The Dáil is obviously wrapping up today. This will be my last legislative act in this Dáil term, and it is a very positive one for us to be finishing on, which is essentially aimed at moving the age, from 18 to 21, at which cigarettes or tobacco is sold to a consumer. Ireland led the way with the workplace smoking ban some years ago and we will be leading the way on this as well. It is very positive legislation with which to be wrapping up this Oireachtas. I thank the Senators for the opportunity to bring the Public Health Tobacco (Amendment) Bill 2024 to the House. The Bill has one purpose, to increase the minimum age of the sale of tobacco products to 21. It is also a signal that we as a country are moving from regulation of these products to beginning the elimination of the use of them. The Bill focuses on our young people, the group most vulnerable to tobacco use and the worst outcomes of it in the long term. Beginning tobacco use earlier in life increases potential duration of smoking, which directly impacts severe risk of underlying conditions, very serious illness and, of course, death. With lung cancer, the risk rises more steeply due to the duration of smoking rather than the number of cigarettes smoked. For chronic obstructive pulmonary disease, COPD, the risk increases directly with the total number of cigarettes consumed over a lifetime. In addition, starting smoking at a younger age increases the likelihood of smoking a higher number of cigarettes per day. These two factors, duration of smoking and intensity of smoking, impact the risk of cancers, including oral, liver, pancreatic and stomach cancers. These factors also increase the risk of cancer of the larynx and lung cancer. Smoking causes two thirds of cancers of the larynx and three quarters of lung cancer.
We are introducing this measure now because the expected continuing decrease in our smoking prevalence has stalled, unfortunately. According to our national Healthy Ireland survey, adult smoking was at 17% just before Covid and increased very slightly to 18% during Covid. In addition, although the prevalence of children smoking is reducing, which is great, the results from the 2019 European School Survey Project on Alcohol and Other Drugs showed smoking prevalence among young people of 15 and 16 years was at 14.5%, up from 13%. This is something we need to watch very closely. This problem is not going away on its own, unfortunately. We expected a decrease rather than an increase because there had been a consistent trend for decades, but that decrease has stalled, and that is one of the reasons we are here today.
Why this measure? Because we know it works. A 2020 study of US states showed that raising the age of sale to 21 was strongly associated with reduction in smoking among 18- to 20-year-olds and, critically, among 16- and 17-year-olds. Analysis of our own 2007 increase in the legal age from 16 to 18 found smoking reduced in that bracket, along with the likelihood of ever trying a cigarette going down among 14- to 15-year-olds. While this move limits availability of cigarettes for 18-, 19- and 20-year-olds, there is, in fact, a secondary benefit which is potentially even better in the long run, which is that it reduces smoking in 16- and 17-year-olds as well. That is very important. A 16- or 17-year-old might be able to pass for 18 in a shop or might have a brother or friend who is 18 or 19. At 16 or 17, the likelihood of being able to pass for 21 or 22 is less, as is the social connectivity of being able to get someone who is 21 or 22 to buy the cigarettes in the first place. When we look at 18-, 19- and 20-year-olds, this will also have an important effect for 16- and 17-year-olds. We have seen modelling from University College London, updated last year, that estimated that if they did in the UK what we are doing now for people aged 18 to 21, they would see a very significant reduction in smoking among younger people. Information from the EU and the UK shows that about 38% of smokers, or two in every five, become regular smokers between 18 and 25. The measure will also have an impact on those under 18 for the reasons I have put forward, which will be a very positive additional benefit of this legislation.
One of the more common objections to the proposal is that the State should leave adults free to make their own decisions, a philosophy I have a lot of time for. We all have the right, when we are adults, to make decisions that do not necessarily improve our health. It is something that is very important. When considering bringing in restrictions for people over the age of 18, we are no longer in the child protection or health space and we have to take that very seriously. Where this situation we are discussing is different and where it is legitimate to move from the age of 18 to 21 is that cigarettes are highly addictive. We talk about personal choice, and that is very important as our society is based on freedoms and personal choices, but if these companies can get a 15-, 16- or 17-year-old addicted to cigarettes, there is a strong argument that, at 18, 19 or 20, they are not making a choice, they are in addiction. I do a lot of work with addiction services in Wicklow, with Tiglin, for example, and I meet amazing people who have been through their services who have been in addiction, be it alcohol, cocaine, heroine, benzodiazepines and all sorts of different things. Several of them have said to me the most difficult thing to give up was the cigarettes. They are highly addictive. What we want is for people to be able to make their own choices, good or bad, but free from addiction. That changes the framing of the conversation.
The level of addiction is quite extraordinary for teenagers. A 2011 study found two things. One in three teenagers develop a compulsion to smoke after just three or four cigarettes. Is that not extraordinary, that level of addiction? Half of them develop a compulsion to smoke with ten to 20 cigarettes - one packet of cigarettes. That is half of teenagers wanting to smoke, which we know quickly develops into addiction. I would argue these tobacco companies and products are robbing teenagers of free choice by turning them into addicts while they are still very young. We have also seen the moves from the vaping companies to very clearly, deliberately, cynically and dangerously target very young people with colours, flavours, point of sale and all these things. The speed at which nicotine addiction can take hold means a lot of young people are becoming addicted without even knowing it. It happens before they realise it. That is something to be aware of. Our own Healthy Ireland study undertaken last year found that half of smokers in the 17 to 24 age group made an attempt to quit in the past year. So, what do we know? We know it is highly addictive for teenagers and, arguably, they are being deprived of free choice coming into their young adult years if they are already in addiction, while half of them tried to quit just last year. This is not something that young people really want to be doing. Tobacco smoking is not only addictive but also catastrophically bad for health. It causes catastrophic illness and premature death, which of course also negates all the other rights, freedoms and choices that people want to make.
I will run through the Bill very quickly-----