The Irish Workplace Ban

1
The Irish Workplace Ban

• Luke Clancy
• Director General
• Research Institute for a Tobacco Free Society
• Dublin
• Monday 10th Sept. 2007 Edinburgh International
  Conference Centre, Scotland

2
Environmental tobacco smoke- is it bad for you?

• For the moment most, but not all, the pressure
  to have the right to breathe smoke-free air must
  be based on aesthetic considerations rather than
  on known serious risks to health.
• Editorial, BMJ, 1976.

3
The 70s

• Active smoking harmful
• Smokers rights universal
• ETS ??effects, intolerance

4
The 80s

• Increasing awareness of tobacco control issues
• Advertising bans
• Health warnings on packs
• Sales to children
• ETS could it be bad for you?

5
The 90s

• Increasing awareness of adverse health effects of
  ETS
• non
  smokers rights
• 
  versus
• 
  smokers rights
• Irish Legislation
• Non smoking areas- in specified
  locations
• e.g. Public offices, schools, colleges, cinemas,
  theatres, taxis, health and child care
  facilities, restaurants
• Voluntary code for the workplace

6
History of Evidence
1 Reducing the Health Consequences of Smoking
25 years of progress. A report of the Surgeon
General. US Dept. of Health and Human Services,
1989. 2 Environmental tobacco smoke Measuring
exposures and assessing health effects.  US
National Research Council, 1986   3 The health
consequences of involuntary smoking.  A report of
the US Surgeon General, USDHHS, 1986 4 Effects
of passive smoking on health  National Health and
Medical Research Council. Australian Government
Publishing Service, 1987. 5 Fourth report of
the Independent Scientific Committee on Smoking
and Health, DHSS, 1988 6 Respiratory health
effects of passive smoking Lung cancer and other
disorders. The report of the US Environmental
Protection Agency, 1993.
7
1994 - Review of the effectiveness of the 1992
voluntary code

• Restructured Consultative Committee
• Only 1,200 copies sent to employers
• Poor awareness of the Code
• Recommend continue voluntary code as against
  legislation
• Further review in 2 years
• Revised code of practice
• Endorsed by IBEC/ICTU
• Circulate widely

8
Parliamentary Enquiry 1999

• Rejected tobacco industry insistence that ETS not
  harmful to non smokers
• Recommended new national anti-smoking strategy,
  many far-reaching initiatives, including
• Restrictions on workplace, including bars
• New unit to deal solely with tobacco control
  issues

9
(No Transcript)
10
Significant Events

• 
  2000 Complete ban on
  advertising in print
  media
• 2001 Joint Committee
• 2001 The Public Health (Tobacco) Bill 2001

11
(No Transcript)
12
Office for Tobacco Control

• Key objectives
• Raise public awareness of dangers of smoking
• Help more smokers to quit
• Protect children by tougher regulation of tobacco
  industry
• (esp. promotional activities)
• Provide additional protections against
  second-hand smoke, and
• Ensure better enforcement of tobacco control laws
  

13
Research Institute for a Tobacco Free Society
The Institute is an independent company formed
on the basis of a partnership between the
Office of Tobacco Control and ASH Ireland IHF
/ ICS 
14
(No Transcript)
15
Dr Connolly was speaking at a seminar organised
by the Office of Tobacco Control (OTC),
4/3/2003  Smokers - Attitudes, Behaviour and
Cessation. The seminar was opened by the
Minister for Health and Children Micheál Martin
TD and was held in the King's Inns, Dublin
16
Expert says 240,000 Massachusetts smokers quit
as a result of state's comprehensive tobacco
control programme
Dr Gregory Connolly, Director, Tobacco Control
Program of the state's Department of Health.
17

• I believe that in every decade, we are
  presented with one major choice - a choice
  where, if we call it right, we change the
  future for the better. This is one of those
  choices, and I'm making the call the way it must
  be made taking tobacco out of the workplace.
  Completely and for good.

Micheal Martin TD, Minister for Health and
Children Jan 30, 2003
18

• Authors concluded
• ETS cause heart disease cancer and respiratory
  probs.
• Employees need to be
  protected
• Ventilation is ineffective
• Legislative measures are required

30th January 2003
19
(No Transcript)
20
NGO/Allied Community
ASH Ireland Irish Cancer Society Irish Heart
Foundation ICGP Trade Unions Professional
bodies Other NGOs
Public Service
Political system
Micheál Martin Batt O Keefe Alan Shatter, Gay
Mitchell, O. Mitchell Liz McManus John
Gormley Tom Kitt
Office of Tobacco Control DOHC Health and Safety
Authority Health Boards
SMOKE-FREE WORKPLACES
21
(No Transcript)
22
Features of Campaign

• key messages positive health protection
• Illness from second-hand smoke in workplace is
  preventable
• Research scientific, attitudinal, economic.

23
Office for Tobacco Control
Public well informed about law rationale
Built confidence that law was workable,
enforceable and would be implemented Prepared
for counter arguments with evidence based
response
24
Success Factors

• Sustained political leadership/commitment
• Cross party political support
• Partnership Health alliance, OTC, DOHC
• Trade union support

25
Irish Indep 29 Oct 03
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
Evaluationof ban
30
Evaluation Strategy

• Change in Indoor Air Quality
• Health effects
• Smoking Prevalence rates
• Compliance with legislation post implementation
• Evaluate economic changes pre and post law
• Media analysis

31
(No Transcript)
32
Effectiveness

• Public support
• Support strong at outset and grows
• 67 support before the law
• 89 success . after introduction (independent
  research
• June .04)
• 82 support (DOHC research July .04)
• Voted no. 1 .high. of 2004 . RTE National New
  Year's Poll
• Overwhelming support one year on (inc. smokers)
• 98 believe workplaces are healthier (inc. 94 of
  smokers)
• 96 think the law is a success
• 93 think it is a good idea

33
Compliance

• Inspection Programme of Premises
• Smoke Free Compliance Line (Complaint Calls)
• Public Attitudes and Behaviour

34
Compliance

• Three years on
• Compliance very high 95
• Throughout the country
• 94 of all workplaces under National Tobacco
• Control Inspection programme (HSE OTC)
• 93 of hotels
• 99 of restaurants
• 90 of licensed premises
• 97 of other premises
• 92 of workplaces inspected by HSA
• Breaches of legislation small no. of offenders
• Prosecutions to end 2004 12 one year 20
• Currently approx. 28 (inc. taxi case)

35
Health Benefits of workplace smoking ban

• Reduced Exposure to SHS
• Improved Health

36
Outcome Measurements

• Health Effects
• Respiratory Symptoms
• Sensory irritation Symptoms
• PFT measurements, (FEV1, FVC, P.F)
• Carbon Monoxide, Cotinine.
• ETS Exposure
• Particles PM2.5, PM10,
• Benzene

37
Self Reported Exposure
38
Result Average PM2.5 Levels
Pre Ban Range 3.2 to 315.1 (?gm-3) Post
Ban Range 21.4 to 0.6 (?gm-3) Benzene
18.8(14) 3.72(1.6)
-80.2 Plt0.01
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
Percentage change in PFT parameters
43
Economic Changes

• Sales Revenue
• Patronage
• Employment Rates/Payroll
• Business Profit
• Tourism

44
(No Transcript)
45
Source OTC
46
Source OTC
47
To summarise

• Improvement in breathing and irritant EYE and
  ENT symptoms
• There has been a marked reduction in breath CO
  and cotinine levels in nonsmokers
• There is an increase in lung function, best in
  those with least exposure to ETS

48
CONCLUSION

• The workplace ban on smoking has been a success.
• It has resulted in an improvement in symptoms
  and lung function.
• It has helped to safeguard health of workers by
  reducing their exposure to the harmful effects
  of ETS.

49
(No Transcript)
50
Research Collaboration

• Pat Goodman - DIT, Kevin St
• Michele Agnew - DIT, St James
• Marie McCaffrey - HSE, DIT
• Gillian Paul - TCD
• Shane Allwright - TCD
• Jim McLaughlin - UCD NUI
• Kevin Kelleher - UCD NUI
• Colin Hogg - UCD NUI

51
Acknowledgments

• Kathleen Bennett, Zubair Kabir
• Funding
• DOHC, RCD Trust, ENSP