Tackling tobacco: Milan is the model of a total smoking ban

SINCE January 1, an outdoor smoking ban has been in place in Italy’s financial and fashion capital, Milan.

Debate has intensified as to whether Ireland should implement a similar ban.

People in Milan are subject to fines ranging from €40 to €240. According to city officials, the measure applies to all public spaces, including streets. There is an exception: People in isolated areas may smoke outside, but only if they can keep a distance of at least 10m from other people.

In 2020, Milan City Council ed an air-quality ordinance that called for stricter bans and the reduction of smoking. In 2021, the first ban was put in to effect, forbidding smoking in public parks, children’s playgrounds, bus stops, and sporting facilities.

The new, outdoor ban, coming ahead of the Milan Cortina 2026 Winter Olympics, is looking to drastically improve the city’s air quality.

Smoking is responsible for approximately 85% of all cases of lung cancer, which is the deadliest cancer, according to the World Health Organisation.

Speaking to The Echo, Dr Zubair Kabir, who has been a senior lecturer in public health since 2012 at University College Cork, and the academic director of the flagship programme the Master of Public Health (MPH), outlines how Ireland and Cork could introduce an outdoor smoking ban, should the authorities ever decide to do so.

“Cork has been considered to be a cultural capital and also the World Health Organisation has considered Cork as a healthy city,” Dr Kabir says.

“You have all these projects ongoing with the Cork City Council and thinking of making Cork a healthy city.

“So, when you talk of Cork, there are some activities in place: We have this workforce and we have a team.

“We are thinking about being a healthy city. So we can just incorporate another additional pillar of tackling tobacco.”

There is plenty to consider from both sides of the debate, for and against the introduction of an outdoor smoking ban.

As Dr Kabir alludes to, the outdoor ban in Milan does not include e-cigarettes.

Dr Kabir also is of the opinion that if an outdoor smoking ban ever came to Cork, improved messaging and communication with the public would be essential for successful implementation.

“The Department for Health, they had this action plan, what to do over the next 10 years,” Dr Kabir says. “This was drafted almost, like, 10 years ago, that Ireland will become almost tobacco free by 2025 and that the smoking rate will come down to less than 5%.

“Now, it is almost like 18%.

“We didn’t do much,” Dr Kabir says. “We were complacent with many things. We didn’t invest in funds, and we have to reset this goal and think about our neighbours, like the United Kingdom, Canada, Sweden, Norway.

“They have this thing called smoke-free generation.

“So, the tobacco end game, which is not possible in Ireland within the next 12 months, we have to rethink and revisit our targets and goals, so that we can.”

As to what he feels decision-makers, such as in Dáil Éireann and Cork City Council, should take in to consideration with regards to introducing any potential outdoor smoking ban, Dr Kabir discusses how collaboration and leadership from the top will be vital.

“We need a political champion who would take this agenda forward. We may come up with orders and strategies, but the implementation part is the key.

“You need to have a vision and road map towards that investment of funds. We have proven strategies, like the FCTC, (the Framework Conventional Tobacco Control), by the WHO, which we haven’t implemented in its entirety.

“They’re looking more at the demand side of the tobacco products, but how about the supply side? The tobacco end game is more about the supply side,” Dr Kabir says.

“There are articles laid out in this framework, which talk about how to tackle the supply side, for example Article 5.3.

“The tobacco companies should be out of any discussion regarding any strategies or a tobacco-free Ireland.

“There should be stakeholders; like Cork City Council may be one of those stakeholders. We need academia; people from higher-education institutions, like UCC.

Dr Kabir says: “Also, we need people in the general public, who have gone through these kind of experiences.

“Like a pregnant mother? How about them having a baby, yet to be born, and someone is smoking within less than 10m in front of them at the bus stop?

“If you have those live messages, real stories captured, and we have to invest in these hard-hitting campaigns, which should be funded through the Government.

“The HSE is underfunded, in of running these hard-hitting campaigns, which need to be not one-off, but sustained campaigns, like in the US.

“So, investment is key and then public awareness.”