Dr. Michael Boland, Irish College of General Practitioners Global Alliance Against Respiratory Disease Primary Prevention & Health Promotion.

Dr. Michael Boland, Irish College of General Practitioners

Global Alliance Against Respiratory DiseasePrimary Prevention& Health Promotion


WG1. Defining the Burden, Risk Factors, & Surveillance

WG2. Awareness, Advocacy, & Priority

WG5. Control of CRD & Allergies, Drug Availability & Affordability.

WG3. Prevention,& Health Promotion

WG4. Diagnosisof CRD & Allergies.

WG6.Paediatric Asthma


WG 3. Prevention & Health Promotion

ChairmanshipChairmanship

Composition of Group ?Composition of Group ?

2005 Annual Report2005 Annual Report

2006 Action Plan & Indicators2006 Action Plan & Indicators

Quarterly Telephone ConferencesQuarterly Telephone Conferences

One face-to-face meeting/yr.One face-to-face meeting/yr.


Open Fires for Cooking & Heating

Which countries ? Then selected nationalinitiatives based on substitution


The Irish Office of Tobacco Control

Research

Inspect Regulate

Inform


Seven Tier Plan

Educate people about smoking and its effectsEducate people about smoking and its effects Provide more help for smokers to quitProvide more help for smokers to quit Further regulate theFurther regulate the Tobacco Industry Tobacco Industry Protect everyone Protect everyone from Passive Smoking (ETS)from Passive Smoking (ETS) Don’t just pass laws – implement themDon’t just pass laws – implement them Extend ‘ownership’ to all the people Extend ‘ownership’ to all the people Use International Use International Co-operation & AdviceCo-operation & Advice


Prevention but also Cessation

If we focus If we focus onlyonly on prevention it on prevention it will be 40 years before the will be 40 years before the substantial benefits will be fully substantial benefits will be fully realised.realised.

Cessation substantially reduces Cessation substantially reduces smoking related risks within 1–2 smoking related risks within 1–2 years.years.


Building a National Partnership

Members of the Parliamentary Committee NGOs - Cancer Society, Heart Foundation etc. Public Health leaders focus on ET Smoke The Minister of Health Statutory Agencies

Health & Safety AuthorityEnvironmental Health Office

(The Tobacco Industry - soon excluded)


Power to Prohibit & Restrict Smoking

Public Transport Hospitals and Clinics Schools and Colleges Public Offices Places of work Cinemas, Theatres, Concert Halls, etc. Pubs, Bars, Clubs, and RestaurantsPubs, Bars, Clubs, and Restaurants Other ‘Specified Places’

Offence to smoke or to permit it - ‘Person in Charge’ isGuilty of an Offence

The Tobacco Acts


Key Influences & Opportunities

An All-Party Committee – disenchanted

The WHO, FCTC, & European contacts

Dedicated Office of Tobacco Control

Workers rights to a smoke-free workplace

Trade Union & (later) Employer Support

A Courageous & Ambitious Minister

A small but highly committed OTC (15 staff)


International Support for ETS Ban

WHO & FCTCWHO & FCTC International NGOs, Conferences, Networks.International NGOs, Conferences, Networks. Experience in New York and elsewhereExperience in New York and elsewhere Authoritative Evidence & ResearchAuthoritative Evidence & Research The ‘week-long visit’ = media, public, privateThe ‘week-long visit’ = media, public, private Ministerial & deputies foreign Visits Ministerial & deputies foreign Visits

All Better Educated


OTC Preparatory Expert Reports

Expert Report on E.T.S. Expert Report on E.T.S. (Allwright et al.)(Allwright et al.) What do smokers want?What do smokers want? (Loscher, MRBI)(Loscher, MRBI) Productivity Costs smokers and society Productivity Costs smokers and society (Welte)(Welte)

Statement by Medical Colleges and DeansStatement by Medical Colleges and Deans Irish Women and Tobacco Irish Women and Tobacco (WHO, Slan, MRBI)(WHO, Slan, MRBI) Ventilation Ventilation (James Repace USA)(James Repace USA)

Economic Effects on the Hospitality IndustryEconomic Effects on the Hospitality Industry

(TNS- MRBI, Durcan/McDowell,UCD)(TNS- MRBI, Durcan/McDowell,UCD)


Ventilation

Bar staff must be protectedBar staff must be protected No ‘Acceptable’ level of exposureNo ‘Acceptable’ level of exposure Effective Ventilation rates are impractical? Effective Ventilation rates are impractical?

Ventilation Costs? - Ventilation Costs? - a level playing pitch? a level playing pitch? Tobacco industry - hospitality programmesTobacco industry - hospitality programmes

Outdoor smoking areas – false walls.Outdoor smoking areas – false walls.


Key messages: Everyone has the right to live in clean air. Repeated exposure to environmental smoke

may cause incurable COPD, asthma, cardiovascular disease and cancer.

Complete elimination of the harmful smoke is the only way to remove the risk.

This applies to tobacco smoke in bars and all other ‘at risk’ environments.


Price Increases can stop teenagers smoking

2% 6%14%

32%

48%

78%

None 10% 25% 50% 100% 250%

8-17 S

Price increase

Very Unlikely To Continue Smoking


Most people obey the law – smokers and non-smokers

Strong support from key stakeholders - unions, health community, policymakers, hotels federation, restaurants, tourism etc.

Intensive compliance building locally -

EHO’s - in partnership with business

Building Compliant Environments


After Two Years Compliance very highCompliance very high Prosecutions after 2 yrs = only 61 (1)Prosecutions after 2 yrs = only 61 (1) Throughout the countryThroughout the country 94% of all workplaces included such as..94% of all workplaces included such as..

93% of hotels; 99% of restaurants; 90% of bars; 97% of other premises


Minister announced new controls on the sale of cigarettes

Total ban on sale of packs < 20 cigarettesTotal ban on sale of packs < 20 cigarettes

Ban on sale of cigarettes to under 18 yr oldsBan on sale of cigarettes to under 18 yr olds

Ban on in-store advertisingBan on in-store advertising

New register of tobacco outlets – those New register of tobacco outlets – those

defying the regulations will be fined and may defying the regulations will be fined and may

lose their right to sell cigarettes. lose their right to sell cigarettes.


Strong Public Support –Still Growing

67% support before the law

89% after introduction, called it a success

Support one year on (inc. smokers)

98% believe workplaces are healthier

(94% of smokers)

96% think law is a success (89% of smokers)

93% think it is a good idea (80% of smokers)


Concerted Action on Tobacco

Since the Irish Office of Tobacco Control was established in 2001 the % of the population smoking has fallen by a quarter (31% to 23.5%).

Smoking is banned in all public places including Bars since 2004.


But lets not forget…….

Smoking is the leading cause of premature Smoking is the leading cause of premature death killing almost 6,000 people in Ireland death killing almost 6,000 people in Ireland each year.each year.

Lifetime smokers have a 50% chance of dying Lifetime smokers have a 50% chance of dying from a tobacco related illness – half will die in from a tobacco related illness – half will die in middle age losing on average 22 years of life.middle age losing on average 22 years of life.

Irish women smoke as much as men – by 2020 Irish women smoke as much as men – by 2020 lung cancer will be mostly a female disease.lung cancer will be mostly a female disease.

One fifth of 15-18 year olds continue to smokeOne fifth of 15-18 year olds continue to smoke


The Possibilityof a Major Breakthrough


That’s all folks !

Dr. Michael Boland, Irish College of General Practitioners Global Alliance Against Respiratory Disease Primary Prevention & Health Promotion.

Documents

tobacco smoke

tobacco industryprotect

health promotionwg4

public health leaders

environmental smoke

harmful smoke

passive smoking etsdont

smoking related risks