is the different priorities. We felt the need to have a dedicated separate agency whose job it would be to help in the reinforcement, to co-ordinate reinforcement, to train people and that. So, we would hope that will be there and in particular we have and wanted to have that there in advance of the legislation coming on stream so that we can hit the ground running.

So, even though the legislation which I'm talking about which will be becoming before the Houses will establish on a statutory basis the Office of Tobacco Control, it is already up and running on an administrative basis so that it will be ready to take on its role when the legislation is in place. You talked about the fiscal measures. I think I've largely answered that but I think what I had more in mind there related to the prices of cigarettes. We're very conscious, and all the evidence will show and particularly studies by the World Bank, that price is a very effective mechanism, particularly for children, the ones that we're trying to target. And you will recall that there was a sizeable increase in the price of cigarettes a couple of years ago and that again is one of the reasons we will be proposing in the legislation that cigarettes can be sold only in packets of 20. Again it's a pricing barrier that we are trying to get at there and that it would be a deterrent for children if they could only buy cigarettes in packets of 20, that it creates a barrier for them there.

Yes, I think, did I say it, or was it one of the bits I hopped over there, we would certainly, if tobacco was only to come on the scene now it would be banned. But we have to be realistic, I think, in relation to it as well. For example, a number of years ago when an oral tobacco came on the scene we were one of the few countries, we banned it immediately even though other European countries had to get special derogation from their EU rules to be allowed keep their tobacco and that there.

The Irish data, yes, I think we have reasonable Irish data on prevalence and all the rest. I agree with you that perhaps we don't have sufficient research data in relation to what is the most effective, some of the most effective programmes. And again, this dedicated research body which we are establishing, again with a protected budget and with simply that core objective of going after that sort of research in relation to tobacco, I think will certainly considerably extend our knowledge.

In relation to tobacco and is there anything else sold, there is not, I think, and it always amazes us. I mean, I thought, because I also deal with food controls on my side, as does Mr. Usher and that, and one of the major issues that we have to deal with, and one of the major concerns I think in society, is genetically modified food. And when the research began to show, or when the evidence began to come out that there was genetically modified product in the cigarettes we thought we were on to a winner, but somehow or other smokers don't seem to have the same aversion to GMO as people on food, so it didn't make the same impact there although we know it's there. So, for whatever reason, people seem to be less concerned about what's in cigarettes or what they smoke than what they eat.

On the clean air issue in relation to pubs I said earlier to Deputy Mitchell that we see that as a very poor second option and, in fact, we would have serious doubt. And certainly, I think, unless it takes the air totally out we would see it as not being extremely effective at all. We don't quite go with the argument about the heating as I think the problem with pubs when they fill up with smoke and people and that, usually it's overheated they are like. I mean I agree with your point on that. The answer to it is, as Deputy Mitchell was saying, just to be able to ban smoking in pubs, or at least in dedicated or specific areas of pubs where there is more than one room, so to speak, in the pub.

On the question of NRT, yes we have made it available for people on medical cards, and you said to make it more freely available. NRT of itself won't stop you smoking, I mean, the person has to be motivated and has to bring themselves to the point that they want to give up smoking, NRT is helpful in that. To make it available indiscriminately, you know, without the other motivations probably wouldn't be of any great help and certainly, I mean, NRT in most instances, I think, I haven't got the most recent price it's probably cheaper than what they are spending on tobacco anyway so people would be better in any event, would be on the plus sign financially, on NRT rather than smoking cigarettes.

You talk about the rights of the unborn and I think that we have made very strong efforts in that and we know and in our contact with maternity hospitals we make serious efforts to get on a one-to-one basis with mothers and expectant mothers who smoke. I read some research recently which is quite revealing in one sense, if not astonishing, the number of women who will actually give up smoking while they are pregnant and go back almost immediately once the baby is born. You would think, having got them so far, it still shows what a powerful addictive drug that nicotine is. At lot of the research that we have been looking at lately would suggest that it may even be more addictive than heroin, and more difficult to get off than heroin and we all know that is difficult.

Spend some serious money on the whole thing? It's always been an ambition of the Department of Health to spend a lot of serious money on many things, but we do have to prioritise and we do have to spend money on what is allocated for, we have to stick with that. But, certainly again, we would wish to see a much more enhanced budget for that. In our report Towards a Tobacco Free Society we put in a rough estimate of what was needed to implement that report, something in the region of £20 million per year, so that is the sort of ambition we would have in relation to spending.

In relation to the GP levels, I can only agree with you on that, not just for smoking related diseases, I mean, we are conscious that there is something in the region of 15 million consultations per year at general practitioner level and we have only a sketchy data as to exactly what are the presenting causes there. That would be based on surveys and that. We have very limited knowledge, if any at all, as to what gave rise to these and certainly it is an area that we are very anxious to tap in. Consequently we have been quite aggressively pushing the whole computerisation of general practice to enable us to give us that information, also that we could get the information as a by-product of the practice, not to be imposing on GPs to have to fill out forms or something like that, whereas if they were computerised and that, they could come as basically as managing information as a by-product of the thing.

You suggested there that in relation to cancer and cardiovascular, perhaps you didn't suggest it but you were saying that we should prioritise it in the Department of Health. Well they are two of the areas that we have prioritised, in fact, we have specific strategies in relation to cancer and cardiovascular disease, the two diseases I think are unique as we don't have strategies for any other.

Deputy Keveaney - There are 7,000 people dying of these types diseases and yet the focus is more on other -

Mr. Mooney: In relation to cancer, I am sure.

Deputy Keaveney While all cancers are important to focus, you say there is nothing else that kills as many -

Mr. Mooney: And the strategy, you will be aware of some of the controversy around the country where we were trying to centralise, co-ordinate and improve services and that, and it has given rise to quite a bit of controversy in various places. They are two areas that we identified a long long time ago and we've had special studies and developed special strategies to deal with them. I am not directly concerned in that operation side of the operation but as far as I know that is being pursued quite vigorously.

Senator Jackman: Thank you very much for coming in and answering questions. Just very briefly, I know we are short of time and maybe we might have been better coupling all our questions and giving them across to you to have them dealt with comprehensively.

Chairman: That was a list that Cecilia gave us.

Senator Jackman: Dr. Howell and Professor Clancy stressed the research area. Now we have a surfeit of prevalent studies. I mean we know ourselves. I don't know if we need any more surveys on smoking, we know that the health boards have done their own surveys and perhaps it would have been good for us if we had a list and copies of all the research material done by you over the last ten years. Because we have life skills, the slán one, we also have the ESPAT report which was done independently by the Swedish group. Whether we like it or not they have stressed that we are in the top three of both tobacco and smoking and they are very closely linked, which really wasn't a point which was made today as regards young people. They do drink and smoke simultaneously if it is possible to do that but you know what I mean and the whole thinking is not the cigarettes for the sake of cigarettes, it is cigarettes linked to smoking.

I would like to ask what the Minister intends to do as regards research and prevention. Have you any idea as regards the areas he is going to look at? Is it that he is going to take all the information from the EU countries from America etc., where they have done that? I think there is a different attitude here in Ireland. There is an ambivalence, there is a lack of interest in enforcement and there is a general tolerance. So I mean we have to look at it from an Irish perspective. I would agree totally with the National Youth Council yesterday where they stated, and this is true of America as well, and I had gone through quite a lot of research down in Canada when we visited Canada. There is no doubt that when the people took responsibility themselves as regards programmes for cessation, they were positive, they worked, because they were looking at it from their perspective, not from an adult perspective telling them what to do. So I think it has to be an utter total focus and it has to start. Being a teacher and having gone through all this I can tell you, there was no smoking in the schools, it was a post primary school, they were addicted when they came into it, quite a percentage of them, but when they left that school gate it was as if nothing we said had an impact and that is the truth. So I mean it may work.

The Minister must really have discussed the methodology and where and how you are going to focus. And secondly I was interested there when you referred to cancer and saying that you did not want it to be looked at disparately, I think you cannot look at cancer in that global sense. And indeed I would not like to think that the whole initiative as regards breast cancer would be seen....we will leave that aside because we are now going to concentrate on lung cancer. I would be very affected and so would Senator O'Meara by the fact that we don't have a breast check in the mid-west region. You have to look at all of them in an equal basis but certainly you should look at the prevention aspect and the whole area of saving lives which is the priority in relation to all cancers. I suppose in a sense just looking at research in the state of Georgia, any woman that goes to a gynaecologist has to sign, I am going back ten years, that she will not smoke during the nine months. If she says she is smoking she is not taken on, she also has to sign that she doesn't drink. And that's a fact of life there. We are too lackadaisical in this country. We have to be very very strong in getting, not the message across that you shouldn't smoke - that is there - but ways and means as regards prevention. The most important question I really would like answered is the research area and the direction it is taking.

Senator Glynn: Thanks for your presentation gentleman. The first comment that comes to mind is the old VFM, value for money. I don't think we are getting value for money at all. I don't think we are getting anywhere and having listened to Doctor Howell and Professor Clancy, to yourself this morning and to the National Youth Council yesterday we have loads of statistics, absolutely loads of statistics. We know for example that there is 31% of the population smoking, give or take 1%. So that indicates the 69% not smoking. What percentage of the 69% are subjected to ETS.

There was a quip that used to be made long ago about the mean smoker, what brand does he or she smoke? Ops - other people's. Now we are smoking other people's every day. What bus conductor will tackle anyone smoking in a non-smoking area? At the very most he would be foolish to do so,because he would be told were to go. He would be given probably the Harvey Smith sign. So there is no enforcement there. In pubs and clubs and restaurants, you say that there are EHOs there why don't you appoint inspectors who would carry out spot checks to ensure law enforcement? It begs the question, do you have to wait for new legislation to enforce what is already there through yourselves and through the health boards? To be honest with you, I do not think you do but I would like you to comment on it.

In relation to the comment that was made about lung cancer and expenditure, that is a damning statistic because Dr. Clancy told us yesterday, this is the second time this point was made and I am making it again if only to underline it, it is not costing us a huge amount of money because there is nothing done about it. The people who mainly suffer from it are in a particular socio-economic group. That is another statistic he had. So is it true to say that we are legislating and regulating but we are not enforcing? I think it is. When the Office of Tobacco Control is set up, what will it do? Will it, as I have already suggested, have inspectors who walk into a restaurant or into a pub-----

Chairman: When we have Mr. Power in we can ask him those questions.

Senator Glynn: Fair enough but from your viewpoint would you not consider that unless you have absolute enforcement - we have legislation and regulation but we have no enforcement and that is where we are falling down? Many of my other questions have already been asked so there is no point in repeating them.

Mr. Mooney: On enforcement, Senator, I did say earlier that we would have to accept that has been one of the weakest links in our whole strategy in relation to smoking. I think I outlined some of the initiatives we're taking in that regard. But, by the same token, though, most of the areas where smoking is prohibited there is a fairly general acceptance by the public and it is, by and large, very well respected. Now, we don't have legislation covering pubs at the minute, so there's very little, I mean there's nothing we can do there, and that's why we'll have to look at that in the context of the regulations there. It is always I suppose a source of surprise to us as well, we would like to try, I think the thing you were hinting at there, 30% or so smoke, 70% don't. You would think that in these areas like pubs or restaurants and that the 70% view would prevail. We would like to think that but that doesn't seem to be the case. We would like to think that it would be that way.

Senator Glynn: That is the point. If 69% is not smoking, what percentage of that number is subject to environmental tobacco smoke?

Mr. Mooney: They are probably all, everybody that's there.

Senator Glynn: Now we are getting to the nub of it.

Mr. Mooney: Certain areas would concern us, you know, some areas would concern us. I suppose you could argue that if any of us go into a pub this evening we're going in of our own free will but we are quite concerned, for example, about staff working in pubs who have no choice in this matter. These are areas that would be, it's all of concern to us but that's of particular concern to us. But I think, I'm not a technical expert in this, but I think it's pretty self-evident everybody else in the environment, if there is smoke there, they are inhaling secondary smoke or environmental tobacco smoke.

Senator Glynn: In areas which are non-smoking, what are the number of prosecutions that have been taken? I put it to you that there are very few because there is no enforcement or detection. So why are we bothering to legislate and regulate if do not enforce?

Mr. Mooney: You probably saw a spectacular case in the paper recently of an assault on a bus where somebody objected to smoking. But, again, CIE and the people involved in the case indicated some of the difficulties they have there - the element of proof and somebody being there. By the time something like that happens the cigarette has been dropped out the window or the person has absconded or whatever, so, you know, getting to the stage from seeing someone smoking to building a prosecution in a case can be, you know, a difficult thing. But I do get back to the point, as I said earlier, I accept that it's one of the areas that we have been weakest in and it's one of the areas that we are now rapidly trying to build capacity in. The capacity doesn't all relate simply to more money or more people; it relates to training, to education and to a whole lot of other things around that as well.

I didn't quite get back to Senator Jackman. I think the main thrust of her question related to research and while I think Mr Fitzgerald can pick up some of the specifics of it, I mean, I explained to you earlier about the research institute that has been established and you were more or less asking what sort of research is the Minister going to carry out. Well, I think we will be guided very strongly in that by the type of people that you're talking about, Fintan Howell and Luke Clancy, because they will be the people who would be involved there advising on what area should be researched and how they should be researched. Do you want to pick up on some specific incidents?

Mr. Fitzgerald: If I may, Chairman, make just a very quick point, a quick defence of research, because up to a number of years ago, I suppose, we were criticised for not having any good data in relation to lifestyle in general and smoking in particular. In fact prior to 1998 we gathered our smoking prevalence status from market research surveys which were being commissioned to a very considerable extent by the tobacco industry as much as anybody else. They were certainly being commissioned by economic interests rather than by ours. So, the National Lifestyle Survey, which is something that we particularly had put in place in 1998 and it is our intention to revisit this process every four years, gives us very, very good data right across the full spectrum of lifestyles, whether it's smoking, exercise, nutrition, alcohol consumption or illicit drug use, by gender, by social class and by region. So for the first time we actually have firm data which will allow us to target and to target subsets of the population in relation to all of these lifestyle issues, we will also have a benchmark against which to measure progress as we revisit this every four years.

So in fact it was a considerable weakness in our own armoury at one point that we didn't have the data and we do have it now. In the context of smoking and to link the two related points that Senator Jackman raised earlier, what it allowed us to do, particularly in relation to smoking, was to identify the key target group for us now, which is young women, and particularly young women from low income groups because if you look at the figures the rest of the population are either improving or holding a line, if you like, in relation to the overall prevalence. The one group that's actually in growth is young women and you've got very starting figures which suggest that young women from low income groups are hitting around 44-45% prevalence against the national prevalence figure of 31%. So that's allowed us to zero in on them.

You talked about young people and out of that we took a decision to run a public awareness, public media campaign aimed specifically at young women. It's a concept called NICO which you possibly have seen on television and that was developed and devised in consultation with young people; there was focus testing of the approach involving young people and we've just got from a market research company an independent evaluation of that particular campaign. I'm happy to be able to tell you that it scored very, very highly, in terms of its appeal to young people because it isn't preachy, it isn't middle-aged adults telling them how to live their lives, it's in a genre that they accept and it has scored very, very highly in terms of that. We've been putting a lot of our investment in terms of public information into that kind of work now which is aimed at young people. in a way that young people like to get their messages. We'll be constantly evaluating these things and we do work them out in terms of focus testing involving young people.

Mr. Mooney mentioned the SPHE Programme which is, I think, to a very large extent, one of the things we're putting a lot of investment in for the future. This is going to allow the educational system, with the health system, to influence young people in a broad curriculum way over future years and begin to skill up young people to make sense of lifestyle decisions for themselves. So, rather than taking smoking or drug misuse or alcohol misuse as an individual topic having somebody come in once a month to talk to kids in school about this, this programme is going to be integrated into the curriculum and is going to hopefully skill up young people to make sense of the decisions, to resist peer pressure and to be able to make the lifestyle decisions based on their own assessment of situations so that's only going into the schools now.

The plan is to have it fully operational in all junior cycle secondary schools by September of this year and we're already talking to the Department of Education about putting in a similar situation in primary schools to begin that process, so we are working with young people. We see that as the investment for the future really and we're doing it through the SPHE. We certainly involve and consult with young people in relation to the campaigns and in relation to this particular piece of research, I take your point we can run the risk of being researched to death but this has given us very, very valuable information in relation to the breakdown and in allowing us to identify subsets of the population that we need to target.

Senator Jackman: Very briefly, just to state that, please, when you get positive reaction to publicise it because that in itself is a much more important message than having youngsters surrounded with the fact that we were just one of many and we would not have been, I would not have been aware now that you are after getting----

Deputy G. Mitchell: Mr. Mooney, did you say that you have power under existing legislation to extend the ban on passive smoking in public houses or does it require new legislation to do that?

Mr. Mooney: No, we could do it but we will be clarifying that and perhaps taking more extensive powers under the new legislation but we certainly could under, well our understanding of the legislation is that we could do it under existing legislation.

Deputy G. Mitchell: I do not know how other Members feel but I would urge you to take dramatic steps.

Members: Hear, hear.

Chairman: Arising from something that other contributors mentioned, Dr. Fenton Howell mentioned the over-reliance of Grand Prix racing on tobacco advertising. Is it your intention in the new Bill that is coming forward to ban Grand Prix racing from the television screens on the basis of the over-reliance on cigarette smoking? Have you any comment to make on the fact that he seemed to intimate that RTÉ, because of the great emphasis on Grand Prix racing and the length of time given to showing it on television, was getting this material at a knock-down price? Is there any evidence within the Department to suggest that this is a fact and would it be the view of the Department that the industry might be subverting the advertising ban through this mechanism? Is there any evidence over the years in the Department, as has again been intimated by Dr. Howell, that journalists have been invited to Grand Prix and other events where the tobacco industry or tobacco related industry is to the forefront, by way of bringing about a softer approach to cigarette advertising and smoking in general in Ireland?

Deputy G. Mitchell: On the CPI, if you do not have the information maybe you could let us know, at what stage are the discussions with the Department of Finance in relation to taking the cost of cigarettes out of the Consumer Price Index which seems to be a very important issue? If you do not have the information on it maybe you would send us a detailed note on it.

Mr. Mooney: I can probably, I think, bring you up to date on it. I mean it's not something for Ireland in itself. We are tied into the EU in relation to inflation and how it's measured and all the rest and my understanding is that there is a common basket of goods that are measured across the, so, but, and we have written and we have encouraged Commissioner Byrne to look at that issue and take it on there. We would also be slightly concerned of course that there may be problems in relation to a poverty issue there that if, taking the points that we were making earlier, the highest levels of smoking are in the lowest socio-economic groups and in some instances it's taking a huge slice of their income on that so while we would certainly love to have it out of the CPI we would need some, I think, other mechanism then to be able to indicate that poverty traps or that are not being created as well. But that is where it lies at the moment. I think there is a fairly general agreement domestically or nationally that cigarettes and tobacco in general should not be part of the CPI.

On the issue of journalists and that, Chairman, I don't have any knowledge, I don't have any information. I'm conscious of the nature of this committee. I mean I could speculate but I really don't have anything or any information to be able to substantiate the suggestions which were made to you there. The question of the Grand Prix is of major concern to us and we have been looking at it. I think that we certainly can have the powers and have the powers, but, and the difficulty is, of course, in relation to television now is that we simply can't put a wall around the country. Even if it was to be banned on RTE, it's on satellite channels and it's on neighbouring channels in the UK so I mean we have to be somewhat pragmatic and sensible about the thing. And while it certainly would be of concern to us and we would like to see the tobacco advertising go out of the Grand Prix it's encouraging that some of the most recent information coming from that quarter would suggest that it will be phased out sooner rather than later. We would welcome that very much because it's something that has really grabbed the attention of, particularly the younger people, and that and for that reason alone we would be very concerned about it. But the practicalities of what we can do about it, you know legislation is one thing but being practical about it you have it on some of the terrestrial channels in the UK and on satellite channels

Chairman: It is European wide television.

Mr. Mooney: It is I'm afraid.

Chairman: First of all thank you very much Mr. Mooney and the other officials for coming before us today I think you have two issues that you have to report back and that's a note from the AG as to when he is likely to report on whether it is proposed that the Department and the Government would take a case against the tobacco companies and then we have to get the cost of the clinical analysis on the tobacco related illnesses within our hospitals system and a wider spectrum as well including research data. I think it would be the wish of the sub-committee as well that we would have a report back, maybe within three months, as to the wider implications of cost outside the statistical data from the clinical side of it that where you are going to place the parameters in relation to the cost of smoking related illnesses, that you would look at that and seriously consider where you are going to draw the line on that issue.

Senator Glynn: Could you add an aggressive programme of enforcement? I know you have proposals there but as has been said they do not seem to be working.

Chairman: We will put that to Tom Power later. Thank you all for coming. It's been very helpful. I now formally suspend the meeting for ten minutes.

Sitting suspended at 11.23 a.m. and resumed at 11.42 a.m.

Chairman: We are back in public session and I'd like to welcome to our second session this morning, Mr. Tom Power, the CEO of the Office of Tobacco Control and David Molloy, the chief inspector at the office.

Mr. Tom Power and Mr. David Molloy were sworn in by the Clerk to the sub-committee.

Chairman: The witnesses may now make an opening statement, which will be followed by questions from members. Before we begin, I would like to advise both witnesses that while members of the sub-committee enjoy absolute privilege, this does not apply to witnesses appearing before it. I would also like to bring to the attention of the witnesses and members, the fact that under section 10 of the Committees of the Houses of the Oireachtas (Compellability, Privileges and Immunities of Witnesses) Act, 1997, certain rights are granted to persons who are identified in the course of the committee's proceedings. Persons being invited before the committee are made aware of these rights and any persons identified in the course of proceedings who are not present may have to be made aware of these rights and provided with a transcript of the relevant part of the committee's proceedings, if the committee considers it appropriate in the interests of justice. I now invite you, Mr. Power, to make your opening statement. Please confine it to 15 minutes, if at all possible.

Mr. Power: Thank you very much, Chairman. I'd like to thank the sub-committee for the opportunity to appear before it and to inform the sub-committee about our new Office of Tobacco Control and to address the issues identified in the sub-committee's terms of reference. I'm accompanied, as you mentioned, by David Molloy, who is the chief inspector of the Office. We've been provided with a copy of the sub-committee's terms of reference and a copy of the two reports prepared by the Oireachtas Joint Committee on Health and Children on this matter.

In my statement, I propose to describe the role of the Office of Tobacco Control, it's policy and it's plans, and would like to touch on the legislative developments in Europe and in the World Health Organisation and address the particular items covered in the terms of reference of the sub-committee. I would also like to address the issue of relations with the tobacco industry and the sales of cigarettes to children.

We circulated a copy of 'Towards a Tobacco Free Society' report, our business plan for this year, and a copy of the latest survey completed on our behalf, with a statement. I hope to answer any questions the committee may have, and to undertake to forward any supplementary information, if necessary. As this is the first time a representative of the Office of Tobacco Control has appeared before the Oireachtas, I would like to take a few minutes to appraise the sub-committee of the role of the office.

The Office of Tobacco Control was established on an administrative basis by the Minister for Health and Children, pending the adoption of appropriate legislation. This was in accordance with a recommendation in the 'Towards a Tobacco Free Society' report. The Office is managed by an interim board of management appointed by the Minister. It is my understanding that the Office will independent in the exercise of its functions, which will be settled in the forthcoming legislation. At present we are concentrating on developing the necessary infrastructure to deliver an effective national inspection programme supported by targeted communications and education programmes and guided by a research programme. We are also concentrating on developing the necessary capacity in health boards to deliver on the recommendations of the Towards the Tobacco Free Society report. The interim board of the Office was appointed on 11 May 2000; we acquired temporary premises in August 2000 and by November 2000 the management in the Office were in place. The management team is comprised of a director of corporate affairs and research, a director of communications and education and the chief inspector and the chief executive officer. We are supported by two general staff and some external advisers.

The policy of the Office is to implement the Government's policy as outlined in Towards a Tobacco Free Society report, in particular, subject to legislation assigning the functions and powers of the Office, we will pursue the following:

Promote the development and implementation of better supports for smokers who wish to quit. The report recognised the importance of providing adequate and effective support for smokers who want to quit. The evidence available to us, is that nicotine replacement therapies double the chance of success of those who attempt to quit and then counselling and brief interventions by clinicians are also valuable. The role of the Office will be to ensure that these services are delivered in a sustained manner and that the efficacy of the services is evaluated on an ongoing basis.

To ensure that consumers are properly informed about the dangers of smoking . The report recognises the central role of all forms of tobacco advertising plays in promoting tobacco use, especially among children and, accordingly, recommended that it be prohibited. The Minister has already implemented a ban on print media advertising. The Office will monitor compliance with the law in this respect and will address any breaches in the appropriate manner. The Office will also ensure that there is ongoing independent research conducted to the highest academic standards into all aspects of tobacco from a public health perspective and that that research is published and disseminated.

To protect third parties against passive smoking. The report has identified environmental tobacco smoke as a pollutant that is a significant risk-factor in a number of diseases. I have seen reference to this form of pollutant being 90 times more toxic that asbestos in buildings, for example. It is a risk that is often imposed on people without their consent. Certain controls already exist in Ireland on smoking in many public places. In some respects there is poor compliance with existing controls on smoking in public places. The Office is currently developing, as part of it's business plan, a national programme of compliance building measures comprised of accessible complaints procedures, inspection programmes that are targeted reactive and have a maintenance component, communication, information and training programmes and these will address these weaknesses. The report has also recommended a considerable extension of these controls. In order to maintain a focus on the mission and strategic objectives in Towards a Tobacco Free Society, the Office will prepare an annual business plan and at the end of each year we will prepare an annual report. The Office adopted it's first business plan this year, and this was approved by the Department at a meeting on the 14th February 2001. This plan provides for the development of a comprehensive framework for a national inspection programme. It also provides for the development of a communications function and for a framework for future research into tobacco and it's use.

The Inspection Programme: As part of this business plan we have prepared a detailed proposal for the appointment of directors of tobacco control in each health board. Subject to the necessary approvals, we hope that health boards will be in the position to begin making these appointments this year. The directors will ensure that all health board tobacco control services will be developed and delivered in a sustained and co-ordinated way. Additional funds have already been invested in this area and my colleagues in the Department of Health already have dealt with that.

Work has already commenced in the development of a national inspection programme. We are developing 11 protocols which will extend best practice models to all health boards and which will give an integrated national focus where that is appropriate. Once these proposals are developed and approved, each health board will be invited to adopt them and the directors of tobacco control will ensure that they are fully implemented. These protocols will be subject to ongoing review and modification in the light of experience and will be supplemented by the issuing of guidance notes by the office on points of detail.

In relation to research we are supporting the development of an academic research institute entitled, Research Institute for a Tobacco Free Society. This is an independent academic institute that will conduct the kind of independent research we need on an ongoing basis. It will be funded by way of fee income and the Office of Tobacco Control will be the initial anchor client. The institute is unique in that it is owned by the Irish Cancer Society, The Irish Heart Foundation, ASH Ireland and the Office of Tobacco Control. On 31 May, World No Tobacco Day, the Minister launched the Research Institute for a Tobacco Free Society.

The Office has begun developing a comprehensive communications programme and this will ensure that those affected by the tobacco control laws are properly and fully informed of their rights and responsibilities. While we have begun some tentative delivery in this area, we are obviously awaiting the development of the new legislative framework. We are at present preparing for a conference on 1 and 2 November this year. The keynote speaker will be Commissioner Byrne who will be joined on the platform by Congressman Marty Meehan and Dr. Derek Yack of the World Health Organisation, in addition to a number of technical experts. We have also launched a new leaflet on environmental tobacco smoking in conjunction with a smoking target action group. This is a very dynamic group established under the auspices of the office of health gain and it is comprised of health board officials and representatives of non governmental organisations. We also participated as a minor sponsoring partner in the Irish Masters Snooker Championship. We have supplied the abbreviated version of this plan with this statement to the committee.

Should the subcommittee wish to have a copy of the more comprehensive plan, I will of course supply that to the committee but I would appreciate if that document would be treated as confidential, if that is possible. The Department of Health has already addressed some of the legislative developments. The office has been closely involved in supporting the Minister in negotiations on the new European Union Directive adopted on 28 May 2001 which regulates emissions from cigarettes as well as the packaging and labelling of tobacco products. Some challenges to this Directive are expected. The Directive lowers the permissible levels of nicotine, the emissions of carbon monoxide and tar yields. It increases the mandatory size of warnings on cigarette packages and specifies starker warnings. It also allows for the inclusion of pictures or pictograms and prohibits the use of misleading descriptors. The directive provides for a full disclosure of toxicological data regarding the many chemical technologies being used by the industry. A scientific committee is being established under this directive to conduct a number of technical inquiries and to propose technical standards related to composition and measurement of tobacco products. The directive adopts a considerable number of proposals of the committee on page 84, points 2-4.

The framework convention on tobacco control - the World Health Organisation is sponsoring international negotiations for a treaty on tobacco control to be known as the Framework Convention on Tobacco Control. This treaty will be legally binding on the subscribing members. It will also provide enabling powers for subscriber members to agree protocols as associated legal instruments dealing with specific areas of interest. The office is directly involved in these negotiations. Because of the complexity of the legal competencies, close co-ordination with the European Commission and other member states of the European Union is essential. This may mean that we have to support positions which may appear less progressive than our own national policy.

On the state of knowledge of the Irish tobacco industry concerning research, the terms of reference of the sub-committee addresses in its first part, the questions of the state of knowledge of the Irish tobacco industry in relation to the harmful and addictive nature of this product. I do not have any direct evidence other than that already in the public domain on the state of mind of the Irish tobacco companies. The main documentary evidence in the public domain with particular relevance to Ireland that I am aware of are the disclosures about Operation Whitecoat, Operation Satire, the Shockerwick House files and those papers which disclose the negative public relation strategies being considered by advisers to the industry.

Chapter 3 of the committee's report points out that the Irish tobacco companies are subsidiary parts of much larger enterprises. It is also noteworthy that the evidence given to the committee on behalf of the industry was in large part given by representatives from the UK. Tobacco products sold in Ireland, according to the tobacco industry spokesman, comply with the standards set in the United Kingdom.

I believe that cigarette manufacturing in Ireland conform to the international technical norms for such products and that to achieve these standards the Irish companies must have a substantial knowledge of the modern chemical technologies used by the industry. I understand they have disclosed some of this knowledge to the Department of Health and Children. Reconstituted tobacco is used to generate complex chemical processes in cigarettes in order to enhance the amount of nicotine that is being released. The exact composition of this reconstituted sheet is a secret but the little we do know about it has to give rise to serious concerns. I do not know if this product is used in Irish manufactured cigarettes but it is certainly used in products imported from other countries. It would be helpful to establish if this type of material is used by the Irish tobacco companies and, if so, what their understanding is of its composition.

I think these facts together demonstrate that the Irish companies are not only owned by larger foreign enterprises but are also closely managed as an integral part of these larger enterprises and that the Irish companies are fully au fait with modern tobacco technologies... addiction, assumption of risk, causation. I would like to refer to the issue of addiction. Addiction is central to this debate. The committee's report discusses the issue in depth and indeed much of the oral evidence as reported focuses on it. The conclusion of the committee was that tobacco was addictive and that the evidence of the tobacco industry on this issue lacked credibility. I would like to add the point that tobacco addiction is classified by the World Health Organisation as a disease.

The industry, in their evidence, stated that the word "addiction" had no exact meaning for them outside of its colloquial usage. The industry representatives stated in evidence to the committee that they did not have a definition of addiction. Is it the case being made by the Irish companies that they have never inquired into this issue? If so, did the industry show a lack of diligence in investigating the concerns expressed by so many eminent authorities?

The companies that gave evidence also appear to be ad idem in asserting that regardless of which definition of addiction anyone might care to adopt, that people who smoke do succeed in quitting. I've heard the same point repeated in the media by industry spokespersons. I believe that the purpose of this assertion is to support the argument that a smoker, being capable of quitting at any time, must in law be deemed to assume the risk associated with each cigarette he or she smokes. The industry appears to have given very careful consideration to the issue of addiction from a legal point of view. The evidence of the Food and Drugs Administration as cited in the committee's report demonstrates that the tobacco industry have a comprehensive understanding of nicotine, they know how to adjust the level of nicotine in their product and have a very thorough understanding of the neurological impact of nicotine.

On causation, the industry representatives have acknowledged that smoking is a risk factor in many fatal diseases. On the question of causation itself the evidence to the committee from the industry tended to vary between outright denials to the suggestion that the case was simply not proven. However, the overwhelming medical evidence is that tobacco smoke has caused fatal diseases and that nicotine is addictive.

On keeping consumers informed, it is difficult to see how the tobacco industry can claim to have discharged its duty to fully inform its customers about the harm tobacco causes when it simultaneously claims that tobacco use does not in fact cause any harm. It is equally difficult to see how the industry can say it has informed its customers of the addictive nature of tobacco products when it denies that these products are addictive. The industry appear to rely on the fact that the State has informed the public about the dangers of smoking, yet the industry has set out, at considerable expense, to undermine the very message it seeks now to rely on as comfort for meeting its duty of care to its customers.

Most adults are informed in a very general way about the dangers of smoking but I would suggest that given the serious nature of the harm this product poses people are not given enough specific information, for example, how long does it take to become addicted? What is Berger's disease? How young can smokers die from smoking? What are the benefits from quitting? Do people know that smoking causes blindness, diabetes, prostate cancer and bladder cancer? Are people told about the dangers environmental tobacco smoke poses to their spouses and children, etc?

Co-operation with the industry - most tobacco companies at one time or another assert that they work closely and constructively with the Government on regulatory affairs. This is a common position promulgated by tobacco companies throughout the world. However, I believe that the industry sees encounters with Ministers, public officials and parliamentarians as exercises in public relations. In my experience they simply will not engage on the one substantive question of how and when we can expect to bring the tobacco epidemic to an end. I believe this can be the only basis on which a meaningful partnership with this industry can be constructive.

Is the industry changing? The industry appears to be adapting its public relations strategies to the evolving climate. There is, however, little evidence of any change in substantive behaviour. For example, in Formula 1 racing, television advertising through Formula 1 sports coverage continues and that imagery is extended wherever possible. By branding Formula 1 racing so closely with tobacco products we encounter the added difficulty that every time Formula 1 cars are exhibited, even if they do not contain the direct tobacco advertisements, they reinforce the tobacco message. In relation to television coverage of Formula 1 racing, it would be of interest to get a better understanding of the position of the public service broadcaster to understand the nature of the contract under which this product is being broadcast, and the technical capabilities of the broadcaster to eliminate indirect advertising.

Cigarette sales to children. Sales of cigarettes to children continue unabated. In a report of a study prepared for this office as received yesterday, and I think it has just been circulated, it is shown that by the time children reach adulthood, 69% have experimented with tobacco and 31% are smokers. And I should say that's secondary school pupils; it's biased towards upper income groups therefore. This smoking prevalence correlates exactly with the known prevalence of adult smokers and I think demonstrates the fact that the vast majority of Irish smokers start smoking before reaching adulthood. This is in line with international evidence and is very discouraging. The children cite addiction and habit as the main reasons for continuing to smoke. Overall 2.4% of the children surveyed reported advertising as the reason for smoking. But 10% of 13 year olds cited advertising as the reason. Other options selected by 13 year olds related to images promulgated by the industry, "to be cool", 20% ,and then peer pressure, 20% and habit or addiction, 60%, are also cited. It does seem that advertising is impacting dramatically on young children. Children appear to have uninhibited access to cigarettes from retailers. Eighty-one per cent of the children reported they buy their cigarettes in local shops. This data tells us three significant things; firstly, that there is extensive non-compliance with the laws relating to sales of tobacco to minors; secondly, that children can afford to buy cigarettes, i.e. the prices are far too low and, thirdly, the assertion that it is the parents or older siblings who provide them with the cigarettes appear incorrect. Over 91% of these children report that they understand smoking is harmful and addictive.

I believe that this is a testament to the consciousness raising by the health promotion activities of the Department of Education and Science and the Health Promotion Unit with the Department of Health and Children working closely with the Health Promotion Units in the health boards and the non-governmental community. However, this does not demonstrate a competence on behalf of these children to evaluate the risk and to make informed choices. It also bears out the point made to the committee by my colleagues from the Health Promotion Unit of the Department of Health and Children and indeed representatives from the Department of Education and Science that education and health promotion on their own are not a sufficient response. Far more needs to be done on the supply side. The existing distribution systems and pricing measures are self-evidently not capable of ensuring that children do not have access to cigarettes. I would not be confident that an extensive inspection regime would, on its own, remedy this problem.

It would be interesting to know exactly what training programmes concerning the dangers of this product the tobacco industry offers to its sales staff and to the shopkeepers who sell their product. It has also been suggested to me that retailers are simply agents of the tobacco industry. It would be very helpful to establish the precise legal relationship that exists between retailers and the tobacco companies which I understand is expressed in the form of a written contract.

On tobacco products, there have, to my knowledge, been no changes recently in the composition of tobacco products. Cigarettes continue to be made in the same manner using the same dangerous chemical technologies. There have been some suggestions made that the tobacco industry should get involved in education programmes for children. I do not believe that this would be appropriate. The duty the tobacco industry owes to children is, if it must sell its products at all, to sell cigarettes in a manner that guarantees that children will not be able to buy them or will not be induced by glamorous images to experiment with them. The industry may have other responsibilities relating to the past harm it has caused.

The tobacco story is one about human suffering, not simply about economics or freedom of speech or commercial property rights. Each year in Ireland approximately 7,000 people die prematurely from smoking. We have no figure on our emigrants. In many instances this is preceded by a long and painful illness that causes suffering and distress to the whole family. The committee in its public hearings recorded some representative voices of the many people who have been injured by this epidemic. From our perspective, these stories have a powerful impact. It is very important that those of us who work in the field who may be remote from the hospital bed side are reminded of the suffering that this glamorised product causes. Thank you.

Chairman: Thank you very much. To say the least, one could describe it as an explosive document. Would you agree with me that you're basically saying to the tobacco industry that they are irresponsible, they have been misleading, they have been incompetent, they have been secretive and they have been deliberately undermining good health policy strategy in this country?

Mr. Power: I think it's self-evident that if you sell tobacco you're undermining public health. I think that the unwillingness of the industry to be forthcoming about its technologies demonstrates its secrecy and I think its reluctance, particularly to disclose what's in reconstituted tobacco, is a serious cause for concern. I would certainly question how they have discharged their duty of care to their consumers given the nature of the denials they have entered into about the causation of tobacco illness and about addiction.

Chairman: The first questioner is Senator Mary Jackman.

Senator Jackman: Thank you very much, Chairman. I agree with the Chairman and thank you very much for the most positive response that we have had over the past couple of days. I am not saying that the others were not positive in what they were doing but you are the enforcement agency and it gives me some hope that what we have been hearing as regards the negative stories regarding health, suffering, particularly in relation to lung cancer ----

Chairman: A question, please, Senator.

Senator Jackman: I have to state to them that it is very positive. Have you an input in relation to the cost of what you want to do and whether you will have sufficient resources? Will you also be able to implement and enforce, particularly in relation to health boards, everything that you wish to do, especially in relation to the passive smoking area where you gave a very short statement there in relation to it being much more dangerous than anything that we might have from asbestos? I mean, the stark details that you've given us there show that you're very serious about it and I suppose what I'm concerned about is support mechanisms costwise and staffing in order to pursue very worthwhile objectives.

Senator Glynn: Well, thank you very much indeed, Mr. Power, for your presentation. On the policy you say here 'the office will monitor compliance with the law in this respect and will address any breaches in the appropriate manner, independent information" and then you go on to say "to protect third parties against passive smoking, the appointment of directors to each health board". Would you please tell me, Mr. Power, exactly what are you going to do because, as I said to the previous delegation here, we're legislating, we're regulating but we're not enforcing? Will there be a situation whereby those inspectors or their staff, or members of their staff, will walk into a place where people are smoking in the non-smoking area, where they've been allowed to smoke in a non-smoking area, where they will walk into a licensed premises or a restaurant full of smoke? I make the point here that 31% of the population is smoking, we suspect that the other 69% are suffering from environmental tobacco smoke. So what exactly are you going to do?

Will we be taking the bull by the horns literally and saying "look here you're breaking the law, this is what's going to happen you now". Will your people, for example, be going on public service vehicles and ensuring that the no-smoking regulation is enforced thereon. So exactly what are you going to do by way of enforcement because we've heard all the statistics?

Senator O'Meara: I too would like to thank you for the presentation here today and indeed to congratulate you on its forthrightness. I have two questions, one in relation to the legislation which will put you on a statutory basis, which is obviously to be welcomed, but I would ask is it intended in so far as you know or can you answer this question that the legislation will give you a proactive role? Will you have adequate power we'll say, for instance, to respond to complaints made by non-smokers about non-compliance in public places, workplaces and so on? What can you do, who will actually conduct the enforcement on the ground, in other words what kind of framework will you have, like maybe to compare with existing agencies such as the Office of the Equality Director and so on? Secondly, the statistics in relation to the marketing, or the survey on young smokers are frightening. It is obviously consistent with what we already know but when you see the extent of it, it is truly frightening. A question was asked earlier of the Department of Health, just before you came in, about the issue of licence. In 1961 we abolished the necessity to have a licence to sell cigarettes. Should we be looking at potentially reintroducing that if the retailer or the point of sale to young people is becoming effectively dangerous? Finally in relation to what the Chairman put to you initially, and your comments on the cigarette companies, the tobacco companies and their activities and so on, to a large extent haven't we allowed them to behave as they have behaved? In other words, they haven't had a duty of care, that's why they've behaved as we know, but to what extent have we, Government, State, community, society and generally allowed that situation to happen and don't we need to change that?

Mr. Power: I think the first question was related to the budgetary position of the office and whether we were secure in that. Our budget and indeed the business plan circulated doesn't contain the budgetary data. That's one of the elements in the longer version of the plan and discussions with the Department were concluded satisfactorily in relation to this year and I would be reasonably optimistic about next year.

Chairman: It must be the first time in history to be satisfied with your budget in the Department.

Mr. Power: Well I said, Chairman, we don't want to splash money about. I'm more conscious I think of mobilising the existing resources within our system to prioritise tobacco and address that but we need to develop strategic management capacity particularly to make that happen on the ground. I think its qualitative improvements we need in the management of existing resources. I don't mean that as a criticism of the way things have been done but it's a question, for instance, of where priorities lie in how people operate and what mechanisms we use to convey public policy down to the level of behaviour of people and how to prioritise. So, in terms of the business plan outlined here, I'm satisfied I have sufficient funds this year but we would be looking to double that expenditure next year. I'm reasonably happy with the preliminary discussion that that will be so.

I think the Senator made a point about what exactly are we going to actually do as opposed to what we say we would like to see done. There is a very substantial problem about public places. In existing legislation, for instance, there are no rights of access for our enforcement people. They have no rights to command a person to give them a statement, to identify themselves. They have no right to take a sample of a product or, indeed, to take any evidence. So, the capacity of our enforcement people to actually do anything to be honest is virtually zero in existing legislation. That's why we badly need the new Bill. In relation to the public places generally, one of our views is that complaints haven't been taken seriously. People complain or they feel they have a cause of complaint but nobody is there to listen.

So, the very first thing we think we need to do is build an effective complaints platform which makes a complaints system accessible to people. And we would hope that we would standardise No Smoking notices and that that would include, for instance, a lo-call number and we would encourage and promote through our communications strategy that people would avail of that number to complain to us. We would try to stimulate complaints to us about non-compliance. That's an important element that's currently missing, that there is no capacity really to take seriously and we constantly hear people complain to us and say nobody does anything about the complaints. Of course, that has a huge depressing effect on the people around them and it undermines the importance of the issues. We would certainly see that as a priority.

We also envisage that we would have targeted inspection programmes which would be guided from our office but would be delivered by the health boards. The chief inspector will have monthly meetings with the directors and they will prioritise high risk areas and we will begin pro-active inspections of those areas. Then we will have maintenance inspections which is that we will have regular routine inspections of both retail places and public places. They would be the three levels at which we would see ourselves responding and we would hope to underpin that by a focused communications package and then obviously continue a process of research. But we want the research to be independent of us so that it can be suitably critical of us and not actually be vulnerable to any either conscious or sub-conscious influences we would like to put on it. We are very keen that the research has the capacity to say to us, "you're getting it wrong here; you should be doing this better" and that it should continuously remind us of where best practice is and challenge us to adopt best practice. So, that's how we see our response to that.

On the question of legislation, obviously you've heard the Department this morning and certainly I think the critical question for us will be to appraise the legislation in terms of the powers and functions we are given. I think that's a matter for the Oireachtas to determine. We would certainly hope that we would be heard in any forum if there is a discussion about what should happen there.

Chairman: Have you made representations about powers of access for your people.

Mr. Power: We have made very comprehensive submissions as part of the deliberative process to the Department on this issue and I understand that these have informed much of the discussions around the Bill.

On the issue of licensing, I think Mr. Mooney referred this morning to the issue of registration systems. I think in modern sort of liberal market economies the theory of optimum efficiency is that all the costs relating to a product are factored into the price. Clearly, this isn't the case in tobacco. I think we need to build liability and responsibility on the tobacco industry for all the requirements, not simply to address the clinical diseases that are presented but also to address the disease of tobacco addiction. I think we need to build liabilities and responsibilities on to the industry. We need also to make sure that those are not opportunities that are meant to progress their marketing practices. That was one of the rationalisations for having the industry maintain registration systems and then we would have the capacity where convictions are taken against non-compliant retailers, to have them removed from their registers and to prohibit the industry from supplying them.

There is also extensive discussions going on within WHO on the Framework Convention about the inclusions of adequate licensing systems and we are particularly pressing for adequate international controls on the distribution of this product. At the moment, tobacco is traded much the same as any other consumer product worldwide. According to the World Bank particularly, there is a much higher attrition in terms of product, there's a much higher loss out of the normal trading volumes. This is a cause of action by the European Commission, for instance, in the United States against the industry. The basis of the case is that the industry appeared to have been involved in organising smuggling. So that is a factor. Clearly we need international controls on the way this product is traded. These then have to be reflected into the internal distribution systems in each country and have to be effectively controlled to protect children against access. That's a priority for us.

Deputy G. Mitchell: Chairman, I join you in welcoming Mr. Power and Mr. Molloy. The whole area, obviously of the inspectorate and enforcement is very important but I would like to see as a priority the whole area of passive smoking in particular being tackled, inspected and implemented. We should start from the very beginning with public houses, no lead-in measures as they have plenty of money in most cases. Urgent, immediate and then inspected. I hope that will come about. I understand you may not need legislation for that, although it's not clear, we might need some legislation.

I want to ask you a particular question, Mr. Power. On 'Towards a Tobacco Free Society' in page 35, the figures for deaths attributable to smoking in Ireland are given and the 1970 figure was 2,700 males and 500 females, total all smoking deaths of 3,200. And that was 9.7% of deaths, of the total number of deaths, 33,000. But by 1989, the latest information available from the ESRI, the male figure had gone up from 2,700 to 4,200 and the female figure had gone up from 500 to 2,600. So the total number of deaths from smoking had gone up from 3,200 to 6,800, more than doubled. And we're told now it's about 7,000. By 1989, the number of all deaths was down from 33,000 to 32,100 but the number of deaths from smoking had gone up from 9.7% to 21.2%. Now at present it is somewhere between a fifth and a quarter of all deaths, quite an extraordinary and sharp increase and in the case of women, more than a fivefold increase in less than 20 years. It's quite an extraordinary figure. Professor Luke Clancy gave evidence here yesterday. One of the things he said was that our approach to lung cancer as a country is mystifying. Now you know the deaths, you know the percentages, you know the fact that 90% of cancer from smoking can be dealt with. What steps will you take to demystify this, our approach to lung cancer? What will your contribution to that be? And would you see a role for yourself and your office, in setting targets perhaps to getting us back for example to the 1970 levels for a start, where do you see your role in that?

Deputy Keaveney: I welcome the gentlemen too, and I first of all wish you well in the aims that you set out, because if you achieve what you're setting out to do, it would be nice to be here in five years' time to see where you're at. Do you know how many people make up the tobacco section in the WHO at the moment? Do you think NRT should be available to non-medical card holders? Who chooses the pictures that are put on tobacco packets? Is it done nationally, in a European context or by the industry themselves? Would you sponsor or is it within your remit to sponsor pilot projects on peer messaging through the media in each county? If you were doing such pilot projects, I would ask you to start in the North and work down. What best practice countries are we following? Will there be real integration between all those involved in this issue and will it be co-ordinated through you from the non-smoker to the smoker or to the critically ill patient or is this going to be one of a plethora of people dealing with the same subject with nobody knowing what the other is doing, which seems to be what is happening at present?

Deputy Kenneally: I, too, welcome Mr. Power and Mr. Molloy. You refer to emissions from cigarettes and trying to put some sort of control on that. How are we going to do that if we do not know what is in the cigarette in the first place? Most people who came in have more or less admitted that we do not really know what constitutes a cigarette. It has also been stated to us that if we were to start with a clean sheet, so to speak, we would not allow smoking to commence at all. You talk about reconstituted tobacco, a new secret formula. Is it not possible to ban reconstituted cigarettes or do we know what is reconstituted and what is not reconstituted?

In relation to passive smoking, it is probable that education will do this more than anything else but what would you like to do in relation to passive smoking? Do we have any figures on the number of people who die each year from passive smoking? We are told 7,000 die from smoking. Do we know how many die from passive smoking? In regard to the schools' smokers survey, there is one matter that puzzles me. If you look at it, it says that for girls at age, there are no girls at age 12 smoking, but 26% of them are former smokers so it suggests that they smoked at nine, 10 and 11 and they then gave it up, and if you look at boys, there are no boys smoking at 12, there are no boys smoking at 13, 44% of them are former smokers at 14 so that again would suggest that they gave up smoking before they reached age 12. You would wonder if we started them all smoking before they are 12 would that get them off it completely?

Mr. Power: Deputy Mitchell made a number of points in relation to the statistical evidence. Obviously I am not an epidemiologist and I am not competent to make any meaningful comment other than to say the statistics we use are obviously the ones that are fully approved by both the Department and by epidemiologists and they are satisfied with the authenticity and accuracy of them. That said, it may very well be that there has been a combination of improved diagnosis, better statistical analysis and so on, but it is a frightening progression in the number of diseases from this. I have seen net analysis done of international studies that show that practically all cancers over the last 100 years have had a relatively flat line in terms of prevalence but in the case of smoking related cancers the graph has gone at 45 degrees. So certainly our experience is not in any way dissimilar from the rest of the western world and it is directly related to tobacco. We see de facto control studies in societies where they are more conservative, where women don't smoke and we have these standard controls.

As regards the role the office has, we have no role in relation to the clinical treatment of ill people obviously. Our role is largely to advance the tobacco free society message and to bring in the controls that are perceived as best practice internationally and by those means to drive down total smoking prevalence. I think in relation to cancers, the latency period is much longer and the actual return on these investments are quite some years away in terms of effort. This isn't the case in cardiovascular disease where we see, for instance, in California a fairly early return on the reduction in smoking prevalence and indeed in child related diseases there is an early and immediate return as well. So lung cancer is probably the one that we really have to invest effort in now for the future. I think our role and I hope our role is sufficiently well focused to deliver the specific interventions to have them properly appraised and monitored and to refine them as we progress. And if like the Sword of Damocles over our head simply smoking prevalence if that is not coming down we are not working. It seems to be a relatively simple issue for us.

On the WHO and on the strength of the WHO tobacco team, there has been a considerable improvement in WHO that I have been aware of but I don't have exact figures. But certainly the deficiencies that were very apparent in the initial inquiries have been resolved and there is a very strong team now headed by Dr. Derek Yack who is director of non-communicable diseases and mental health and I am not aware that they feel they have any shortages of staff at the moment. That's I think it's now a chapter item within WHO which means that the director general has taken a particular interest in it and, therefore, there is sustained focus on it.

You asked in relation to the new Directive under the questions of the pictures and the pictograms, there is a provision in the Directive that the European Union will issue guidelines and notices because there will have to be some standardisation under the internal market terms to allow trade. So the language is probably a bit ambivalent in the Directive at the moment. It was pretty much a last entry to it.

Certainly on the issue of sponsorship we are in discussions with one group in particular. We are very taken I think by the committee report on setting up a youth advocacy movement. We think that unless young people take ownership of the positive message, I don't think we are going to deliver it. We have to widen ownership and we have got to give it to children and young people particularly. And give it to them in a credible manner that they can use. So we are certainly very interested in that and that would depend on the functions the office is eventually given. In relation to best practices country-wide, we are obviously the national counterpart within WHO. We meet reasonably regularly and we discuss within WHO, Europe particularly, initiatives that are going on there. We also have extensive contacts through the United States and obviously within the European Union we have contacts there. And we are aware in the various practices that are involved in developing generally speaking, the ideas and measures proposed in the tobacco-free society report would be the ones perceived to be best practice at the moment. I think foremost among them is high price, elimination of advertising sponsorship, particularly the indirect advertising, the product placement and so on. I think the prohibition of smoking in public places, we see significant return from that.

I think the office's function in terms of the disparate agencies that are getting involved in this issue, first of all I think we welcome involvement from by as many different agencies and interests as we can and our job will be to stimulate bodies as diverse as FÁS, ICTU and the social partners to actually prioritise this issue. We hope if you like to operate a cuckoo strategy as much as we can and try to get other agencies to carry our message as well. We see this as part of our communications package.

On the technical questions about the emissions from cigarettes, it is correct to say that the existing legislation compels the industry to disclose to us or to disclose to the Minister the ingredients in cigarettes but it exempts tobacco, water, reconstituted tobacco and doesn't obviously cover the paper with a filter. We know from some of the patents that we have seen internationally the type of possible technologies that work around these exempted areas. For instance tobacco could include genetically modified tobacco to give very high yields. Tobacco can include tobacco ash where they would burn waste tobacco and use the ash. I have no direct evidence, people tell me that would be regarded simply as tobacco but the ash could in fact have a higher ammonia content and, therefore, help release more nicotine. The paper, there are technologies approved in patents to allow the paper to be sprayed with nicotine or to add nicotine dots on to the paper. So what exactly is on the paper and in the paper is something we don't know. Reconstituted tobacco itself is really a processing of waste tobacco as best we understand it where all the nicotine and other ingredients are taken out of it. The product is then emulsified and then rolled out, in the form, for all the world, like corrugated cardboard and then added on to that then the extracts are put back in in concentrations that the industry wish, and then they will say well there is nothing other than natural tobacco ingredients in the reconstituted sheet. So, there has been very little disclosure internationally about the exact nature of this and it remains probably one of the best kept secrets within the industry as to exactly what's in it. It would be interesting to know the degree to which there is an understanding even within the Irish companies if they are using this product, do they know what they're using.

Chairman: We have no role as a committee in terms of taking action against the tobacco companies. Rather our role is that the public interest out there needs to know what exactly went on, who knew, when and what. We feel that would be in the best interests of future public health policy in this area. So that is the definition of our role in this matter. Do you think, for instance, from what you were saying there, that the Irish tobacco companies were very well aware and that their knowledge was absolutely in line with the knowledge that we now know internationally was available to them in relation to the fact that smoking was injurious to health and that nicotine was addictive? Would you also comment on subliminal advertising and how concerned you are about that in this country? In relation to an item that appears here that seems to be in line with a suggestion made by Dr. Fenton Howell in his presentation about the role of RTÉ as a statutory authority and the subliminal promotion of tobacco in relation to the Grand Prix and indeed other areas, what are your views on all that?

Mr. Power: As regards the state of knowledge of the Irish companies I can only speculate and surmise from the evidence they've already given and that, as I said in my statement, would seem to suggest that the Irish companies are not only owned by larger enterprises but the management of them seems to be integrated. I couldn't understand how a company could produce modern cigarettes without knowing these technologies. It would seem a contradiction in itself to say that cigarettes comply with these modern standards, which we know they do, and at the same time say well we don't know how they're made or what technologies are used. It seems to be an inherent contradiction to assert they don't know so I think it's a reasonable surmise that they must know their own business.

Chairman: I suppose it is ironic that they are very well aware of how to argue the legal position in relation to addiction.

Mr. Power: I think, on the issue of RTÉ, I mean I wouldn't like to add much to it, as I said in my statement. There is very compelling evidence that advertising bans only work when they're complete. There isn't a proportionate effect. If you ban 90% of advertising, you don't get a nine tenths proportionate return, because the gap in the ditch you've left is where the tobacco industry run into. And we've seen this very strongly with Formula One and indirect advertising. And clearly, Formula One product is heavily built by its sponsors. The Jordan team as I understand it receives substantial funding from the Gallagher group, and other teams are similarly funded. Some way or other that must feed into the building of the product or into its marketability. I think that, I've never been able to fully understand how a broadcaster can distance themselves from the impact this advertising is having, by saying that it's not of commercial significance to us. It seems to me the question is, is the advertising being delivered through Formula One type promotions? Is that impacting on consumption? And I think that, Judge Fennelly's judgment as Advocate General when he appraised the Advertising Directive for the ECJ said that, and I don't have the exact quote, but his view was advertising is indivisible and that it doesn't matter what you say your intentions are it impacts on children. Indeed the little evidence we're now building shows this to be true. So, I do think that the Formula One thing is the fundamental gap in our prohibition on advertising and I think the public service broadcaster might be able to help us understand it better.

Chairman: My question about the State taking a case from the evidence that is apparent, what would your views be, now that you've separated yourself from the Department of Health and Children? In your new role, do you think the State should pursue a case?

Mr. Power: I'm not that separated, Chairman. I think that the tobacco free policy review group prepared a report which was forwarded to the Attorney General and I think that the deliberations of the Attorney General will have to be awaited. The outcomes achieved in the United States litigation, in my view, were threefold. The first one was equitable reliefs. Largely these are reliefs that we can attain in Ireland through legislative measures and which we already had. In the United States it wasn't possible because of the particular political cultures. They achieved financial transfers to the public health community. Thirdly, and perhaps more importantly, they achieved a discovery process and I think it was the discovery process that changed public opinion in America and informed us all about the extent of the problem. I suppose from translating that into an Irish context I would certainly see very considerable value in the discovery process and I think that this committee has given a very, very powerful one - the plenary committee and this sub-committee has given a very powerful discovery process and I think that if that helps to inform public debate that is a major outcome that was sought in the United States. I'm not so sure that behaviours that are pertinent to one particular legal culture readily translate into other cultures. I think we have to allow lawyers time to evaluate these situations and to give it the care and attention that it deserves.

Chairman: On the broadcasting of the Grand Prix, Mr. Malone was here earlier and I put a similar question to him but he was making the case, why would you ban it on an Irish television channel when all the other satellite channels will actually have broadcast this particular Grand Prix? So, it won't have the direct effect and when you can't have a global ban then you cannot ban the national utility.

Mr. Power: Well, I think we're addressing this both at European Union level. There's a new advertising directive that has just been published which will try and address that and, hopefully within the framework convention in the international Treaty - and it's one of the reasons we need the Treaty - this question will also be addressed. As regards why the public service broadcaster should in some way be disadvantaged in broadcasting this, I think the question really probably is if this is not perceived to be a public good, which I think most people agree it is not, then I think that it's reasonable to ask them, you know, where do their judgments lie and how do they form them. I think the case may be very valid, I don't know, that they shouldn't be disadvantaged relative to competitors from outside the country and so on but I think there's a question of law and then there's the question of what is appropriate behaviour. It seems to me that I'm not really equipped to answer for any television station about how it perceives its duty. I'm sure they're well able to answer it for themselves.

Chairman: We've written to them anyway on that particular issue.

Deputy Keaveney: This may be irrelevant but I think it's probably relevant, the small packets of stick cigarettes, the sweet cigarettes for children, were they banned?

Mr. Power: No, there's a proposal, I think, to ban them but they're not currently banned. There is an EU Directive, for instance, banning imitation foods because of the danger of children ingesting them but for some reason it didn't extend to cigarettes.

Chairman: I wish to thank Mr. Power and Mr. Molloy for appearing before us and for giving us what was an extremely enlightening presentation that will be very helpful to us when we're putting our report together. We wish you well in your new office and, Mr. Power, we know that it's in safe hands and we have been very impressed with your presentation here and your grasp of the whole issue. So, well done.

Mr. Power: Thank you very much.

Chairman: As there is no other business we will adjourn.

The sub-committee adjourned at 12.40 p.m.

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