Ireland once led the world on smoking bans – but now must do more

In 2004, Ireland made global headlines when it became the first country in the world to introduce a comprehensive workplace smoking ban. This bold step was hailed internationally as a model of public health leadership. However, two decades on, Ireland is no longer the pioneer it once was in tobacco control.

New research from the RCSI has delivered a sharp reminder of the dangers smoking still poses to our society, despite 2025 being the year Ireland was supposed to become ‘tobacco-free’.

The study, which was funded by the HSE Tobacco Free Ireland Programme, with additional support from Research Ireland, calculated that current smokers in Ireland will lose almost five million years of life and 2.5 million years of productivity, leading to healthcare costs of around €20.2 billion.

The analysis – the first of its kind in Ireland – tracks the long-term health and economic impacts of tobacco use across outcomes such as life years, disease burden, productivity-adjusted life years, and associated healthcare costs.

It estimates smokers will also spend a combined 5.9 million years living with chronic conditions such as chronic obstructive pulmonary disorder, lung cancer, stroke, and heart disease.

In its Tobacco Free Ireland policy, published in 2013, the Government committed to reducing the national smoking rate to 5 per cent – a level that would effectively mean a ‘tobacco-free’ society. However, the new RCSI research notes that the prevalence rate “stalled” at 18 per cent in 2023. Across the EU, the picture is mixed, ranging from just 8 per cent in Sweden to 37 per cent in Bulgaria.

Co-author Prof Frank Doyle, Associate Professor at the RCSI, underlined the need to regain momentum.

“There is an urgent need to reinvigorate the national tobacco policy discourse and refocus policymakers on achieving this goal, as this research shows the costs of inaction both in lives lost and the billions of euros it will cost our health system and economy.”

At the individual level, the figures are stark. A 20-year-old man who smokes daily is expected to lose eight years of life, more than eight years of productivity, and face an additional €28,000 in healthcare costs compared to a non-smoker.

Dr Paul Kavanagh, Public Health Advisor to the HSE Tobacco Free Ireland Programme, said the findings show the scale of the challenge: “Despite progress, smoking remains the greatest challenge facing population health in Ireland. This research shows its impact goes beyond health, with 2.5 million years of lost productivity meaning fewer people in work, reduced earnings, and a smaller contribution to the economy. With reductions in smoking stalling, there is a need to strengthen proven measures like increasing tobacco taxation, accessible stop smoking support and a new Tobacco Free Ireland plan to end the health, economic, and wider social harms of smoking.”

While Ireland once led the way in this area, that leadership is now slipping. Without a renewed push, the country risks falling far short of its own targets and undermining its public health achievements in the fight against smoking.