dr. michael boland, irish college of general practitioners global alliance against respiratory...
TRANSCRIPT
Dr. Michael Boland, Irish College of General Practitioners
Global Alliance Against Respiratory DiseasePrimary Prevention& Health Promotion
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
Open Fires for Cooking & Heating
Which countries ? Then selected nationalinitiatives based on substitution
Dr. Michael Boland, Irish College of General Practitioners
The Irish Office of Tobacco Control
Research
Inspect Regulate
Inform
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
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)
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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)
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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)
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
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)
Dr. Michael Boland, Irish College of General Practitioners
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.
Dr. Michael Boland, Irish College of General Practitioners
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
Dr. Michael Boland, Irish College of General Practitioners
The Possibilityof a Major Breakthrough
Dr. Michael Boland, Irish College of General Practitioners
That’s all folks !