Blog: Tobacco Endgame – One step closer on the island of Ireland?
Tobacco

In this blog for World No Tobacco Day, Louise O’Connor from IPH's policy team discusses the recently proposed changes to tobacco control legislation in Ireland and Northern Ireland and why these measures are needed.

 

 

Significant progress is being made on tobacco control legislation on the island of Ireland. Although the proposed legislations differ north and south of the border, both aim to protect children, improve the health of the overall population, and decrease pressure on health services.

Northern Ireland: 

On Tuesday 21 May, outgoing Health Minister, Robin Swann, welcomed the passing of a motion to include Northern Ireland in the UK Tobacco and Vapes Bill. The Bill will now be brought forward by his successor, Mike Nesbitt.

The Tobacco and Vapes Bill

The Tobacco and Vapes Bill, introduced to the UK Parliament on 20 March 2024, seeks to reduce smoking and tackle vaping among young people across the UK. If passed, the law will ban the sale of tobacco products to anyone born after 2009. The aim of this legislation is to create a ‘smoke-free generation’. It will also change the way that e-cigarettes or vapes are marketed and sold so that children are less likely to use them. 

The UK government intends to enact the smoke-free generation measures in 2027. If the Bill successfully passes through the House of Commons and the House of Lords, Northern Ireland will introduce the measure alongside England and the devolved administrations. However, following the announcement of a UK general election on 4 July 2024, the Bill was not included in the “wash-up” period and therefore, the timeline of passing the Bill is unclear. As both Labour and Conservative parties support the Bill, it is expected that the outcome will be unchanged. 

Why is this legislation needed?
  • Tobacco use is the single largest preventable cause of death in Northern Ireland (1)

  • Tobacco contributes to 2,200 deaths annually (2) 

  • The death rate from tobacco-related diseases in the most socially deprived areas is double that of the least deprived areas (3). 

Sources: Foster C, Scarlett M, Stewart B. Young Persons’ Behaviour and Attitudes Survey 2022 - Substance Use - (Smoking, Alcohol & Drugs). Belfast; 2023 (4), 

Corrigan D, Scarlett M. Health Survey (NI): Data tables 2022/23. Belfast; 2023 (5)

 

IPH’s contribution to the Tobacco and Vapes Bill

  • IPH published a Policy Brief on the Tobacco and Vapes Bill and what it will mean for Northern Ireland in the near future

  • In April 2024, members of IPH policy team attended Stormont to give evidence to the Northern Ireland Assembly Committee for Health on the Tobacco and Vapes Bill. Watch the Northern Ireland Assembly Committee for Health recording here.

  • In May 2024, IPH provided written evidence to the Northern Ireland Assembly and the UK House of Commons on the Tobacco and Vapes Bill.

 
Ireland: 

On Tuesday 14 May 2024, the Cabinet approved a proposal for legislation that will increase the age of sale of tobacco from 18 to 21, a policy known as ‘Tobacco 21’ (T21).

Tobacco 21

Ireland will be the first country in the EU to introduce this measure. Other countries, including USA, Singapore, Guam, Honduras, Samoa, Uganda, and Sri Lanka, and Kuwait have already introduced T21. 

This measure aims to reduce the number of children who start smoking, as recent estimates showed an increase in smoking among 16-year-old boys (9). The T21 measure is projected to have the largest reduction in uptake among children aged 15 to 17, the same age groups being targeted in the first few years of Northern Ireland’s proposed smoke-free generation measure (10). While T21 may act more quickly to reduce youth initiation, the impact may not be as significant as that gained from the smoke-free generation measure over the longer term. 

In a hypothetical scenario where the UK Tobacco and Vapes Bill is enacted in 2027, and T21 is enacted in Ireland in 2026, the legal age of sale could become aligned in 2029, after which Northern Ireland could see additional benefits in terms of reduced smoking prevalence. 

This hypothetical scenario is outlined below:

 

Why is this legislation needed?

  • Tobacco use is the leading cause of preventable death in Ireland (6)

  • Almost 6,000 people who smoke die each year from tobacco-related diseases (6)

  • In 2016, there were 33,615 tobacco-related inpatient hospital admissions, with an estimated cost of €172 million (7).

Source: Gavin A, Költő A, Lunney L, Maloney R, Walker L, Gabhainn SN, et al. 

The Irish Health Behaviour in School-aged Children (HBSC) Study 2022. Galway; 2024 (8)

IPH’s contribution to Tobacco 21

  • In 2020 and 2021, the Royal College of Physicians of Ireland (RCPI) Policy Group on Tobacco and IPH submitted joint written positions on the Pre-Legislative Scrutiny of the Public Health (Tobacco Products & Nicotine Inhaling Products) Bill 2019. Both submissions included recommendations to raise the age of sale of tobacco to 21.

  • In February 2022, IPH Director of Policy Dr Helen McAvoy and Professor Des Cox from the RCPI Policy Group on Tobacco appeared before the Oireachtas Joint Committee on Health to give evidence on the Public Health (Tobacco and Nicotine Inhaling Products) Bill 2019, including the recommendation to raise the age of sale of tobacco to 21.

  • In September 2022, the RCPI Policy Group on Tobacco and IPH published a report which makes the case for raising the minimum age of sale of tobacco to 21.

  • Public Health Development Officer, Lauren Rodriguez, presented the findings from this report at the Faculty of Public Health Medicine Summer Scientific Meeting in May 2023.

     

  • IPH also developed T21 Mythbusters to debunk some of the myths that persist around tobacco.

 
Summary

There has never been a more important time to legislate on tobacco. The epidemic of tobacco-related disease rages on across the UK, Ireland and Europe. The aim of both legislative proposals is to protect children from starting to smoke in the first place. The Tobacco and Vapes Bill and the T21 policy are not an attack on people who smoke and will not prevent today's adults who smoke from accessing a tobacco product. Progressing both of these tobacco measures on the island of Ireland offers a once-in-a-lifetime opportunity to make a big step forward in the tobacco endgame.


References

1. Department of Health, Social Services, and Public Safety. Ten-Year Tobacco Control Strategy For Northern Ireland. Belfast; 2012.

2. Department of Health Northern Ireland. The 10 Year Tobacco Control Strategy For Northern Ireland: Final Review. Belfast; 2023.

3. Atcheson R, Laverty C. Health Inequalities: Annual Report 2023. Belfast; 2023.

4. Foster C, Scarlett M, Stewart B. Young Persons’ Behaviour and Attitudes Survey 2022 - Substance Use - (Smoking, Alcohol & Drugs). Belfast; 2023. 

5. Corrigan D, Scarlett M. Health Survey (NI): Data tables 2022/23. Belfast; 2023.

6. Health Service Executive. Smoking - the facts Dublin: HSE; 2023

7. Sheridan A, Quintyne, K.I., and Kavanagh, P. Counting the Toll of Smoking-Attributable Hospitalisations. Irish Medical Journal. 2020;113(1):8.

8. Gavin A, Költő A, Lunney L, Maloney R, Walker L, Gabhainn SN, et al. The Irish Health Behaviour in School-aged Children (HBSC) Study 2022. Galway; 2024.

9. Sunday S, Hanafin J, Clancy L. Increased smoking and e-cigarette use among Irish teenagers: a new threat to Tobacco Free Ireland 2025. ERJ Open Res. 2021;7(4).

10. Royal College of Physicians in Ireland. Tobacco Free Ireland: Time For Tobacco 21. Dublin; 2022.

 

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