Controlling passive smoking through legislation in Ireland: an attack on civil liberty or good public health policy?

comprehensive legislation was enacted in Ireland banning all forms of smoking in the workplace. This legislation was designed to prevent any worker being subjected to passive smoking and represented the first legislation of its kind in Europe. While broadly similar legislation is in place in parts of the USA, particularly in New York and California, the Irish legislation represented the first national legislation banning smoking in the workplace. Similar legislation has followed in Norway, and is likely to be introduced shortly in several other European countries. The Irish legislation represents the culmination of efforts on the part of the national government and health authorities, dating back several decades, to reduce tobacco consumption. Successive legislation and regulations from the 1970s onwards prohibited tobacco advertising on radio and TV, and limited advertising in the print media. Taxes on tobacco products were maintained among the highest in Europe and discount selling was prohibited. Furthermore, spending on advertising and promotion by tobacco companies was strictly regulated. Education programmes were also developed by the Health Promotion Unit of the Irish Department of Health to promote voluntary smoking cessation, and a voluntary ban on smoking in the workplace was developed in conjunction with major trade union and employer organisations. Organisations such as the Irish Heart Foundation, Irish Cancer Society, Irish Thoracic Society, and Action on Smoking and Health (ASH) were actively involved in lobbying efforts and education programmes aimed at reducing the level of tobacco consumption. The measures described above had considerable success in that the prevalence of smoking in Ireland fell from 45% in the mid 1970s to below 30% in the mid 1990s. However, smoking-related diseases remained highly prevalent and international statistics demonstrate that Ireland has one of the highest mortality rates in Europe from ischaemic heart disease. Furthermore, the European Lung White Book [1], produced in 2003 by the European Respiratory Society and European Lung Foundation, demonstrates that Ireland has the highest mortality rate in Europe from lung disease. The evidence for a direct association of passive smoking with disease and death is now very strong, both in general [2], and specifically related to respiratory disease [3–7], ischaemic heart disease [8–11] and cancer [12–14]. There is also good evidence of specific molecular mechanisms involved in these relationships [15–17]. The present Irish legislation banning smoking in the workplace has its direct origins in 1999, when the Parliamentary Committee on Health undertook a detailed examination …