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Home > Dail Eireann topical issue debate. Tobacco control measures [in pregnancy].

[Oireachtas] Dail Eireann topical issue debate. Tobacco control measures [in pregnancy]. (14 Nov 2013)

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Deputy Catherine Byrne: Each morning as I pass the Coombe Women & Infants University Hospital on my way to the Dáil, I see pregnant women standing outside taking a smoke break before they return to their hospital beds. These women are often heavily pregnant and one cannot help but feel concern given the risk to their unborn babies and themselves.


The medical community is in no doubt about the dangers. According to the Irish Cancer Society, "smoking during pregnancy can lead to miscarriage, stillbirth and illness in early infancy".In fact, so sensitive is the unborn baby to the effects of smoke that the Irish Cancer Society says that smoking in the presence of a pregnant woman may also endanger the health of the foetus. Aside from these very serious risks of miscarriage and stillbirth, a recent study shows in stark detail the infection risks associated with smoking during pregnancy. The findings, published on 6 November in the US journal, Paediatric Infectious Diseases, show that babies born to mothers who have smoked during pregnancy are at increased risk of developing a wide range of infections. They are 50% more likely to be hospitalised or die as a result of these infections, compared with babies born to mothers who did not smoke during pregnancy.


We must do something to address this problem, but we must first know its extent. The Economic and Social Research Institute, ESRI's, 2012 Perinatal Statistics Report calls for better tracking and recording of smoking during pregnancy in Ireland "given its importance as a risk factor for adverse perinatal outcomes".We simply do not know the extent to which Irish women continue to smoke throughout their pregnancies. It is important that we know the scale of the problem before we begin to address it.


I applaud the Minister for the stance he has taken on the general problem of smoking in this country. The proposed plan to introduce plain packaging is a welcome start. It must be noted, however, that any such initiatives must be brought forward in conjunction with measures to tackle the illegal trade in cigarettes, which is making life very difficult for retailers in this country. Recent figures from the retail industry show that one in four tobacco sales are illegal, according to "ShelfLife", the retail magazine.


While I welcome the Minister's initiatives on smoking, I ask him to address the particular problem of smoking in pregnancy. In terms of finding solutions, education must be key, not only in the hospitals but also in our schools. For example, the risks of smoking during pregnancy must be outlined as a standard measure during antenatal classes and in other places attended by pregnant women. General practitioners, GPs, midwives and obstetricians must also receive special training in how to relay this critical information to pregnant women. We must be conscious that to give up smoking is a huge challenge for many people, and it is not made easier by the stresses and strains of the early stages of pregnancy. Young women, in particular, need our understanding and assistance in this matter, not a lecture.


We must equip our medical professionals to provide the advice and information in a compassionate way, but also in a way that leaves no doubt as to the dangers of smoking during pregnancy.


Minister of State at the Department of Health (Deputy Alex White): I thank the Deputy for raising this important issue. As she is aware, the Minister for Health and our Department have been public in our aims and objectives regarding smoking in Ireland. Last month, he launched Tobacco Free Ireland, which sets an ambitious target of Ireland being tobacco free by 2025. In public health terms, this means having fewer than 5% of people smoking by the year 2025.


Approximately 5,200 Irish people die every year from smoking related diseases. One in every two smokers will die of a tobacco related disease. These diseases are frequently protracted and unpleasant, not to mention distressing to the persons suffering and their families and friends, and all made even more upsetting by the fact that they are preventable. Unfortunately, 22% of our adult population are smokers. It is estimated that between 18% and 21% of Irish women smoke in pregnancy. Most smokers start smoking very young. Research shows that 78% of smokers started smoking before the age of 18 years. It also shows that Irish people start smoking younger than those in any other EU country.


Tobacco Free Ireland sets out the tasks that need to be undertaken to help people to stop smoking and to prevent our children from starting the habit. Currently, smoking cessation services are available nationwide, including the national smokers quitline. Tobacco Free Ireland has a recommendation that the State should target its smoking prevention and cessation interventions at specific groups. Pregnant and post partum women comprise one of those groups. This is important. Research has shown that age and socioeconomic factors are key determinants of smoking in pregnancy. Given this, it is equally important that children and young women are targeted with prevention interventions, particularly those in lower socioeconomic groups.


Tobacco Free Ireland contains a number of measures that, when combined, will go a long way towards denormalising smoking in our society. The denormalisation of smoking and the protection of children are the two key themes in the report. As the Deputy referenced in her contribution, pregnant women who smoke are specifically mentioned in Tobacco Free Ireland as a group requiring targeted interventions. It is the combination of all of the measures in the report that will bring about a significant reduction in the numbers of women who smoke generally and also those who smoke during pregnancy.

 Tobacco control measures are working. The number of children and adults smoking is declining. It is the Minister's aim to make a significant further reduction in those. One of the measures that will assist in this is the introduction of standardised packaging for tobacco. Research indicates that standardised packaging can reduce the appeal of tobacco products and increase the effectiveness of health warnings. It also reduces the ability of branded tobacco packaging to mislead people about the harmful effects of smoking. Another measure being undertaken is the development of legislation to prohibit smoking in cars where children are present.


The Irish public has already shown a healthy appetite for and commitment to the introduction of tobacco measures, not least by fully embracing the workplace smoking ban, which was introduced some years ago. This is despite numerous pessimistic predictions and spurious arguments as to how and why people would not comply. This positive approach gives me confidence that the public will engage and support the Government and the HSE in the important journey ahead.


We all know that smoking in pregnancy is associated with significant health risks to the baby as well as low birth weights and premature births. There is an obligation on all of us as policy-makers, health workers and members of society to take the steps necessary to assist those who smoke during pregnancy in stopping and to prevent future mothers from starting.


Deputy Catherine Byrne: I thank the Minister of State for answering in such great detail. It is shocking to see the figure of how many people die yearly from smoking. I am concerned, as I have seen many children smoking on their way home from primary school. The Minister of State has given me some figures with which to work. For example, approximately 21% of pregnant women smoke.


It is a matter of education, which begins at home. If children see their parents smoking while women are pregnant, they will reflect that behaviour as they grow up. The Minister of State is correct in that certain social backgrounds lead to younger smoking, for whatever reasons.


Will the Minister of State consider making a medical intervention such as is found in other European countries, for example, England, where nicotine patches are made freely available to pregnant women as a matter of course? This could be the first step in making a difference in the lives of a mother and her unborn baby. Giving the unborn a chance to survive when a mother smokes would be the legacy of the Minister for Health and the Government.

I thank the Minister of State for his reply and I will revert to him on some of those figures.


Deputy Alex White: I will certainly discuss the Deputy's suggestion with the Minister. I thank her again for her insights and for the compelling additional points she has made. The value of Tobacco Free Ireland is that a policy statement and set of actions are in place to give guidance to those policy decisions that need to be made. In a sense, it can be added to in future, as new suggestions, such as those raised by the Deputy and others, can be incorporated into this policy compendium. That can only help us in the objective that we all share.

Item Type
Dail Debates
Publication Type
Drug Type
Tobacco / Nicotine
Intervention Type
Crime prevention, Policy
14 November 2013

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