Not smoking is the most important thing one can do to affect one’s cancer risk. In any given week, more than 100 people in Ireland will die of tobacco-related diseases and it is estimated that last year, Ireland spent between €1 billion and €2 billion on treating tobacco-related disease.
Tobacco smoking causes one-third of all cancers and, most significantly, accounts for 85 per cent of lung cancers. Lung cancer is the second-most common cancer diagnosed in Ireland in both men and women and numbers continue to increase by 5 per cent per year in women and by 1 per cent per year in men. The chance of survival at five years after a diagnosis of lung cancer remains low, at 15 per cent, and more than 1,600 Irish people die of lung cancer every year.
It is estimated that some 50 persons died in 2012 of diseases caused by second-hand smoke exposure. Some 90 per cent of cases of lung cancer in this country are caused by smoking and this disease now kills more Irish women than breast cancer. These are entirely preventable deaths.
The availability of nicotine replacement therapies is important but the World Health Organization points out that the highest quit rates are achieved when cessation support is combined with medication. Nicotine replacement therapies work, Kathleen O’Meara of the Irish Cancer Society said. “There is much evidence to show that they increase the rate of quitting by between 50 and 70 per cent,” she added. While medication on its own is extremely useful, a high quitting rate is achieved when it is combined with the assistance of a smoking cessation officer in a supportive environment in a community setting.
‘Weak’ services
O’Meara said a multifaceted, strategic approach by the Government — particularly in regard to cessation — is required. The cessation services are weak compared to what is needed and such services need to be funded at a higher level in order to be effective, said O’Meara.
There are approximately 60 people providing support services across the country, but the services are available only in hospitals. A person in West Clare, for example, has to travel the long distance to Ennis General Hospital to meet a smoking cessation officer.
The cost of nicotine replacement therapy is good value for money, added O’Meara, however less than 0.5 per cent of what the Government spends on prescription drugs goes on nicotine replacement therapy. In 2009, the cost of nicotine replacement therapy was 0.42 per cent of the overall cost of prescription drugs and since 2001, nicotine replacement therapies and general therapies have been free for those who have a medical card.
Those who must pay for nicotine replacement therapies in the Republic face a significant price difference compared to the UK; effectively, it costs €45, which is almost twice the price of £25 in the United Kingdom. The Government, in its dealings with the drug and pharmaceutical companies, could do something to bring down the cost of drugs, said Ms O’Meara.
Unfortunately, there are probably not any ‘quick fixes’. There has been an increase in smoking among some socio-economic groups — the less well-off in particular, but an increase of 10 per cent in cigarette prices would lead to a 4 per cent reduction in smoking.
“Increasing tobacco taxes supports the young and the poor in not smoking, as they are most affected by the price of cigarettes,” said Dr Triona McCarthy, Consultant in Public Health Medicine with the National Cancer Control Programme. The children of smokers are more likely to smoke, ASH Ireland’s Dr Ross Morgan added.
Source: Gary Culliton, Irish Medical Times, 28/01/13
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