Tobacco Free Research Institute Ireland

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Annual Report 2004

 

 

 

Government and Executive

Board Members

• Dr Patrick Doorley, Director of Population Health, HSE.
• Mr. Tom Finlay, Chairman, Irish Cancer Society.
• Dr Michelle Egan, Irish College of General Practitioners
• Dr Charles Gallagher, Consultant in Respiratory Medicine, St Vincent's Hospital
• Dr Fenton Howell, Specialist in Public Health, North Eastern Health Board.
• Dr Mark Morgan, Psychologist, St Patrick's College of Education
• Professor Michael Ryan, Professor of Pharmacology, UCD
• Professor Miriam Wiley, Research Professor, ESRI

 

Company Secretary

Mr. Justin McCarthy, Solicitor.

Members of RIFTFS

Ordinary Members

 

Mr Tom Power, CEO, Office of Tobacco Control.
Dr Bernadette Herity, Irish Cancer Society.
Dr Brian Maurer, Irish Heart Foundation.
Dr Michael Boland, Chairman, Office of Tobacco Control.

Associate Members

Mr John McCormack, CEO, Irish Cancer Society
Mr Michael P. O'Shea, Irish Heart Foundation
Ms Mary Carney, Former Director of Corporate Affairs/Research OTC

Staff

Director General - Prof Luke Clancy

Research and Communications - Ms Sheila Keogan

Corporate Affairs - Ms Vanessa Clarke

Legal and Banking

Auditors

OSK Accountants and Business Consultants,
East Point Plaza,
East point,
Dublin 3.

Bankers

Bank of Ireland,
85 James's Street,
Dublin 2.

Legal Advisors

MacCarthy and Associates,
10 Upper Mount Street,
Dublin2.

Insurance Brokers

Coyle Hamilton Willis,
7-9 South Leinster Street,
Dublin 2.

 

• Seed Enterprise Cluster
• Test Bed for Innovation
• Doorstep access to leading edge research
• Benefit of Ireland's low corporate tax
• Location - 10 minutes walk from Dublin city center
• Infrastructure - Broadband Telecommunication and Enterprise facilities
• Government support

Some capital works were necessary within the office and these have been completed. Office accommodation is open plan and has been suitably furnished to accommodate the current staff members. There are a number of shared services provided centrally within the Depot including:-

• Meeting/Conference Rooms with state of the art presentation facilities
• Video Conferencing Facilities
• Centralised security
• Secure storage for IT server in the NOC area
• Photocopying
• Café Area
• Car Parking for staff and visitors

Information Technology Development/HEAnet

To ensure the effective functioning of the research institute the development of a secure information technology system was considered essential.

A detailed specification of the Information Technology requirements was drawn up in consultation with Dovetail Technologies. Subsequent tenders were sought for the supply, installation and maintenance of an information system for RIFTFS. A decision was made based on the following criteria:-

• ability to meet the technical specifications
• cost competitiveness
• company reputation

The contract was awarded to VBT.
A local area network (LAN) was established linking the three office based PC's with a central server located in the NOC area. There is an automated back up device to ensure safe keeping of data. Email and Internet facilities are provided by HEAnet (Ireland's National Educational and Research Network). Email and web site addresses were sought and registered on behalf of RIFTFS by Dovetail Technologies.

The services of Dovetail Technologies have been engaged to design and develop RIFTFS website.

Telephone System

A phone system and fax line was installed within the RIFTFS offices.

Publishing

The RIFTFS logo has been designed and developed by "Digital Ink Graphic Design".

Subsequently customised stationary and business cards were procured.

Education

It is planned that RIFTFS will develop a post graduate course in the area of Tobacco Control. Work commenced looking at options for developing this course using e-learning technology and distance learning.

Library

Prof Luke Clancy in his capacity as Director General of RIFTFS became a Member of GLOBALink, the online international tobacco control community network.

Subscriptions were made to a number of tobacco control professional journals.

It is proposed to develop the library service within RIFTFS and provide access to this service for the wider tobacco control community in Ireland and in time for those students undertaking studies in Tobacco Control.

Funding

Funding for RIFTFS in 2004 was provided by the Department of Health and Children and from a grant received by the Royal City of Dublin Trust Board.

RIFTFS was compliant with all statutory financial obligations and accounts were submitted to the Companies Registration Office in keeping with requirements.

 

 

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Scientific Meetings / Conferences

RIFTFS staff attended the following scientific meetings and conferences in 2004:

• American Thoracic Society 100th International Conference (May 21st - 26th 2004) "The Ban on Smoking in Pubs and Restaurants in Ireland"

• 8th World Congress of Cardiac Rehabilitation and Secondary Prevention (May 23rd - 26th 2004 Dublin) Conference Speaker - Prof Luke Clancy

• "How Healthy is Our Environment?" Environmental Health Conference 2004 (13th & 14th May 2004, Dublin) Conference Speaker -Prof Luke Clancy, " Internal and External Air Quality"

• 7th Annual Scientific Meeting of the Royal City of Dublin Research and Education Institute (9th June 2004) Chair of evening session, Prof Luke Clancy.

• "Change is in the Air - Future Directions in Tobacco Control in the EU" (17th & 18th June 2004, Limerick) Conference Speaker, " Strategic Direction for Research on Tobacco Control in Europe" and Chair of Parallel Sessions - Prof Luke Clancy

• European Respiratory Society Annual Conference (4th - 8th September 2004, Glasgow)

• "The Future in Focus - Building Research and Development Capacity in Health Services" (October 7th & 8th 2004, HRB, Dublin)

• Meeting of Representatives from House of Commons and House of Lords - ( 7th October 2004 , Dublin) Presentation by Prof Luke Clancy

• The launch of the new national media campaign "Smoke Free is Working" by Mr Sean Power TD, Minister of State at the Department of Health and Children (October 21st 2004, Dublin) Presentation by Prof Luke Clancy

• "Smoke Free Liverpool" Visit by group of Health and Local Government Representatives from Liverpool (9th November 2004, Dublin) Presentation by Prof Luke Clancy

• Meeting of ENSP Co-ordinating Partners in Ireland (11th November 2004, Dublin.)

• World Conference for Cancer (16th -19th November, 2004, Dublin) Chair of Workshop" Tobacco Laying down the Law" - Prof Luke Clancy

 

 

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Research Report

RIFTFS was responsible for co-ordinating a number of research projects in 2004.

Many of theses projects related to the evaluation of the exposure and health effects of the Workplace Ban which was introduced into Ireland on the 29th March 2004. An outline of the research studies is provided below.

Particulate pollution levels and smoking prevalence in Dublin Pubs pre and post the introduction of the workplace smoking ban.

Introduction: On the 29th March 2004, the workplace smoking ban came into operation in the republic of Ireland. This was seen as an important opportunity to conduct a rigorous scientific study into the exposure of bar workers both pre and post the introduction of the smoking ban, and to see if the ban would have the predicted effect in reducing indoor pollution. The aim was also to determine if any acute health benefits could be detected among bar staff. In anticipation of a workplace ban, early in 2003 work commenced to develop the Dublin Bar Workers exposure and health effect methodologies. Bar workers were chosen as they were a working group who were viewed as having high exposure to Environmental Tobacco Smoke (ETS) in the workplace.

Methods exposure: It was decided to measure PM2.5 and PM10 concentration in bars pre and post the workplace smoking ban. Measurements commenced in 40 bars, which represents the biggest exposure based scientific study of this nature available.

In putting together such a study it's important to consider as many confounding factors as possible, so a protocol was developed for the monitoring.

All monitoring was conducted at busy times in the bars, usually at evening times. The monitors (optical based light scattering devices, which are portable and data logging) were placed on a table in the centre of the bar. The device recorded readings for a minimum of three hours at each bar. The number of people present, the number smoking (inside or outside) was recorded each hour. The existence and or use of ventilation systems and whether doors and windows were open or closed were also recorded.

The post ban measurements were conducted on the same day of the week and in the same month of the year, one year on from the original measurements, this ensured that day of the week and seasonal variations were controlled for. Outdoor particle measurements were also recorded at each bar.

Benzene: Benzene is a gas emitted by burning cigarettes, (petrol is another source), it is a known carcinogen, and it is legislated for by the EU. Benzene concentrations in each bar both before and after the introduction of the smoking ban were measured. The benzene monitors were co-located with the PM10/PM2.5 monitors.

 

Research Supervision:	Dr Pat Goodman, Dublin Institute of Technology
	Prof Luke Clancy, RIFTFS
Researcher:	Ms Marie McCaffrey, Dublin City Council.

 

Ultrafine Airborne Particle Measurements in Dublin Pubs before and after the Smoking Ban

In order to assess the impact the smoking ban has had on airborne particle concentrations in Dublin pubs, work commenced in measuring ultrafine particle in twelve pubs throughout the city and county both before and after the introduction of the ban. The pre- and post- ban measurements for each pub were carried out at the same time of day and on the same day of the week using a P-TRAK condensation nucleus counter. These measurements were typically made over a four-hour period, during which a record was made of staff, customer and smoker numbers. Pre-ban ultrafine airborne particle concentrations on occasions reached as high as 250,000 per cm3 with an overall average of approximately 85,000 per cm3.

 

Research Supervision:	Prof James McLaughlin, Environmental Physics Group, Physics Dept., University College Dublin.
	Prof Luke Clancy, RIFTFS
Researcher:	Kevin Kelleher, Environmental Physics Group, Physics Dept., University College Dublin.

Evaluation of the Lung Function of Bar Workers in Dublin Pubs Pre and Post the Introduction of the Workplace Smoking Ban

Background: It is well recognised that passive smoking causes respiratory, cardiac and vascular damage to those exposed to it. Bar workers, both smokers and non-smokers are a group with long hours of workplace exposure to high levels of second hand smoke. The intervention to prohibit smoking in the workplace, including bars and restaurants, provided an opportunity to study the health effects of such an intervention.

Methods: Bar workers were recruited to the study through their Trade Union (Mandate). 81 volunteered. The average age was 46.9yrs (range 22 - 68yrs). They had long years of workplace exposure to environmental tobacco smoke with the average being 28.4 yrs (range 6 - 52yrs). They attended the Respiratory Laboratory in St. James's Hospital between September 2003 and March 2004 for initial (pre ban) evaluation of breath Carbon Monoxide (CO), spirometry (FEV1, FVC), lung volumes and diffusing capacity (DLCO), and for similar tests a year later (post ban). In addition a questionnaire covering history of asthma, working hours, hours of exposure to cigarette smoke (home/ workplace), personal smoking history, and recent respiratory symptoms was completed by each subject. Exhaled Carbon Monoxide was measured using a MicroCo meter (Micromedical, UK) and lung function was measured using a Vmax 22 system (SensorMedics, USA).

 

Following the introduction of the workplace ban, work began on repeat measurements of the lung function of bar workers.

 

Research Supervision:	Prof Luke Clancy, RIFTFS
	Dr Pat Goodman, Dublin Institute of Technology
Researcher:	Ms Michelle Agnew, St James's Hospital, Dublin.

All Ireland Bar Study

RIFTFS was also a partner in the National Study of the Health Impact of the Workplace Ban, known as the All Ireland Bar Study. RIFTFS awarded research grants to Dr. Shane Allright TCD and to Dr Birgit Greiner UCC as part funding for these studies outlined below.

 

Evaluating the health impact on barworkers of the Republic of Ireland smoke-free workplace law (All Ireland Bar Study)

Background: As workers in the hospitality industry were at particular risk of high and sustained exposure to secondhand smoke (SHS), a study was set up to evaluate the impact of the law on bar workers' exposure to SHS and on their respiratory health (All Ireland Bar Study). The study methods will be described together with an update on progress to date.

 

Methods: The respiratory health of barworkers was assessed, in the six months before the workplace smoking, ban, by questionnaire and lung function tests . Exposure to secondhand smoke (SHS) over the previous few days was assessed by measuring salivary cotinine and verbal report. Participants were also asked about their attitudes to the ban. A follow up survey was undertaken one year later in order to assess changes in exposure to SHS, in respiratory health and in attitudes. Bar staff from Northern Ireland were also enrolled in order to control for secular changes unrelated to the smoking ban.

The study also includes air measurement in a sample of Dublin pubs to compare levels of exposure pre- and post-implementation of the law (conducted at the same time of year to adjust for seasonal effects).

 

Study personnel
Dublin:	Shane Allwright, Michele Agnew, Luke Clancy, Pat Goodman, Kevin Kelleher, James McLaughlin, Gillian Paul, Michael Ryan, Alan Smith
Galway:	Maureen D'Eath, Marie Galvin, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan, Lisa Pursell
Cork:	Birgit Greiner, Sangeetha Kalimuthu, Bernie Mulally, Ivan Perry, Meenakshe Uppal
N. Ireland:	Eamon O'Kane, Brendan Bonner, Damian Gavin, Bill McConnell

The Effect of the Legislative ban on smoking rates among bar workers

B Mullally¹, B Greiner¹, I Perry¹, S Allwright^{2 1}Department of Epidemiology and Public Health, University College Cork, Ireland. ²Department of Public Health and Primary Care, Trinity College Centre for Health Science, Adelaide & Meath Hospital incorporating the National Childrens hospital Tallaght, Dublin 24.

Background: Bar worker health has gained a lot of attention in Ireland due to the ban on smoking in workplaces including bars. It is expected that the smoking ban will have a positive effective on the smoking behaviour of Irish bar workers. There is concern about the widening gap in mortality and morbidity between the managerial and professional social classes, and those with lower levels of education. As bar workers are a heterogeneous group comprising of owners, managers, part and full time staff (including students), social class and educational status can vary widely. Although the overall number of smokers from 1999-2003 (SLAN,2003) has decreased, this is not occurring at the same rate for males and females across all sectors in society or for all age groups.

Objectives: To determine the prevalence of smoking and smoking amount among bar workers in Cork City.

To determine the influence of social class, gender and age on smoking behaviour in Irish bar workers.

To determine if the legislative ban has had an effect on smoking behaviour and the role of social class, education, gender and age.

Method: A follow-up study on bar workers (random, N=129; refusal rate of bars was 8%) and catering staff(control) from Cork City was conducted before (Jan & March 2004) and planned for one year after (Jan & March 2005) the implementation of Europe's first legislative ban on work place smoking. This study is part of a larger national study on bar workers' health, including participants from Cork, Dublin, Galway and N. Ireland. Data obtained a questionnaire, a salivary sample (cotinine) and respiratory health (FEV1 and PEF) measurements.

Attitudes of bar owners and workers in rural Galway before and after the smoking ban.

Lisa Pursell, Marie Galvin, Maureen, D'Eath, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan and Shane Allwright, NUIG, Galway.

 

The Galway element of the muticentre study of the respiratory health of bar workers (All Ireland Bar Study) recruited 68 bar owners (58%) or staff (42%). Potential participants in all public bars in County Galway were initially contacted by letter. Arrangements were made with respondents to visit them at their place of work for completion of a questionnaire, repiratory tests and cotinine samples. Post-ban follow up visits are being arranged approximately 1 year after the initial visits.

 

Participants were asked to state whether they agreed or disagreed with a series of statements positing either positive or negative aspects of the ban on smoking in public bars. They were also asked whether they agreed or disagreed with the ban in general.

European Network of Smoking Prevention

In response to the call for the European Network of Smoking Prevention (ENSP) Framework Project Applications 2004 - 2005, the Research Institute for a Tobacco Free Society (RIFTFS) submitted a proposal to undertake a comprehensive health impact assessment of the Workplace Tobacco Ban in Ireland.

Studies were proposed in the following areas:-

• Changes in exposure from ETS in a number of locations pre and post the introduction of the ban including bars, homes and hospitals.
• Assessment of the characteristics and influence of the media campaign which accompanied the proposed introduction of the ban
• Pharmacoeconomics of the ban in terms of cardiovascular and respiratory drug usage changes

The proposal was successful and in 2004 a project team was formed. The project team met regularly in 2004 and work began in the all areas:-

Exposure: The project proposes to study the particle exposure changes resulting from the ban and endeavour to correlate these with nicotine measurements made in other European laboratories within the consortium in particular the "Environmental Tobacco Smoke Exposure in a sample of European Cities (Project leader : Manel Norbot, PHI, Barcelona, Spain). It is planned to collaborate with Dr G Gorini and colleagues in the evaluation of the optimum method to assess ETS. This will be facilitated by supplying data to test the conclusions from their study using their "synoptic tables" and our measured data.

In 2004 exposure measurements were conducted for the most part in bars. A pilot study measuring particles in the home was conducted and preparations were made to conduct measurements in psychiatric hospitals. A meeting took place with Manel Norbot in Barcelona to discuss collaboration of findings.

Professor Clancy cooperated with Dublin City Council, Dublin Institute of Technology, and the EU Joint Research Centre in the planning and launch of the Peoples Project. This Project is a European wide study of exposure to Benzene. Tobacco smoke is the main indoor source of Benzene.

Media Campaign

A study of the media campaign which accompanied the proposed introduction of the ban to asses it characteristics and influence will be conducted. This project will analyse the Irish Media Coverage of the smoking ban in work-places from November 2003 to April 2004 and assess the effectiveness of the media strategies adopted by all concerned bodies.

Project meetings in 2004 allowed the team to refine project methodology. A suitably qualified and experienced researcher was then recruited.

Health Effects/ Pharmacoeconomics

As a surrogate for health effects it was proposed to study the pharmaco-economics surrounding the ban in terms of cardiovascular and respiratory drug usage changes as indicators of early changes in health. The objective of this component of the research project was to determine the implications of the smoking in the workplace ban which commenced on the 29th March 2004 on cardiovascular and respiratory drug utilisation and expenditure.

 

Project meetings in 2004 allowed the research objectives to be clarified and protocols established.

 

Research Partners and Associates engaged in the ENSP Project are as follows:

 

Principal Investigator:

Prof Luke Clancy, Director General, Research Institute for a Tobacco Free Society

 

Researcher Supervision:

Dr Pat Goodman, Lecturer in Physics, Dublin Institute of Technology.

 

Prof. James McLaughlin, Senior Lecturer in Physics, University College, Dublin.

 

Dr. Michael Barry, Director of the National Pharmacoeconomics Centre, St James's Hospital, Dublin.

 

Dr. Brian Trench, Senior Lecturer and Head of School of Communications, Dublin City University, Ireland

 

Researchers:

Ms Marie McCaffrey, Dublin Institute of Technology.
Mr Kevin Kelleher, University College, Dublin
Mr Colin Hogg, University College, Dublin
Ms Michelle Agnew, St James's Hospital, Dublin.
Mr Declan Fahy, Dublin City University, Ireland.

 

Programme Grant Application to the Health Research Board.

A programme grant application was submitted to the Health Research Board (HRB) in September 2004. The research programme proposed to examine the health effects of tobacco smoking and passive smoking in Ireland particularly with regard to the impact of the workplace ban. It was proposed that measurements of cardiovascular health would be collected including

 

• mortality from routinely collected data
• hospital admissions
• use of cardiovascular medications
• ICU and chest pain clinic admissions

It was planned to monitor respiratory health by questionnaire, pulmonary function assessment, hospital admissions and mortality.

Health effects on children were to be evaluated using ISSAC and Slan data.

This application also proposed to study the determinants of the demand for smoking and estimates of marketing expenditure on smoking and anti-smoking campaigns and to evaluate the economic costs of smoking. The study also proposed to assess the effects of price on tobacco consumption.

A response from the HRB in October 2004 proved the application to be unsuccessful.

 

Developing Research Capacity

In partnership with Prof Gerard Hastings of the Centre for Tobacco Control Research, University of Stirling, Scotland, preparations commenced to establish a Research Fellowship in Tobacco Control in Ireland. A number of meetings took place in both Dublin and Scotland. Prof Clancy met with both Prof Gerard Hastings and Prof Ron Borland of ITC (International Tobacco Control Survey) in the frame of ERS, Glasgow 2004.

 

The aim of the fellowship is to develop a researcher who can build tobacco control research capacity for Ireland. At the end of the Fellowship period it is expected the successful candidate to be well on the way to establishing a leadership role in Irish tobacco control research. It is planned that the research associate will initially focus on the analysis of previously collected data on smoking prevalence, including data from the following surveys:-

• ITC Ireland data Set
• Slan
• ISSAC
• ESPAD
• OTC prevalence data

It is envisaged that the appointee will contribute on an ongoing basis to RIFTFS research projects, originate and contribute to peer reviewed publications and reports and submit at least one competitive research grant application to advance tobacco control research in Ireland.

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The Research Institute for a Tobacco Free Society would like to acknowledge the support of its partners throughout 2004:

 

• The Office of Tobacco Control
• ASH Ireland
• The Irish Heart Foundation
• The Irish Cancer Society

The Institute appreciates the financial support provided by the Department of Health and Children and the Board of the Royal City of Dublin Hospital.

 

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