The vast majority of cancers are clustered around four common areas: smoking, alcohol consumption, unhealthy food consumption and obesity. Our goal, as legislators, should be to attempt to influence people into making healthier choices while not restricting choices. An example of this might include taxing sugar to subsidise healthier foods.
There is no question that Ireland, with the second highest incidence of cancer per head in the world, needs to make changes urgently.
If we look at the first major cause of cancers, smoking, we can see some indisputable facts: smoking causes 85% of all lung cancers, and one third of all cancers. Tackling this is the single most-effective route in terms of saving lives. There are a number of recommendations which are set forth: banning cigarette vending machines, banning smoking on all educational campuses and introducing plain packaging are all worthy of discussion.
In particular, the introduction of plain packaging has been the subject of much correspondence from outside groups, and much discussion in the media. Two things are equally clear: one, the introduction of plain packaging has been effective in Australia and, two, the tobacco industry and the associated lobby really doesn’t want this to happen.
One of the smokescreens – if you’ll forgive the pun – that they set forward is that this will lead to a higher incidence of counterfeit cigarettes, hence we see a lot of pre-emptive discussion in the media surrounding counterfeiting, even though counterfeit cigarettes, by value, is down since 2005. The reality is, if executed correctly, plain packaging could actually reduce counterfeiting.
Instead of small taxation labels at the back of the packet, this could now make up a main part of the front of the packet, therefore making it clearer, while also making it less appealing to younger people. The attempt to make smoking less appealing to young people is vital, as we know, the number of young women smoking continues to rise.
In Australia, plain packaging has been introduced and according to the majority of independent studies, it has been successful. It has not lead to a demonstrable increase in counterfeiting and has made smoking less appealing to young people and young women in particular. Therefore, I believe that this is something that needs to be implemented here, at least on a trial basis.
Similarly, banning smoking on educational campuses would also add a hurdle for young smokers, and would effectively put an end to passive smoking in our colleges and universities. This, in itself, is reason enough to do it.
The second area we need to focus in on is that of alcohol consumption. This is something which I’ve done a lot about during my time as a Senator. There are 1,200 cases of cancer each year from alcohol in Ireland, and again there is much we can do to curb this while also limiting the societal negative effects from alcohol. For instance, introducing a minimum floor price for alcohol would seem, to me, to be one straightforward way to curb excess consumption, while also introducing Section 9 of the Intoxicating Liquor Act 2008, which would allow alcohol to be separated from grocery sales.
Thirdly, there is the area of diet – which in my mind is slightly separate to that of obesity – for somebody can eat an unhealthy diet, maintain a reasonable level of fitness, not be obese and still be at risk of cancer due to a high meat, high fat or high sugar diet which is low in fruit and vegetables. We need to incentivise healthier eating, which is mentioned in the report from the Seanad Public Consultation Committee.
This can be achieved through a combination of factors: taxing sugary processed foods and using the funds to directly subsidise fruits and vegetables, doing work on product placement with retailers, such as placing fruit near the till in school canteens increased the amount of fruit eaten by children by 70% according to one study.
Meanwhile, putting something as simple as a yellow line across supermarket trollies and inviting shoppers to only put fruit and veg in front of it doubled the amount of fruit and veg purchased, according to another large study. These changes in choice architecture invite people to think about their food consumption in a slightly different way and, instead of using a stick to incentivise people, we can sometimes use a carrot.
Finally, the problem of obesity is another one which needs to be tackled: both for the sake of societal gains, and also in order to prevent at least some future incidences of cancer. What we know is that there are over 300,000 overweight and obese children in Ireland, and this is a health time bomb for the country. One fifth of three year olds are now obese or overweight, and this rises to one quarter of over nine year olds.
The number of obese children is increasing by 10,000 per year, and in 2005 the cost of obesity was calculated at four billion euro. The changes in policy with regard to food consumption as mentioned earlier could be helpful here, while also a renewed emphasis on children getting a minimum level of physical activity per day would also help. Banning the sale of sugary drinks in schools may also be a consideration, as might the introduction of appropriate physical activity programmes being introduced to all schools.
All told, we know that changes to improve lifestyle can prevent approximately one third of cancers. This is an incredible number, and we as legislators should be fighting tooth and nail to make these seemingly simple, small changes which, when taken together in a macro view, can cause significant improvements to the health and wellbeing of our citizens in both the short-term and the long-term. While we can put these things on the long finger, and cave in on the individual lobbying requirements of each given industry, I believe that now is the time to take in the big picture, take these brave decisions and – in a decade or two – we will reap the dividends of having a healthier nation.