Question proposed: "That the Bill be now read a Second Time."

Gerry Horkan, Acting Chairperson: I welcome the Minister for Health, Deputy Donnelly, back to the House once again. I also welcome to the Public Gallery my own intern, Mr. Mason Shaver from St. Louis, Missouri who has been interning with me for a few weeks and will be here for a few more weeks.

Mr. Shaver is very welcome and I hope he is enjoying his time here in Leinster House.

Stephen Donnelly, Minister for Health: 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.

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