Tobacco and Vapes Bill
Tuesday 16th April 2024
(3 weeks, 2 days ago)
Commons ChamberRead Full debate Tobacco and Vapes Bill 2023-24 Read Hansard Text Watch Debate Read Debate Ministerial Extracts
18:56 - The House divided: - Ayes: 383 / Noes: 67 - Question accordingly agreed to.
The Secretary of State for Health and Social Care (Victoria Atkins)
I beg to move, That the Bill be now read a Second time.
Before I start, I should declare an interest: before I was elected to Parliament, I used to prosecute serious and organised crime, including organised crime gangs who attempted to import illicit cigarettes.
For a moment, I would like us to imagine that we are not in this historic and magnificent Chamber but instead standing at the entrance of a local hospital. A patient comes through the doors, struggling to breathe; smoking sent their asthma spiralling out of control. A minute later, another patient passes by; smoking caused the heart disease that they are battling. A minute later, another person comes in, and then another. That vicious cycle repeats itself nearly every minute of every day in our national health system, because here in the United Kingdom almost one hospital admission a minute is the human cost of smoking.
Smoking leaves people with premature dementia. It puts them in care, attached to oxygen, for the rest of their life. It increases the risk of stillbirth by almost 50%. It is responsible for 75,000 GP appointments every month, and it takes about 80,000 lives every year.
Dr Luke Evans (Bosworth) (Con)
I urge everyone who has come to the debate to go to a respiratory ward—I served on one for a year in my first junior doctor role—to watch people gasp for breath, struggle and fight, with their relatives asking you as a doctor to do something and you simply cannot. If the Bill is a step forward in stopping that situation, I am very much in favour of the Secretary of State taking it forward.
Victoria Atkins
I thank my hon. Friend for bringing to the Chamber his professional experience and the real-life consequences for his patients. If I may, I will unpack some of the details behind that invaluable intervention. The premise behind the Bill is exactly as he says—to stop the start—because there is no safe level of smoking and no safe tobacco product. In fact, it is the only product that, if consumed as the manufacturer intends, will kill two thirds of its long-term users.
The Bill is not about demonising people who smoke or stopping them from buying tobacco if they can do so today. It will not affect current smokers’ rights or entitlements in any way. Indeed, we want to help them to quit. We are supporting them by almost doubling funding for local stop-smoking services. Instead, the Bill is looking to the future, to give the next generation the freedom to live longer, healthier and more productive lives.
Sir Edward Leigh (Gainsborough) (Con)
How does the Secretary of State counter the Conservative argument that if we ban something, we massively increase criminality?
Victoria Atkins
I am extremely grateful to my right hon. Friend. I will genuinely come to that, because I know that that is a concern that colleagues have. I will develop my arguments, if I may, but I also remind him of my declaration of interest and, believe you me, I have no interest whatsoever in making life easier for smoking gangs. That is why as part of the package I will announce further funding and investment for law enforcement agencies both at the border and at local level.
Some have said that it is concerning that we are banning things. I totally understand the concerns of fellow Conservatives. We are not in the habit of banning things—we do not like that. We will bring these powers in only when we are convinced—following a no doubt robust debate, with the intellectual self-confidence that we have on the Government Benches—that there is no liberty in addiction. Nicotine robs people of their freedom to choose. The vast majority of smokers start when they are young. Three quarters say that if they could turn back the clock, they would not have started. That is why, through the Bill, we are creating a smoke-free generation that will guarantee that no one who is turning 15 or younger this year will ever be legally sold tobacco, saving them from the misery of repeated attempts to give up, making our economy more productive and building an NHS that delivers faster, simpler and fairer care. It is our responsibility—indeed, our duty—to protect the next generation. That is what the Bill will do.
Lilian Greenwood (Nottingham South) (Lab)
The Secretary of State is right that we should protect the next generation. Labour proposed the smoke-free generation legislation in January 2023. We voted to crack down on marketing vapes to children in 2021, but the Tories blocked it. I welcome this Bill, but does it not show that where Labour leads, some Conservatives follow? Is she not concerned about the number of her colleagues, who we see lined up in the Chamber, who will vote against this legislation today?
Victoria Atkins
That is a brave submission from the hon. Lady, given the debate in the Chamber yesterday. I certainly will not take lectures from Labour on this legislation. We are bringing it forward because we have looked carefully at the evidence. What is more, we have tempered it so that existing adult smokers will not be affected. If the message from the Labour party is that it wants to ban smoking for adults completely, it should make that argument. We have tempered this carefully to ensure that it only deals with future generations.
Sir John Hayes (South Holland and The Deepings) (Con)
I commend my right hon. Friend for her approach to young people smoking, her determination to deal with illegal tobacco and her crackdown on vaping, which is a menace to young people as these things are sold like an item of confectionery. Will she accept that in doing all those things, she needs to be open minded about how the Bill can be improved? The idea of a rolling age of consent, with the consequence that someone of 35 will be able to buy tobacco but someone of 34 will not and so on, is at best a curiosity and at worst an absurdity.
Victoria Atkins
I am extremely grateful to my right hon. Friend and close Lincolnshire neighbour. He knows that on any piece of legislation I will always want to listen to and do business with colleagues. The principle behind this legislation is that these emerging generations will never take up smoking. That is the point.
Victoria Atkins
I will just finish this point. We are bringing forward this legislation so that we stop the start from 2027. Future generations will not have that addiction to nicotine.
Ms Brown
Let me say from the outset that I completely support this Bill. In Newham, 22% of sales last year were to under-age children—higher than alcohol, knives, fireworks and so on—and a total of £135,000-worth of illicit tobacco products were seized in just six months. Will the Secretary of State ensure that councils get the resources they need to continue the vital work of keeping these products out of the hands of the young?
Victoria Atkins
Yes, I can assure the hon. Lady, because the illicit trade is often the greatest in the most deprived areas of the country, and I am about to develop exactly how we will help law enforcement. I very much understand the concerns across the House about ensuring that the illicit trade does not flourish.
Sir Jake Berry
Has my right hon. Friend seen the latest statistics that say twice as many schoolchildren smoke cannabis as smoke tobacco? It is already illegal—for all of us, not just children—to smoke cannabis. If a ban really worked, how can she explain those statistics? How can she show that this ban to stop people who are currently 15 will be different from the anti-drugs legislation that we already have?
Victoria Atkins
To be clear, is my right hon. Friend suggesting that we repeal the Misuse of Drugs Act 1971, under which cannabis is prohibited? Although I have no experience of it, I understand that the consumption of marijuana also involves the consumption of tobacco and cigarette papers. The point is that we are trying to move away from the idea that current youngsters will be able to buy their cigarettes legally in shops from the age of 18 in 2027, precisely because we want to ensure that they can lead longer, healthier lives. In a moment I will come to some of the myths that the tobacco industry has put around about the impact of introducing age restrictions on cigarettes, which will be interesting evidence for those who are concerned about that.
Jim Shannon (Strangford) (DUP)
First of all, I commend the Secretary of State and the Government for bringing forward this legislation. I support it because I believe it is right, but I have been contacted by vaping groups. My right hon. Friend the Member for Belfast East (Gavin Robinson) and I met some last week. They sent me a small comment, and I want to ask the Secretary of State a quick question about it, so that we move forward with consistency to try to achieve something.
Those groups referred to the impact assessment report by the Department of Health and Social Care, and said that it fails to consider potentially detrimental effects of restricting vape users and smokers looking to switch. I think we all try to be helpful and constructive in our comments in this Chamber, so being constructive, they requested a vape retailer and distributor licensing scheme in the Bill. The industry has developed a comprehensive framework for such a scheme, which is designed to deal effectively once and for all with underage and illicit vape sales—a situation that could get worse. Does the Secretary of State intend to develop a vape retailer and distributor licensing scheme?
Victoria Atkins
I am extremely grateful for the hon. Gentleman’s support. We understand the level of lobbying that has been undertaken by both the vaping industry and the tobacco industry. We know that the vaping industry has pushed that as one of its lines. In the current vapes market, when walking into a local shop or a newsagent the vape products can be seen on sale next to the till, often next to the sweets—the part of the shop that children will be very attracted to, if my experiences are anything to go by. The industry markets them in very cynical ways. We are saying that it is already unlawful to sell vapes to under-18s, but we want to take the powers in this legislation to consult on flavours, design and so on, to ensure that vapes are sold as they are intended—to help adult smokers to quit, because no child should ever vape.
Victoria Atkins
I am going to make a little progress, if I may, because I want to come to the age of sale.
On the point raised by my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) about the age of sale and the black market, tobacco industry representatives claim that there will be unintended consequences from raising the age of sale. They assert that the black market will boom. Before the smoking age was increased from 16 to 18, they sang from the same hymn sheet, but the facts showed otherwise. The number of illicit cigarettes consumed fell by 25%, and smoking rates for 16 and 17-year-olds dropped by almost a third. Consumption of illegal tobacco plummeted from 17 billion cigarettes in 2000-01 to 3 billion cigarettes in 2022-23. That is despite the further controls that this House has put in place in the meantime. Our modelling suggests that the measures in this Bill will reduce smoking rates among 14 to 30-year-olds in England to close to zero as soon as 2040. I hope that many of us in the Chamber today will still be here in 2040. This is our opportunity to play that part in history.
Thanks to constructive engagement with colleagues across the devolved Administrations, the measures will apply not just in England but across our entire United Kingdom, saving lives and building a brighter future. Having listened carefully to colleagues’ concerns about enforcement, we are making sure that local authorities will be able to keep every penny of the fixed penalties they bring in to reinvest in rigorous enforcement. In other words, we are looking not just at national enforcement, but at helping our very important and valuable local trading enforcement officers to keep the proceeds from the fixed penalties they hand out.
Vicky Ford (Chelmsford) (Con)
Does my right hon. Friend agree that, largely, the Bill will not affect people in this House but younger people, and that it is therefore incredibly important to listen to their voices on this issue? With that in mind, I wrote to every secondary school in my constituency to ask young people their views. The majority of young people in Chelmsford, when asked for their views, said they would support the measures in the Bill. It was not unanimous, but we work by majority. Given that it affects them and not me, I will be respecting their views when I vote today.
Victoria Atkins
I thank my right hon. Friend. Yet again, she reminds us what a brilliant local constituency MP she is. She has drawn out the voice of young people. When I pose questions about our NHS and the future I want to build for it—reforming it to make it faster, simpler and fairer—one thing I think about is the voice of younger people. If they are in work paying their taxes, they are paying for our NHS at this moment and they will be the users of it in the future. Part of my role as Health Secretary is to ensure that it has a sustainable funding model, that we are doing everything we can to increase productivity, and that we move the demand curve so that it celebrates its next 75 years.
Ian Paisley (North Antrim) (DUP)
I thank the Secretary of State for giving way. She knows that I take a particular interest in the impact of retail crime. The British Retail Consortium indicates that there are about 1,300 acts of violence against shopkeepers across the UK daily. It has been suggested that one of the biggest triggers of attacks on shopkeepers is asking for proof of age. What additional resources can be put in to assist retailers and ensure they are protected from attacks?
Victoria Atkins
The hon. Gentleman raises a very fair point. Interestingly, the latest survey of retailers shows—I think I am right in saying it—that the majority of retailers support this policy, but he knows just how carefully the Government have listened to the concerns of retailers. My hon. Friend the Member for Stockton South (Matt Vickers) has led a relentless campaign on this issue, and I was really pleased that the Home Secretary was able to announce in recent weeks a specific crime relating to violence against retail workers.
Giles Watling (Clacton) (Con)
I smoked until 30usb years ago and it was a very hard business to stop the evil weed. I come from a completely different era and I am considered something of a dinosaur. [Hon. Members: “Never!”] But I do still hope to be here in 2040. I wish to God that vapes had been around when I was going through the process of stopping smoking. Do we not need to be very careful that the Bill does not throw the baby out with the bathwater and stop helping people come off the evil weed?
Victoria Atkins
First of all, I completely reject my hon. Friend’s suggestion that he is a dinosaur. He brings a great energy and effervescence into the Chamber—or indeed any social situation. He articulates really well the struggle of addiction to nicotine and how tough it can be to give up. That is not a judgment on anyone; the substance is designed to addict. That is how the sales pitch is made. What we are trying to do is stop children being ensnared in that way. He is also right that at the moment the evidence suggests that vaping is a good way to help existing smokers to quit. If you do not smoke, please do not vape. Certainly, children should never vape. What we have tried to do with the Bill is build a balance in, so we are taking powers to look at packaging, flavours and so on. There will be a thorough consultation before any regulations are set, because we want to ensure that we are helping adults to quit, but in a way that is considered and well designed. I am extremely grateful to him for raising that point.
Alexander Stafford
I am listening very carefully to what my right hon. Friend is saying. She outlined how the consumption of cigarettes has collapsed over the last couple of decades, and my right hon. Friend the Member for Chelmsford (Vicky Ford) talked about how the young people she reached out to do not want to smoke any more. Is that not the heart of the matter? That is why I think the Bill is fundamentally wrong and misguided. Young people are not smoking. It is not cool to smoke. The Bill should be focused more on the vape side of things: illegal vapes, supercharged vapes, the colour and flavour of vapes. We are debating cigarettes, which are naturally going out of existence anyway, rather than focusing on the dangerous vapes that are addictive for young children. That is where the Government should put their focus, rather than wasting time talking about something that is dying out anyway.
Victoria Atkins
Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.
Nickie Aiken (Cities of London and Westminster) (Con)
I thank my right hon. Friend for giving way. She is making a very important point about young people and children smoking today. It is not just about cigarettes. Shisha smoking, in particular in Westminster, Marylebone and Edgware Road in my constituency, has become very fashionable for young people. An hour of smoking shisha equates to 100 to 200 cigarettes within an hour. Will she confirm that shisha tobacco will be included in the Bill?
Victoria Atkins
I thank my hon. Friend for bringing the City of Westminster right into the Chamber. There are, in fact, five times more people in England today smoking non-cigarette tobacco, which includes cigars and shisha, than there were a decade ago. Worryingly, the greatest increase is in young adults. That is why we have said that tobacco in all its forms is a harmful product, and that we therefore wish to ensure we are consistent in the policy and the messaging that this is about helping young people to stop the start.
Victoria Atkins
I am going to make some progress and then I will give way.
As I have said, the tobacco industry questions the necessity of the Bill on the grounds that smoking rates are already falling. It is absolutely correct that smoking rates are down, but as I said, there is nothing inevitable about that. Smoking remains the largest preventable cause of death, disability and ill health. In England alone, creating a smoke-free generation could prevent almost half a million cases of heart disease, stroke, lung cancer and other deadly diseases by the turn of the century, increasing thousands of people’s quality of life and reducing pressure on our NHS. An independent review has found that if we stand by and do nothing, nearly half a million more people will die from smoking by the end of this decade. We must therefore ask what place this addiction has in our society, and we are not the only ones to ask that question of ourselves. We know that our policy of creating a smoke-free generation is supported by the majority of retailers, and by about 70% of the public.
The economic case for creating a smoke-free generation is also profound. Each year smoking costs our economy a minimum of £17 billion, which is far more than the £10 billion of tax revenue that it attracts. It costs the average smoker £2,500 a year—money that those people could spend on other goods and services or put towards buying a new car or home. It costs our entire economy by stalling productivity and driving economic inactivity, to the extent that the damage caused by smoking accounts for almost 7p in every £1 of income tax we pay. As Conservatives we are committed to reducing the tax burden on hard-working people and improving the productivity of the state, which is why this Government have cut the double taxation on work not once but twice, giving our hard-working constituents a £900 average tax cut. That is a moral and principled approach.
Having celebrated the first 75 years of the NHS last year, I am determined to reform it to make it faster, simpler and fairer for the next 75 years, and part of that productivity work involves recognising that we must reduce the single most preventable cause of ill health, disability and death in the UK. This reform will benefit not just our children but anyone who may be affected by passive smoking, and, indeed, future taxpayers whose hard-earned income helps to fund our health service. Today we are taking a historic step in that direction. Creating a smoke-free generation could deliver productivity gains of £16 billion by 2056. It will prevent illness and promote good health, help people to get into work and drive economic growth, all the while reducing pressure on the NHS.
Alex Cunningham
Of course, the tax burden is the highest it has been for some considerable time. I welcome the Bill, but the Khan review estimated that the Government’s smoke-free ambition would not be fulfilled in poorer communities until 2044, and there are many such communities in my constituency, so how will the Bill tackle that issue? Will it really be another 20 years before we see a result in poorer communities?
Victoria Atkins
No, because, as I have said, the modelling suggests that among the younger generation smoking levels will be close to zero by 2040. As for the hon. Gentleman’s point about tax, I do not remember him voting against the Government’s furlough scheme and other support during covid; nor do I remember him complaining that we were trying to help people with the cost of living. We as Conservatives understand that this is sound money, rather than the magic money tree that will somehow fund Labour’s £28 billion black hole.
Anthony Mangnall (Totnes) (Con)
I am somewhat perplexed by this debate, and indeed by the Bill. I do not consider it to be enforceable, and I also think it fails to take into account the effective tax measures and health campaigns that have been run by successive Governments to reduce the number of smokers. Nor does it respond to the fact that, in the long run, bad and poor diets are likely to kill more people than smoking. According to a recent study conducted by the Institute for Health Metrics and Evaluation in Seattle, more people are dying from malnutrition than from smoking. There is a principle at stake here: should the Government step in and deal with people who are eating unhealthy food?
Victoria Atkins
I am, of course, responsible for healthcare in England, so I will not trespass on the health needs of people in—as I think my hon. Friend said—Montreal. As for the Bill, it is intended to help children and young people to end their addiction to nicotine, which we know is one of the most addictive substances. As I said earlier, we should not assume that decreases in smoking rates such as those we have seen are inevitable; indeed, I have cited countries in which we have seen an increase. We also know that tobacco is being consumed in ways that are different from the ways in which it was consumed, say, 20 years ago. My hon. Friend the Member for Cities of London and Westminster (Nickie Aiken), for instance, mentioned the rise of non-cigarette tobacco smoking. We are trying to address that, for the health of the individual as well as the wider health of society.
Several hon. Members rose—
Victoria Atkins
I have already taken an intervention from the hon. Member for North Antrim (Ian Paisley). I will take one more, from the hon. Member for York Central (Rachael Maskell), and then I will make some progress—although I will give way to my hon. Friend the Member for Dartford (Gareth Johnson) in a moment.
Rachael Maskell
The Secretary of State has talked about addiction to nicotine. If, as she has suggested, vaping is a pathway to stopping smoking, why does she not envisage a vape-free generation arriving in parallel with a smoke-free generation, so that we can have a nicotine-free generation across the board? Why does she not expand her legislation to ensure that young people take up neither smoking nor vaping?
Victoria Atkins
The House has already legislated to ensure that vapes cannot be sold to people under 18. However, as we are seeing in our local shops, the vaping industry is finding ways of marketing its products that seem designed for younger minds and younger preferences. Once the Bill has been passed, that age limit will be maintained for vaping but, importantly, from January 2027 onwards we will not see the sale of legal cigarettes or tobacco to those aged 18 or less.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Will the Secretary of State give way?
Victoria Atkins
No; I want to make some progress. I want to say something about the measures on vaping because, as Members have already demonstrated today, there is a great deal of interest in the subject.
As any parent or teacher will know, there has been a dramatic and dangerous increase in youth vaping. At least one in five children have tried it. Many will say that the solution is simply to enforce the law, and of course that is a vital component, which is why we are investing £30 million in our enforcement agencies and hitting cynical businesses that sell vapes to children with on-the-spot fines. However, we must and will go further, because vaping damages our children’s future. It could damage their lungs while they are still developing, intensify the long-term pressure on the NHS, and damage their concentration at school—a point that many teachers have made.
We cannot replace one generation addicted to nicotine with another, and vapes are cynically marketed towards our children. They are sold at pocket-money prices, they share shelf space with sweets, they are branded with cartoon characters, and they are given flavours such as cotton candy and watermelon ice. Our children are being exploited, and we cannot and will not let that continue. The Bill will give us powers to crack down on child-friendly flavours and packaging and to change the way in which vapes are displayed in shops—measures on which we will consult.
Through separate environmental legislation we are banning the disposable vapes that young people favour and that do so much harm to our planet. Some 5 million are thrown away, either in bins or on our streets, every single week. That is equivalent to some 5,000 lithium car batteries from electric vehicles being thrown away every year. We have a responsibility to tackle the harm to our planet that is perpetrated by the vaping industry. While vapes can be helpful in assisting adult smokers to quit, our message remains clear: if you do not smoke, do not vape, and children should never vape.
Gareth Johnson (Dartford) (Con)
I thank the Secretary of State for giving way; she is being very generous. The Bill gives her wide-ranging powers in relation to the flavours of vape liquid, packaging and so on, but does not oblige her to consult widely or look at impact statements. In fact, the word “consultation” does not appear anywhere in the Bill. Will she give the House a commitment that she will consult fully before exercising any powers given to her by the Bill?
Victoria Atkins
I thank my hon. Friend for highlighting that. I give a commitment here at the Dispatch Box that we will consult. We are very conscious of the complexities of this issue. We want to get it right, and my hon. Friend has my absolute undertaking that we will consult before regulations are brought before the House.
Victoria Atkins
If the hon. Gentleman wants to dive in before I conclude, I will let him do so.
Ian Paisley
That is kind of the Secretary of State. I appreciate her taking these interventions.
Given that this a flagship policy for the Government, will the Secretary of State give me a guarantee from the Dispatch Box that the Bill will apply equally to all parts of the United Kingdom? I have raised a number of concerns about the fact that because we have a land border with the European Union, the EU will insist, under the Windsor framework, that it can block the implementation of the Bill in Northern Ireland, as it did with the Danish Government when they tried to introduce a similar measure. Can I have a guarantee that if the Bill will apply from 2027 in the United Kingdom, it will apply in the United Kingdom of Great Britain and Northern Ireland?
Victoria Atkins
I thank the hon. Gentleman for raising a really important point. May I, through him, thank the new Northern Irish Health Minister, who has been very collaborative in bringing forward what needs to be brought forward as quickly as possible, given the historical context, so that we can have the Bill aligned across the United Kingdom? Our intention is absolutely as the hon. Gentleman describes: it applies throughout the United Kingdom. Of course, if he or his colleague in Belfast have concerns that there may be ways in which it could somehow be circumnavigated, we will listen carefully, but I should be clear that our intention is that the Bill applies to all children and young people across the United Kingdom, because we want to protect children living in Northern Ireland just as much as those in England, Wales and Scotland.
Rehman Chishti (Gillingham and Rainham) (Con)
On the Secretary of State’s point about tackling illicit tobacco, I raised that question with the then Prime Minister in 2016, because in Medway we had one of the highest rates of illicit tobacco sales. The maximum sentence that can be given for the supply and sale of illicit tobacco is seven years. As part of the strategy to deal with illicit tobacco, will the Government look to increase sentences for its sale and supply? The Secretary of State is right to say that the Conservative party is committed to lower taxation, but tax avoidance and evasion costs this country £2 billion. If we do not get things right with regard to the banning of cigarettes, which I do not agree with—I think we should do it through education and awareness—we will get more people buying illicit tobacco. That cannot be right.
Victoria Atkins
My hon. Friend gives me the ideal opportunity to talk about my favourite criminal offence: cheating the public revenue, which is a criminal offence with very settled law. It has a maximum sentence of life imprisonment, and I have deployed it myself against the organised crime gangs to which I referred at the beginning of my speech. A sensible prosecutor will always look at that criminal offence, because it is settled law and good law, and it has a maximum sentence of life imprisonment for those who indulge in it.
Victoria Atkins
I am going to conclude. In fairness, I have been generous with my time.
We want to build a brighter future for our children and grandchildren, which means moving from the tossing sea of cause and theory to the firm ground of result and fact. The result of this legislation will be to free future generations from the tyranny of addiction and ill health. The facts include that parents worry about youth vaping and want us to take on the tobacco and vaping industries. The result and facts of this change will save hundreds of thousands of lives, reduce pressure on our NHS and increase millions of young people’s chances in life. The decisions we make today will stand the test of time. For those many reasons, I commend the Bill to the House.
Mr Deputy Speaker (Mr Nigel Evans)
I will try not to impose a strict time limit. If I were wishing to speak, I would start to think about taking seven minutes for my contribution. That does not apply to the shadow Secretary of State.
Wes Streeting (Ilford North) (Lab)
Until the early 2000s, every pub you walked into was filled with smoke. One in every four people in this country was a smoker. The last Labour Government banned smoking in public places, which had an enormous impact on the health of our nation. The following year, there were 1,200 fewer hospital admissions for heart attacks, according to the British Medical Journal. Since 2007, the number of people who smoke has been cut by almost a third. Our understanding of second-hand smoke grew, and there was a cultural change around where it was acceptable to smoke. Even at home, people went outside to smoke, instead of smoking in front of their children.
A study in Scotland found that whereas hospital admissions for children with asthma were increasing by 5% a year before the smoking ban, admissions were down by 18% in the three years following Labour’s legislation. In short, Labour helped to build a healthier society: smoking was down, the number of patients needing treatment was down, NHS beds were freed up and lives were saved. But there is more to do. During the 13 years when Labour was last in office, life expectancy was extended by three and a half years, but in the 14 years that the Conservatives have been in office, it has grown by just four months. For men, it is beginning to decline. We are falling into ill health earlier in life today than we were a decade ago, which is a shameful indication of our country’s decline.
What more motivation could this House need for once again taking seriously the health of our nation? Today, smoking remains a scourge on our society. Some 75,000 GP appointments every month are to deal with the impacts of smoking. The cost to our economy, after taxes, is £10 billion. Around 80,000 of our friends, neighbours and colleagues lose their lives to smoking every year. It is a lethal addiction, a scourge on society, an enormous burden on our NHS and a drag on our economy, and it is time to consign it to the dustbins of history. Let us act today so that the next generation of young people can live healthier, happier and longer lives than the generations before them.
Labour will give our wholehearted support to this Bill. In fact, we needed no persuasion. In an interview with The Times in January last year, I said that it was time for a New Zealand-style smoking ban. I argued that a progressive ban would have a transformational impact on the health of individuals, the health of the nation as a whole and the public finances.
After around two and a half years in this job, I am getting used to the Government nicking Labour’s policies. In the last year alone, the magpies opposite have swooped in on Labour’s NHS workforce plan, Labour’s plan to recruit dentists in the most under-served areas, Labour’s plan for a windfall tax on oil and gas giants, and Labour’s plan to abolish the non-dom tax status. Even so, I was shocked when I saw that the Conservative party—the party of Ken Clarke—is nicking the Labour party’s plan for a progressive ban on tobacco. Of all the policies that the Conservatives have adopted from the Labour party in the past few years, nothing shows our dominance in the battle of ideas more than this latest capitulation.
Where Labour leads, the Conservatives follow. Indeed, when I first floated this proposal, Conservative MPs called it “nanny state” and
“an attack on ordinary people and their culture”,
and I was accused of “health fascism”. What irony, when Conservative MPs are overseas today in Brussels, lining up with the European far right. Anyway, it is water off a duck’s back to me. I am delighted that just a few months later the Prime Minister announced this policy at the Conservative party conference, and that a Conservative Health Secretary has brought this progressive ban before Parliament today.
However, it seems that not every Conservative Member got the memo. It has been widely reported, and we have seen indications of it today, that there are still Members on the Conservative Benches—as many as 100, if we believe rebel Tory briefings to the media, although in our experience these Tory rebellions tend to evaporate when the moment comes—who resist the new interventionist consensus, who continue to fly the flag for small-state libertarianism, and who believe that the Health Secretary and the Prime Minister have surrendered to the lobbying of big health and those tyrants in Action on Smoking and Health, the British Heart Foundation, Cancer Research UK, Diabetes UK, Alzheimer’s Research UK, Mind, Asthma and Lung UK, the Royal College of Physicians, the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health, the Royal College of Midwives and the British Medical Association. Well, we happily align ourselves with big health in defence of the nation and we are only too happy to defend the Health Secretary against the siren voices of big tobacco that we see gathered around our former Prime Minister, the right hon. Member for South West Norfolk (Elizabeth Truss), in the corner of the Chamber today.
Sir Jake Berry
On the issue of unity, does the hon. Gentleman agree with the comment made by his colleague the hon. Member for York Central (Rachael Maskell) that if we bring in a progressive ban on cigarettes, we should mirror it with a similar ban on vaping? If he becomes Health Secretary, will that become the policy that he will promote?
Wes Streeting
My hon. Friend the Member for York Central made the really good point—a point that needs to be well understood in the context of this debate—that vaping is undoubtedly, unquestionably a useful smoking cessation tool, but we should not send the message to the country that vaping is good for our health or that it is without harmful consequences. When it comes to banning things, it should be on the basis of evidence and there should not be a predisposition to ban. I have not yet seen evidence to persuade me that vaping is harmful enough to introduce a ban of the sort suggested by my hon. Friend the Member for York Central. I hope I can reassure the right hon. Gentleman that, when the general election eventually comes, the Labour party will not go around trying to ban things left, right and centre, but I certainly want to consign to the history books the 244,000 people on NHS waiting lists in his area as a direct result of the policies of the Government whom he supports and has served.
Wes Streeting
I will happily give way. Perhaps the right hon. Gentleman would like to take the opportunity to apologise to his constituents in Rossendale and Darwen for his abysmal record in government.
Sir Jake Berry
I will resist the hon. Gentleman’s offer. He has just said that vaping should only ever be used to help people to stop smoking cigarettes. If this Bill passes, it will be illegal for people who are now aged 15 ever to smoke cigarettes, so there will be no requirement in his world for them ever to vape. So I repeat the question, which he has refused to answer: will the Labour party bring forward—this is supported by his own party—a ban on vapes to mirror the tobacco ban? Yes or no?
Wes Streeting
The record will show that I answered the right hon. Gentleman’s question. I talked about banning things and taking away people’s choice, and there are plenty of things that we do on a daily basis that might be harmful to our health in some way. Indeed, participating in most physical contact sports carries a risk of injury, but we are not going to ban football, rugby or boxing. I refer him to my previous answer, which is that I have not seen evidence to persuade me to ban vaping in the way that this Government are proposing to phase out smoking. I have answered that question already and I answer it again now, but I am sure that it will not be lost on the people of Rossendale and Darwen that he did not take the opportunity to apologise to the 244,000 people in his area who are stuck on record long waiting lists.
Once again, the Prime Minister has shown that he is too weak to stand up to his party. The psychodrama in the Conservative party is being put before the interests of the country. In the press today, the Secretary of State for Business and Trade, the right hon. Member for Saffron Walden (Kemi Badenoch) is the latest to let it be known that she will be opposing this Bill. Journalists were helpfully pointed towards comments about her belief in the limits of the state made during her last leadership campaign. I say “her last leadership campaign”, but I am sure that it will not be her last leadership campaign. Indeed, I do not think it has ever stopped. Anyway, that is what she said. In fact, she bemoaned Governments who try to “solve every problem”. Well, if she has a problem with Governments solving problems, she must be delighted with the record of this Government, who can barely solve any problems. They cannot even solve the chaos in their own party.
The Business Secretary is not the only one who is desperate to tell Conservative party members that they oppose this Bill. The former Prime Minister joins us today. The right hon. Member for South West Norfolk and recently declared candidate to be the next leader of the Conservative party, has said that the Bill is “profoundly unconservative”. A stopped clock is right twice a day, and I find myself agreeing with the former Prime Minister. This is absolutely an un-Conservative Bill. It is a Labour Bill, and we are delighted to see the Government bring it forward. [Interruption.] Yes, even this stopped clock is right twice a day for the Trussites in the corner. The right hon. Lady is in fine company when it comes to former Prime Ministers. Boris Johnson has said that this proposal is
“absolutely nuts…It’s just mad”.
Well, now he knows how the rest of us felt when he was Prime Minister.
The right hon. and learned Member for Fareham (Suella Braverman) could not be with us today because she is currently in Brussels surrounded by the police who are trying to shut down the event she is attending with some far right fanatics, with whom she has much in common. A source close to the right hon. and learned Lady has said that she is “not a fan” of the Bill. Well, now she knows how the rest of us feel about her, too.
Some dark horses have also spied an opportunity to play to the gallery. It seems that even my former bête noire, the Secretary of State for Environment, Food and Rural Affairs, the right hon. Member for North East Cambridgeshire (Steve Barclay), fancies his chances in the ongoing battle for the Conservative leadership, because he too has come out against this Bill. To be fair, he has a strong case for the leadership of the Conservative party. As Health Secretary, he had to face a workforce in constant dispute with him, which is good practice for dealing with the party, and he has to deal with a steady stream of toxic sewage in his current job, so who could be more experienced in coping with the travails of the modern Conservative party than the right hon. Gentleman?
I want to praise the one member of this Government who has consistently made the case for the Government’s Bill. No, of course I am not talking about the Prime Minister. Since his party conference speech in October he has shrunk away from the debate, once again too weak to stand up to his own party, and instead left it to others to make the case for him. To her credit, the Health Secretary has cast aside any leadership ambition she may have once held and come out in full-throated defence of Labour’s policy. So let me assure my comrade opposite that we will stand with her today in the voting Lobby, even as the forces of conservatism stand against her.
Sara Britcliffe (Hyndburn) (Con)
Going back to the subject of what we are trying to debate rather than playing a political game, I hope that the hon. Gentleman is not going to pick up a sheet and throw some figures at me, because this is a serious question. When my hon. Friend the Member for Dartford (Gareth Johnson) asked a question about a consultation on vaping, those on the Opposition Front Bench shook their heads at the idea. Can I ask why? As a former smoker myself, I have moved to vaping in order to quit smoking, and I genuinely think that this issue needs to be considered. I ask the hon. Gentleman a simple question: why does the Labour party think a consultation should not go ahead?
Wes Streeting
I am grateful to the hon. Lady for her intervention. It falls to me to defend the Government against their own Members, but to be fair to this Government, they have consulted on measures to clamp down on inappropriate vaping. They have consulted, and we have been urging them to go faster in cracking down on the sale of vapes to under-age people in this country—a generation of young people who have become addicted to nicotine. I will talk about that further on in my speech.
The Government have consulted and the Bill will go through the legislative process. We will no doubt have a rigorous debate today and in the Bill Committee. It will then report to this House and then go to the House of Lords, where it will be continue to be scrutinised, and it is unacceptable that there are still people who would tie the Health Secretary’s hands behind her back and slow her down when urgent action is needed to clamp down on the people who are selling nicotine to children. Those people are addicting children to nicotine. I do not understand why on earth the Trussites in the corner are trying to tie the hands of their own Health Secretary when she is trying to do the right thing by young people.
Sara Britcliffe
The hon. Member is putting me on the wrong side of this argument as a former smoker, so I would appreciate it if he had a little bit more respect. What I am trying to ask is this: why does he not agree that people who are using vaping as a substitute for smoking should be consulted on what they believe should happen through this Bill?
Wes Streeting
I do not know whether there is a problem with the speaker system in here, because this is the second time I have had an intervention after answering the question. I have already said that the Government have consulted on measures to clamp down, and I am absolutely not against the Government talking to people who, like the hon. Lady, have used vaping as a smoking cessation tool. In fact, I fully support the point she is making, which is that vaping can be a really effective tool to help smokers to quit smoking. I am in favour of that; that is good for health. If the Government want to talk to and engage with people who vape as part of the passage of this Bill, that is absolutely fine. What I am not in favour of is tying the Secretary of State’s hands when she wants to do more, and more quickly, to prevent children becoming addicted to nicotine.
Victoria Atkins
Just to be clear, we will consult on this. It is a simple question that requires a simple answer: will Labour consult further?
Wes Streeting
Mr Deputy Speaker, we are now in this parallel universe where the Secretary of State is asking me, the shadow Secretary of State, whether I am going to consult on her Bill. Now, I am willing to help her out, but if she wants me to sit on that side of the Chamber and run the Department of Health and Social Care, I am ready and willing, but we need a general election to do that. I do not understand—this is just extraordinary. I feel like I am living in a parallel universe this afternoon. It was bad enough when the former Prime Minister, the right hon. Member for South West Norfolk, walked in with her book and her fan club, and now we have the absurd spectacle of the Secretary of State asking me whether I will run the consultation on her Bill. This is extraordinary. I will allow her to correct the record and save her blushes.
Victoria Atkins
The hon. Gentleman is not listening. He has been asked repeatedly whether he supports the concept of a consultation on vaping in order to ensure that these regulations are drawn up properly. He is not listening. He refuses to answer the question. We on this side of the House are clear: we want to get this right and we will consult. I am simply asking whether he will answer the questions that he has been asked.
Wes Streeting
Honestly, Mr Deputy Speaker, you just can’t help some people. I am trying to help the Secretary of State out and defend her against her own side, and now, to curry favour with them, she has turned on me. Now I know what it is like being in the Conservative party. This is like a 1922 committee meeting—absolutely absurd.
For the final time, let me just explain the situation we find ourselves in today. The Secretary of State is currently in government. This is her Bill. She is taking it through Parliament. She is perfectly able to run a consultation. I will support her in running a consultation, if that is the support she needs. [Interruption.] I am so pleased. If only I had known it was that easy. If all she needed was a bit of moral support from me to run the consultation, then you go, comrade—don’t you worry; I have got your back, and it is absolutely fine.
I am trying to be helpful to the Secretary of State this afternoon, but I just have to say to her that I am not sure that the best way to persuade her colleagues was to invoke the great cigar chomper, Winston Churchill. Some have estimated that Churchill went through 160,000 cigars in his time. Indeed, on one occasion, at a lunch with the then King of Saudi Arabia, Churchill was told that no smoking or drinking would be permitted in the royal presence. He responded:
“If it was the religion of His Majesty to deprive himself of smoking and alcohol, I must point out that my rule of life prescribed as an absolutely sacred rite smoking cigars and also the drinking of alcohol before, after and, if need be, during all meals and in the intervals between them.”
I appreciate the Health Secretary’s efforts, but I fear that Lord Soames was probably on to something when he said that his grandfather certainly would not have approved of this Bill.
Just before any Conservative Members decide to wage yet another culture war and accuse me of talking down one of Britain’s greatest Prime Ministers, I would just add to the historical record that it was thanks to the Labour party that it was Winston Churchill, not Lord Halifax, who became the leader of our country at a crucial time, and thank goodness that he did. Nevertheless, I do commend the Secretary of State on a good effort—she was close, but no cigar. Anyway, let us go back to the economic arguments of the Bill.
Vicky Ford
I want to go back to the point about consultation. I think that the hon. Gentleman has agreed that, for people who smoke cigarettes, moving on to vapes can be helpful. What he may not know is that people who have moved on to those vapes tell us that, if they are unflavoured and just taste of nicotine, they taste revolting. That is why many vapes are flavoured. That is why my hon. Friend the Member for Hyndburn (Sara Britcliffe) may be so concerned about making sure that people’s views are listened to before flavours are removed from the market.
It appears to me that the hon. Gentleman did not get that point, because he was refusing to believe that any such consultation was important. Therefore, out of respect to the people who use these products to stop smoking, can he confirm again that if he is in government at the time, soon after this Bill is passed, he will consult people and listen to their views before banning the products they use?
Wes Streeting
I am grateful to the right hon. Lady for her intervention. I think she makes a perfectly sensible point, actually, and I am perfectly open to lobbying from Conservative Members on how a Labour Government will behave after the general election—she seems to think it is a foregone conclusion, but I certainly do not; we will be working hard for every vote. I can reassure her that our concern has been about children becoming addicted to nicotine. In relation to adult use of vapes as a tool for stopping smoking, I think she makes an absolutely reasonable point about flavourless vaping, and of course she is right that we need to ensure that we get the regulation right on that so that we do not unwittingly deter people from stopping smoking. However, as I will come on to talk about when I come to the vaping section of the Bill, there is no excuse whatsoever for the kinds of flavourings and marketing of vapes that we have seen, which I believe have been deliberately and wilfully designed to addict young people to what is, let us not forget, a harmful substance. I make that very clear.
Anyway, back to the Bill—someone has to defend it, and I get the sense that there are not going to be too many on the Government side, so I will have a go at doing what the Prime Minister is too weak to do and take on the arguments of his own party. They say that the progressive ban on smoking is unconservative. Let me tell them what is unconservative: the heaviest tax burden in 70 years, and it will get heavier if we do not act to prevent ill health.
If we continue down the road that the Conservatives have put us on, with more and more people suffering, falling sick and falling out of the workforce, we will not just be letting those people down; we will all be paying a heavy price for it too. The costs of sickness and disability benefits are due to rise on the Government’s watch, from £65 billion this year to over £90 billion by the end of the next Parliament.
The budget for the NHS is £165 billion this year, and the health service is not coping with existing demands. If society continues to get less healthy, those demands will only rise. If the health service and our welfare service are to be made sustainable for the future, then we must act to prevent ill health in the first place. What better way to do that than by wiping out the leading cause of cancer? It is not just our public finances that are held back by ill health; so too is our economy.
Alexander Stafford
I am trying to follow the hon. Gentleman’s argument to its logical conclusion. He talks about substances that are bad—addictive and harmful to people’s health—and have a huge impact on the NHS through those costs, but there are so many more things that are in fact worse for health. Sugar and salt are highly addictive. Does this mean that Labour’s plan is to ban foods with high levels of salt or sugar? Logically, that is the next step, and therefore, if we need to protect the NHS and cut costs, we should be banning anything that is slightly bad for us, rather than actually taking a better enjoyment of life and saying, “A little bit of what you fancy every now and again is okay, and good for your mental health.”
Wes Streeting
I think that is extraordinary. I do not think that smoking is slightly harmful; I think it is the single biggest cause of cancer, and I think that the costs to people’s health, to our national health service and to our economy are enormous. This sort of argument—that if we ban smoking for young people, we have to ban everything else—is absurd. I think that the Secretary of State just pointed out the absurdity of it when she pointed to a whole range of harmful things in our country that are already banned.
Let me put the question back to the libertarian wing in the corner of the Chamber. Will the new modern Conservative party not ban anything? Will we have a libertarian dystopia in which people are free to do whatever they want in the name of liberty? [Interruption.] I am just trying to help the Secretary of State by taking on the libertarians in the corner. I would be very sad if she wants me to give in to them but, with 187,000 people on the waiting list in the local area of the hon. Member for Rother Valley (Alexander Stafford), I think we should do something about it.
Sir Simon Clarke (Middlesbrough South and East Cleveland) (Con)
I proudly call myself a libertarian, because I believe in the fundamental value of freedom of decision making. On what we should and should not ban, I would argue there is a very substantial difference between banning class A and class B drugs, which do immense harm in all our communities, and banning tobacco. We already struggle to stop the former, so why on earth would we try to create and police a huge black market in the latter?
Wes Streeting
I admire the right hon. Gentleman for sticking to his convictions as a libertarian in making that case, even though I strongly disagree with him, but how far does his commitment to libertarianism go? He is defending the right of our country’s children to become addicted to nicotine for the rest of their life, which is an extraordinary argument. There are 356,000 people in his local area on NHS waiting lists. Does he want a future where that gets worse and the disease burden and cost pressures rise? When he was in government, the low-tax Conservatives crashed our economy and sent people’s mortgages through the roof, and rents, bills and the tax burden rose. That is their record. I wish he would do more to stand up for his low-tax convictions than his libertarian desire that children growing up in our country today should become addicted to nicotine. I have to respectfully disagree with him.
Compared with three years ago, half a million more people are out of work due to long-term sickness. People’s careers are being ruined by illnesses that prevent them from contributing to Britain’s economic success. We cannot build a healthy economy without a healthy society. Not only is there a moral argument for backing this progressive ban, based on the countless lives ruined by smoking and our shared determination to make sure that children growing up in Britain today will not die as a result of smoking, but there is an economic argument, too.
It is certainly true that vaping is less harmful than smoking and is a useful smoking cessation tool, but vapes are harmful products none the less. In the past few years, entirely on the Conservatives’ watch, a new generation of children have become hooked on nicotine. An estimated quarter of a million children vape today, and there is no doubt that this is the result of vaping companies’ decision to target children. On any high street in the country today, people can buy brightly coloured vapes and e-liquids with names such as “Vimto Breeze” and “Mango Ice”. They are designed, packaged, marketed and deliberately sold to children. The effect of this new nicotine addiction on our country’s young people should trouble us all.
Ms Lyn Brown
A couple of years back, Newham did a survey and discovered that 4% of year 6 children—that is 10 and 11-year-olds—had already vaped. I met Community Links in Canning Town in January, and it has been working on projects to tackle misinformation. Its students explained to me that they and their friends have been encouraged to believe that vaping is somehow safe and will not cause them the same problems with nicotine. Surely we can all agree that the voices of young people need to be heard and that they need to be encouraged and assisted to tackle the misinformation about vaping that is clearly out there.
Wes Streeting
I strongly agree with my hon. Friend, and I am very familiar with Community Links, which does brilliant work. We should take the voices of children and young people seriously—the right hon. Member for Chelmsford (Vicky Ford) made that point earlier.
Teachers monitor school toilets where children congregate to vape. Kids are making up excuses to leave their classroom in order to satisfy their nicotine cravings, and children in primary school, aged 9 or younger, have ended up in hospital because of the impact of vaping. Paediatric chest physicians report that children are being put in intensive care units for conditions such as lung bleeding, lung collapse and lungs filling up with fat. One girl who started vaping at school told the BBC that she has
“no control over it…I start to get shaky and it’s almost all I can think of.”
The question that must be asked of Conservative Members should not be whether they will take action today, but what has taken them so long. In 2021, Labour supported an amendment to the Health and Care Act 2022 to ban the branding and marketing of vapes to appeal to children—Conservative MPs voted it down. In 2023, my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) led a debate on an Opposition day motion on the same proposed ban—once again, Conservative MPs failed to support it. Thanks to their delay in acting against this, and thanks to their awful, shocking complacency, thousands more children have taken up vaping and become addicted to nicotine. Can the Health Secretary tell the House whether the Government’s delay in acting against youth vaping had anything to do with the £350,000 donation her party received from the boss of a major vaping company that sells vapes with flavours such as “Blue Razz Lemonade” and “Strawberry Mousse”?
We are an ageing society facing rising chronic disease. We are approaching these challenges with an NHS already in the worst crisis in its history, with the longest waiting lists and lowest patient satisfaction on record, 121,000 staff vacancies across the health service and 14,000 fewer hospital beds than in 2010. If we do not act today to ease the pressures coming down the track, they threaten to overwhelm and even bankrupt the health service.
Prevention is better than cure. This progressive ban must be the beginning of a decade in which we shift the focus of healthcare in this country from sickness to prevention, which is mission critical to making sure the NHS can be there for us in the next 75 years, just as it has been there for us in the past 75 years.
If the Government are serious about taking on this challenge, Labour has many more plans that they can adopt before they finally call the general election. They could adopt our children’s health plan to give every child a healthy start to life. They could ban junk food ads aimed at kids so that children are not targeted by unhealthy food. They could tackle the mental health crisis facing young people, with support in every school, hubs in every community, and 8,500 more mental health professionals to cut the disgracefully long waiting times for treatment.
They could treat the 152,000 children who have been on NHS waiting lists for more than 18 weeks, ending long waits for children for good. We will do it by providing 2 million more operations, and by providing evening and weekend appointments to beat the Tory backlog. We will have supervised toothbrushing in schools to tackle the moral emergency of children needing to have their rotting teeth pulled out, which is the No. 1 reason why children aged six to 10 end up in hospital. We will have breakfast clubs in every primary school so that kids start the day with hungry minds, not hungry bellies. We will digitise the red book, making sure that all kids are up to date on their checks and vaccines. And we will once again put an end to measles in this country, after it has been allowed to return on the Government’s watch.
We want the next generation to be chasing their dreams, not a dentist appointment. They should aspire to reach their potential, not to reach a doctor. Labour’s plan is to make sure that today’s children are part of the healthiest generation that has ever lived, and this ban is just the start.
The Prime Minister may be too weak to whip his MPs to vote for this important Bill, but Labour will put country first and party second. We will resist the temptation to play games on votes. Instead, we will go through the Lobby to make sure this legislation is passed so that today’s young people are even less likely to smoke than they are to vote Conservative.
I commend this Bill to the House.
Several hon. Members rose—
Mr Deputy Speaker (Mr Nigel Evans)
Order. I remind everyone that there is a lot of interest in this debate, particularly among Government Members, so I ask speakers not to stray too much beyond seven minutes. I call Liz Truss.
Elizabeth Truss (South West Norfolk) (Con)
Thank you, Mr Deputy Speaker.
I am not speaking in this debate because I love smoking, although I have voted against every single smoking prohibition since I have been a Member of Parliament. I am speaking today because I am very concerned that the policy that has been put forward is emblematic of a technocratic establishment in this county that wants to limit people’s freedom. That is a problem.
Kirsten Oswald (East Renfrewshire) (SNP)
Will the right hon. Lady give way?
Elizabeth Truss
I will not give way to the hon. Lady—[Hon. Members: “Oh.”] I will not give way. I will give exactly as much opportunity as the Opposition gave me to talk about my private Member’s Bill, which I shall come on to later.
The problem is that the instinct of this establishment, which is reflected in cross-party consensus in the Chamber, is to believe that it—that the Government—is better at making decisions for people than people themselves. I absolutely agree that that is true for the under-18s. It is very important that we protect people while they are growing up until they have decision-making capability. However, I think the whole idea that we can protect adults from themselves is hugely problematic and effectively infantilises people. That is what has been going on. We are seeing, not just on tobacco but on sugar, alcohol and meat, a group of people who want to push an agenda which is about limiting personal freedom. I think that that is fundamentally wrong.
I go out canvassing a lot in my Norfolk constituency. People raise all kinds of issues with me on the doorstep. They are concerned about immigration. They are concerned about the cost of energy. They are concerned about the rise of China. They want to support Ukraine. Not a single voter has ever said to me, “My big concern is adults smoking.” This proposal has not come from people—our constituents—talking to us. It has come from a group of people who, by and large, work in a professional capacity pushing these policies. When my right hon. Friend the Member for Suffolk Coastal (Dr Coffey) was Secretary of State for Health and Social Care, this proposal was sitting on her desk, so it is not new. I am pleased to say that she put it in the bin, but unfortunately since then it seems to have been pulled out of the bin and resuscitated. My real fear is that this is not the final stage that the health police want to push.
Elizabeth Truss
They are the health police, and people are concerned about this. They want to be able to make their own decisions about what they eat, what they drink and how they enjoy themselves. If the hon. Gentleman does not understand that, I suggest that he starts listening to the public.
What I also find extraordinary is the fact that almost four weeks ago I put a private Member’s Bill to Parliament to ban under-18s from being able to access puberty blockers and cross-sex hormones in the private sector and on the national health service. Children have been taking those drugs, and that has had life-changing effects on them. They have prevented them from having their own children, created problems with their physique and their bodies, and damaged their health.
Not only did the Labour party not support my private Member’s Bill but its Members talked and filibustered—they talked about ferrets—so much that I was not even able to speak. These are the same people who are saying that in future we should ban cigarettes for 30-year-olds, yet they will not vote to ban puberty blockers and cross-sex hormones for the under-18s. Thank goodness that Hilary Cass has come forward with her report. I welcome the support of the Health and Social Care Secretary for that report, but that is what we should be legislating on. We should be legislating on implementing the recommendations in the Hilary Cass report to prevent real danger to our children, rather than a virtue-signalling piece of legislation about protecting adults from themselves in future.
I am afraid that too many Members of Parliament have gone along with this orthodoxy. I am not surprised that that is the case for Labour and Liberal Democrat Members, who generally do not support freedom. They believe that the Government know best—the state knows best—and we understand that. I am disappointed, however, that a Conservative Government has introduced the Bill. The only other country in the world where such a Bill was brought forward was New Zealand, under a very left-wing Prime Minister. That Bill has now been reversed under the new conservative Government in New Zealand. I have a message for my colleagues on this side of the House. If people want to vote for finger-wagging, nannying control freaks, there are plenty of them to choose from in the Opposition, and that is the way they will vote. If people want to have control over their lives, if they want to have freedom, that is why they vote Conservative. We have to stand by our principles and ideals even if—
Elizabeth Truss
No, I am not giving way to the party that filibustered on my Bill and stopped us taking action to protect children. That was a disgrace.
Sir Christopher Chope (Christchurch) (Con)
Did my right hon. Friend hear the comments of Sir Chris Whitty on the radio this morning? He refused to apologise for or explain the failures of the NHS to deal with the issue of puberty blockers while, at the same time, he professed great support for these oppressive measures which are before the House.
Elizabeth Truss
My hon. Friend makes absolutely the right point. There are double standards in this debate. My view is that it is absolutely right that we protect the under-18s from these potential dangers before they have full decision-making capability, but we should allow adults to exercise that freedom. It seems to me that the medical establishment, the national health service and others working in the health industry have unfortunately been captured by this gender ideology, which is preventing them from seeing the truth of what is happening. That is why the Cass report is welcome. If only the hon. Member for Ilford North (Wes Streeting) had shown the same level of interest in dealing with the issue of young people and puberty blockers that he has shown in pursuing his crusade against smoking—he was not saying this a few years ago.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
As my right hon. Friend will know, I was in the Chamber on that Friday listening to the filibustering, and was unable to contribute to the important debate on puberty blockers. I support her Bill and am grateful for the Cass report.
In reality, there are some products that are banned for adults—things such as cocaine and heroin—so society as a whole has made a choice that some products must be banned for adults as well as children. It is about where we draw the line. My right hon. Friend said that people should be able to do whatever they want as adults, but in fact unless we want to liberalise laws on drugs and allow people to have heroin, cocaine and everything else—perhaps she does—a line has to be drawn somewhere, and it is just a case of where.
Elizabeth Truss
I certainly do not support the liberalisation of those drugs. We know that people who become addicted to heroin and cocaine are a huge danger to other people and to their families; it destroys society. That is not the level of danger that tobacco poses, so those are very different scenarios.
I will come to my conclusion, because I know that a lot of people want to speak in the debate. What I ask is that Members do not just follow the instructions of the health lobby. We have heard about what the chief medical officer says. I know from being a Government Minister that there are often schemes pushed by officials and civil servants because, fundamentally, there is a belief that government knows best. I want Members of Parliament to think not just about what happens if we ban smoking for people who are over the age of 18, but about the implications for shopkeepers who have to identify whether people are the right age. Will it mean that people have to carry ID into shops with them into their 40s? What are the practical implications? It is a very dangerous precedent to start saying that some adults can have the freedom to smoke and some cannot. That is a fundamental problem. It is fundamentally unconservative, it is unliberal and I will not be supporting the Bill.
Wes Streeting
On a point of order, Mr Deputy Speaker. Is it in order for Members of this House to attack individual officers, such as the chief medical officer, or the civil service more generally, when they cannot answer back? Ultimately, advisers advise and Ministers decide. If people do not like Government policy or its consequences, they should take responsibility as Ministers and not attack officials who cannot answer back.
Mr Deputy Speaker (Mr Nigel Evans)
I will allow that to rest on the record.
Kirsten Oswald (East Renfrewshire) (SNP)
I am pleased to speak here today in favour of the Bill, part 2 of which specifically relates to Scotland, because smoking is the leading cause of preventable death in both Scotland and the UK. We know that, so we are surely duty bound to act and prevent harms. To be clear from the outset, I want us to help people to stop smoking. Smoking cessation, as well as preventing future harm, requires our action.
Dr Ian Walker, executive director of policy at Cancer Research UK, has correctly pointed out that nothing will have a bigger impact on reducing the number of preventable deaths in the UK then ending smoking. I will not go into detail about the terrible reality of the health impacts of smoking. We have heard about them already today, particularly powerfully from those who have worked directly in the medical environment. We have seen significant successes where we have acted on smoking in the past. I remember when the ban on smoking in indoor public spaces came into effect in Scotland, a first in the UK. It was a bit controversial, but not for long. It has undoubtedly hugely improved our environment and, importantly, our health outcomes. We have seen an important decrease in the numbers of smokers, but let us be real—there are still far too many lives being destroyed by smoking.
I am very glad that Scotland has been in front of the curve on these issues, whether that be with the indoor ban, the overhaul of tobacco sale and display, the ambitious goal of a smoke-free Scotland by 2034 or an issue that I have often spoken about here, the consultation on disposable vapes. The direction of travel is welcome. The SNP welcomes the collaborative step towards creating a smoke-free generation. It is not just us—the public are looking for action too. Action on Smoking and Health tells us that the largest poll of public opinion conducted to date—over 13,000 adults were polled—found 69% in support, including over half of all current smokers.
I watched with some despair—a little bit like I watched some of the proceedings in the House today—media interviews this morning where the right hon. Member for South West Norfolk (Elizabeth Truss) said some of the things she repeated here in the Chamber. She said:
“I don’t know why this legislation is being brought forward”.
I would have thought that was pretty obvious really, but let me help her with that: it is to stop people dying. She then said, as she has again during the debate, that this is “unconservative” legislation. To be fair, I know absolutely nothing about being a Conservative and I am very much OK with that, but what a bizarre statement. Surely regardless of our varying political views, we can look at the health impacts of smoking and say they is not the future we want, and not the damage, harm and heartbreak we want for future generations.
Let us be clear that any arguments put forward about personal choice or personal freedom make no sense at all when we are talking about children and a highly addictive substance. Smoking is not a free choice; it is an addiction. Nicotine is a horribly addictive substance. That is why this is a positive and necessary move, and one widely welcomed, including by Asthma and Lung UK. That organisation points to the significant harm to future generations if we do not act now, and highlights the enormous cost to the NHS if we do not take this preventative action when we have the opportunity to do so.
Scottish Government Public Health Minister Jenni Minto MSP has welcomed the Bill, pointing out that Scotland has been a world leader on a range of tobacco control measures. While there has been a steady reduction in the proportion of people smoking, we know it still damages lives and kills more than 8,000 people a year in Scotland. If we do not act, we know perfectly well what the impact of that inaction will be.
We also know that smoking causes and exacerbates health inequalities, which is exactly why we need to have a tobacco-free Scotland. Indeed, Mark Rowland, chief executive of the Mental Health Foundation, points out:
“Smoking harms disproportionally affect those with poor mental health and stopping smoking has been shown to be as effective as anti-depressants. The Tobacco and Vapes Bill is a once in a generation opportunity to prevent the known mental and physical harms that smoking causes and regulate commercial interests from undermining the health of future generations.”
Asthma and Lung UK notes that the harms of tobacco are not equally distributed. In fact, smoking is responsible for half of the difference in life expectancy between the richest and poorest in society. That generational nature of tobacco addiction means that children born today to parents who smoke are four times as likely to take up smoking themselves and to find it harder to quit. So the impact of smoking in terms of generational inequality and harm is clear and known, and we should aim to change that.
I am grateful to Asthma and Lung UK, and to the many other groups that sent me briefing materials. The breadth and range of organisations, including many medical and health groups, that have been in touch to urge me to support improvements in health and to stop future generations becoming addicted to tobacco, is very interesting and speaks to the wide spectrum of those determined to stop this harm, including, as we have heard, a majority of the public and retailers.
I would like to spend a little time talking about vapes, particularly disposable vapes. To nobody’s surprise, I am going to be positive in my support for any and all measures to arrest the tidal wave of children vaping, which should absolutely chill us all. The health impacts on children are terrifying, and that is only the ones we know about. My view is very firmly that all disposable vapes should be banned now, immediately. We should deal with the utmost urgency with the significant harms these devices are causing to our environment and to eye-watering numbers of children. Which of us can seriously say they are confident it is not their children? Members are deluding themselves if they believe that is the case.
Dr Caroline Johnson
As the hon. Lady knows, as we worked on this subject together, I brought forward a ten-minute rule Bill to ban disposable vapes last year. The measures in that Bill do not form part of the legislation today, because this is health legislation, but the banning of disposable vapes forms part of a statutory instrument that has been brought forward as environmental legislation. Does she welcome that?
Kirsten Oswald
I am grateful for the hon. Lady’s intervention. As she knows, it is important for us to look at disposable vapes in the round, including their devastating environmental effects as well as the terrible impacts they have on the health of our young people. Whichever angle we look from, these are devices of which we have no need and that we should get rid of as soon as possible, before they cause any more harm.
Alison Thewliss (Glasgow Central) (SNP)
The proliferation of vapes has happened almost overnight. Does my hon. Friend share the concerns of my constituent, who runs a newsagent and tobacconist, that he is holding the fort on legislation about the sale of tobacco, yet vapes are not subject to the same controls? He may refuse somebody because he does not think they are of age to buy a vape, but he finds they just go down the street to purchase it at another shop that does not have the controls and responsibilities that he has as a tobacco salesperson.
Kirsten Oswald
I am grateful to my hon. Friend for making that important point. I can understand the concerns of her constituent; these devices are far too accessible and far too easily available. They are in all of our schools and on all of our high streets. We need to open our eyes to the damage that is being done. ASH Scotland does great work in that regard. It tells us that, in Scotland, data from the health behaviour in school-aged children survey showed that current e-cigarette use—that means those who have used them in the last 30 days—among 15-year-olds increased from 7% in 2018, which I would have thought was scary enough, to a horrifying 25% in 2022. Obviously we are a bit beyond that now, so I wonder exactly what the figure is, but we have heard enough in the Chamber today to know that, whatever that current figure is, it should cause us grave concern.
These products are designed to be attractive. They are undoubtedly attractive—we have all seen them. They are disposable, so young people can chuck them before their parents find out, they are pocket-money prices, and they are appealing—green gummy bear flavour, anyone? In fact, the green gummy bear flavoured one is on sale for £1.50, which is a disgrace. Vapes should not be accessible in that way, and should certainly not be sold at £1.50. They could not be designed any more obviously to attract young people. Very often, we are talking about children who have never smoked, but who are now getting hooked on these vapes and getting hooked on nicotine. There is also the worry about the unknown harms that vapes cause to their bodies and their health. The sooner that we can change all of that the better.
I also have a personal gripe: vapes being advertised via sports. There is no reason for that—no justification at all. Yes, I am looking at Blackburn Rovers among others. When I raised the matter previously, Blackburn Rovers, based in the vaping capital of the UK, said:
“At no point during our long-standing relationship has the idea that the Totally Wicked brand might appeal disproportionately to children been raised, and we have seen no evidence to suggest that our sponsorship has encouraged an uptake of vaping among children.”
Well, I am raising it, and raising it again. I urge all sports clubs—because there are others—to have serious thought on this. We want to see our sporting heroes as positive influences on our young people and their health and wellbeing.
To be clear, I support measures to help people stop smoking. It is hard to do and all help is welcome, but that help does not come in the form of candy-coloured, candy-flavoured, pocket money-priced disposable vapes. Let us deal seriously with smoking cessation. Let us deal seriously with the terrible harms caused to our young people by disposable vapes, and let us have the backbone to take the chance now to stop smoking killing so many of our loved ones.
I wish to end by reflecting on the words of William Roberts, chief executive of the Royal Society For Public Health, who said:
“Smoking continues to cut lives short, killing up to two in three long-term users, and placing significant strain on an already overstretched health and social care system. Protecting future generations from the dangers of tobacco is vital if we want to build a healthier future. It is vital that the Bill passes and MPs of all political stripes put prevention at the heart of public policy when it comes to protecting our health.”
I sincerely hope that we do.
Several hon. Members rose—
Mr Deputy Speaker (Mr Nigel Evans)
Order. Let me just remind Members of the seven-minute guidance.
Steve Brine (Winchester) (Con)
I start with a spoiler alert: I will be voting to give the Tobacco and Vapes Bill a Second Reading this evening. As we might say, prevention is the new cure. I will not spend my time reading out the screeds of statistics that we have already heard, but the bottom line is that smoking products are the only product on sale legally in our country today that—if you follow the instructions—will kill you. Both Labour and Conservative Governments have acted in the past, and we have seen smoking rates tumble as a result. It is now time to finish the job, and this Bill can be part of that.
Here is where I am coming from. We talk a lot about the pressures on the NHS. Indeed, there have been some new waiting list figures published while we have been away. We talk about public satisfaction—colleagues will be aware of the latest British social attitudes survey last month. We talk endlessly about systems, budgets and staffing, which is all quite proper. They are all issues that we face, and my Health and Social Care Committee does not duck any of them.
We can increase the budget, and we have done so hugely. The NHS in England has never had more money. We can put in a place a properly funded workforce plan, as my Committee called for—and we have. We can produce credible recovery plans for urgent and emergency care, primary care and elective waiting lists, and the Government, to their credit, have done all of those things. We can make use of a much wider workforce—Pharmacy First is a good example—but the truth is that demand continues to outstrip supply, and we cannot continue to increase the health budget faster than our economy is growing. We have to think long-term about population preventive health.
For me, there is no more obvious and glaring candidate for healthcare gains from prevention than action against smoking. When looking at this legislation, I ask not whether we want to finish the job on smoking, or whether it is right to save tens of thousands of lives lost to cancer, heart disease and stroke by doing that—I lost both my parents to cancer before I was 50—but whether the proposed measures aimed at creating a smoke-free generation will actually work. I also ask: how strong is the resolve of Ministers to swiftly use the powers they are taking in the Bill to tackle the use of vapes among children? An issue often overlooked is whether we will we keep the focus on the current smokers we must also help to quit.
Modelling from the Department shows us that if the age of sale were increased by one year every year, as proposed in the Bill, smoking rates among 14 to 30-year-olds are likely to be zero by 2050. I have said this since the Prime Minister announced his intention to bring forward these measures in his conference speech last year, and he deserves so much credit for bringing this change to the House. The Government must win the argument on this as well as the vote, now that the Bill is before Parliament. The Secretary of State, who is no longer in her place, did that today, and I pay credit to the shadow Secretary of State for his part in that.
I wish to touch on an issue that we have already heard of today. The fact is that at some future point we will have a situation in which a 50-year-old can legally smoke while a 49-year-old cannot. There is no getting away from that. That is a possible scenario for sure and, yes, it is rather inelegant, but it also misses the very point of the smoke-free ambition at the heart of the Bill. The clue is in the name: smoke free. The Bill does not criminalise existing smokers, and it ensures that the purchase of tobacco by those under the legal age of sale will not be criminalised. Compliance will be the responsibility of the business, as is the case with the current age-of-sale laws in England. The Bill makes it illegal to sell tobacco products to anyone who is born on or after new year’s day 2009. That includes my 13-year-old son, William. By passing this legislation, the state is saying to him that it is not okay to start smoking when he reaches 18—I think that when we look back we will ask how we ever said it was—and by doing so my son never becomes that 49-year-old. End of story.
We are told that raising the age of sale will fuel the black market, and the next generation of smokers will pick up the habit via illicit sales. A comprehensive anti-smuggling strategy, updated over time, has succeeded in halving the illicit market share from 22% to 11%. I welcome the fact that the anti-smuggling strategy of Border Force and His Majesty’s Revenue and Customs has been updated in the light of this proposed legislation. Am I just being hopeful in thinking this will work? Select Committee Chairs do not just do hope; they do evidence. I do not think I am just being hopeful. When the age of sale was raised from 16 to 18 in 2007, the illicit market did not increase.
Of course, all this—and, as I have said, we must continue to give help to current smokers to quit—needs funding. I welcome the investment of £70 million a year for the next five years into stop-smoking services, but that is a lot of money, so I cannot for the life of me see why Ministers do not look again at the Khan review call for a “polluter pays” principle in the form of a tobacco industry levy. Let us make that a reality.
Let me turn to vapes. The Bill gets 10 out of 10 for intention, but on planned enforceable action I am not so sure, because we just do not know enough. Increasingly, the genie is already out of the bottle—or out of the unknown, untested, bubble-gum flavoured canister—when it comes to vaping, but the kids are not alright on this. Let us make no mistake: users are mostly youngsters, who these days will seldom even think of trying the fags. Vapes are no longer only or even principally aimed at adults who are trying to quit cigarettes. Just when smoking by children was decreasing, vaping by children has started to rise hugely. Between 2018 and 2020, vaping rates doubled.
The benefit of vaping as a safer option for those who currently smoke tobacco is clear, but it is also increasingly obvious that for those who have never smoked it is certainly not risk free. The World Health Organisation has said that vapes are harmful. Schools are worried, as colleagues will hear from any headteacher in their constituencies. In my Committee’s oral evidence hearing on vaping, our witnesses repeatedly raised concerns about the health and behavioural effects of vaping-led nicotine consumption and addiction in schools, including on concentration in class.
The long-term effects of vaping are simply not known, so I cautiously welcome the fact that the Bill takes powers to crack down on youth vaping through regulations to restrict flavours, point-of-sale displays in retail outlets and packaging. However, I cannot go further, because the Bill states throughout:
“The Secretary of State may by regulations make provision”,
and by virtue of the fact that we do not have those regulations before us, it is hard to get a sense of their scope. In winding up, will the Minister update the House on when we might see those regs?
I am pleased to see the new excise duty on vaping products to discourage non-smokers and young people from vaping. I know that the Department for Environment, Food and Rural Affairs will lead on the ban on the sale and supply of disposable vapes, and that the draft Environmental Protection (Single-use Vapes) (England) Regulations 2024 were out for consultation until the end of March. Again, I would be grateful if the Minister updated the House on when that legislation will be taken forward and whether the Bill must first receive Royal Assent? Obviously, I understand the environmental case for a ban on disposables, but I have concerns about us taking away a ladder for adult smokers to climb down. We must be super careful not to tip adults who use vapes to quit cigarettes back to smoking by taking away options.
There has been some talk of a retail licensing scheme—we heard the Secretary of State refer to it earlier. We could perhaps disregard such a scheme if we went down the road of a prescription-only model for vapes so that they are used only under clinical guidance to help adults smokers to quit. In truth, I do not think our current regulatory environment, courtesy of the Medicines and Healthcare products Regulatory Agency, makes it easy to bring a prescription vape to market. The speed of innovation in the sector alongside the slowness of regulation would make it a real challenge for providers, and unless Ministers address that, I do not see how we advance that cause.
We will hear today—we certainly have in the media—about banning things. We will hear about the nanny state, and perhaps even an echo from the distant past about Anglo-Saxon England. Well, as the MP representing the capital of the former Kingdom of Wessex, I do not hold much truck with that. I prefer to listen—fool that I am—to the four chief medical officers of our nation, who say:
“To be pro-individual choice should mean being against the deliberate addiction of children, young people and young adults to something that will harm them, potentially fatally.”
I have always believed that in a publicly funded healthcare system we have a right and, indeed, a responsibility to act on public health, because it becomes everyone’s problem when we do not. Conservatives for whom a smaller state is their thing—although I can never pinpoint which part of the state they do not want their constituents to have—should be right behind a healthier society, because it is one that needs the state less, relies on the state less and costs the state less.
In the light of the important points that I have tried to cover, I will vote to give this important and historic Bill a Second Reading.
Mr Virendra Sharma (Ealing, Southall) (Lab)
I support the Bill in principle, and will vote for its Second Reading later, because it is an anti-smoking measure. Smoking is the forgotten killer of our society, and the Bill contains initiatives against child vaping that I and others have been urging for some time. Let us not be in doubt: the Bill will pass, but it will pass with Labour votes, so I will direct my remarks to its shortcomings.
The Bill is late, it is slapdash and it makes several big mistakes. It seems to have more to do with the Prime Minister’s legacy than with the need for effective interventions against smoking. Disposable vapes arrived in this country and started the youth vaping epidemic during pandemic lockdowns, the last of which finished three years ago. The Prime Minister is concerned about it only now, with his time in No. 10 drawing to a close but very little to show for it. The Government were too slow and slack to get out in front of the issue. Even after three years, they do not have precise proposals for vape regulation to put before the House. As others have said, no consultations have been conducted and nobody is sure what exactly needs to be done—although we all know that something must be done. Children vaping, fake vapes, fake cigarettes that are even more harmful than real ones—these are public health disasters, but they are already illegal, so will not be deterred any more than they are now.
What does the Bill do for the 6.4 million existing smokers? Nothing. In 2019, the Government set a target of bringing prevalence down to 5% by 2030. That was a stretch target and was to be applauded—it was ambitious, but it could have been done. Instead, the Government have dropped all mention of it, and are covering their tracks and distracting us with the generational smoking ban, which will do nothing to help those who already smoke.
What we really need is relentless, thorough and inescapable enforcement, including massive boosts to the resources of trading standards, so that local councils can blast the crime gangs out of their neighbourhoods and keep them out. The fact is that most vapes sold to our children are already illegal. It is illegal for them to be sold to under-18s, to have tanks exceeding 2 ml and 600 puffs, to not carry the right warnings, and to be sold without MHRA approval. While enforcement remains feeble, the disposable ban will make little difference.
Adam Afriyie (Windsor) (Con)
I am listening closely to what the hon. Gentleman says because I share his passion for driving cowboys out of this industry. Does he recognise my observation that those in the industry, and particularly small shop owners, who are quite often from ethnic minority groups, are equally keen to have greater levels of enforcement because they want to drive the cowboys out as much as we do?
Mr Sharma
The hon. Gentleman jumps to a point that I will cover later in my remarks.
Most of the vapes being sold to our children are already illegal. While enforcement remains feeble, the disposable ban will make little difference. The Government are offering £10 million per year for three years to trading standards. That would be good if there were only 20 trading standards departments across the UK; unfortunately, there are 197, so the offer is pure tokenism. Under the generational smoking ban, the Government want to make every shop worker a target for every shopper, just to cover their own failure, Shopkeepers in my constituency are greatly concerned about the pressure this ban will place on them as retailers and on their staff. Retail workers already suffer unacceptable behaviour from customers on a daily basis, which will only get worse. Age-restricted sales are the biggest cause of violence against staff, apart from shoplifting. This ban places often disadvantaged workers at threat of risky and dangerous working environments.
Smoking is a major driver of health inequality. Disproportionate numbers of sufferers of smoking-related diseases are from more disadvantaged backgrounds. Many are dyed-in-the-wool, hardcore smokers. They should give up—they know that—but most of them are not able to do so. None of them thinks that smoking is healthy or safe, so it is urgent that wherever possible they are helped to transition to less dangerous forms of nicotine such as vaping, nicotine pouches and heated tobacco products. No one alternative suits every hardcore smoker. It is an ideologically blinkered mistake to prevent future under-age smokers—those we can never stop—from accessing relatively safer heated tobacco products. I have stated before in this House the relative benefits of HTPs. I said earlier that this Bill does nothing for existing smokers; incredibly, this provision actually makes things worse for them. A pragmatic policy would have seized the potential of all these alternatives, not just vapes, and a smoke-free 2030 could have been a reality. Instead, the Government are playing with people’s lives and making the perfect the enemy of the good.
Finally, the Bill also overlooks the highly carcinogenic scourges of paan and betel in the south Asian community. Only a targeted, community-specific intervention would have any effect in tackling those scourges—I have been drawing attention to them for years. We have waited years for primary legislation on tobacco, but it seems that our needs have again been overlooked, and south Asians will remain at the back of the queue for years to come.
I will support the Bill on Second Reading, but there is huge room for improvement. In particular, trading standards should be given the tools it needs to break the hold that illegal products already have on the market, and while we still have smokers, heated tobacco products should be removed from the generational ban as part of a broad range of less harmful alternatives. I must say that all those ethnic minority shopkeepers are concerned but supportive of this move; they believe that the ban should be in place, but that they should be supported. They feel strongly that at present, not enough support is coming from the Bill and the Government. I hope that the Government will take on board some of what I have said, and that the Bill will emerge much amended on Third Reading.
Sir Sajid Javid (Bromsgrove) (Con)
When I was appointed Health Secretary in 2021, we were still in the midst of the pandemic. That challenging time taught us so much about the strength and resilience of our nation, but it also cast an uncomfortable light on truths that we have too often chosen to ignore. In the past, this country has been at the cutting edge of preventive healthcare, but while we have talked a good game on that issue in recent decades, in truth, we have not always delivered.
I would argue that we still face a public health emergency in this country—one that consumes 40% of the NHS budget, ensures that regional inequalities persist, and limits the life chances and opportunities of individuals right across our country. This public health emergency has many causes, and at the top of the list must be smoking, especially of cigarettes. That is why I commissioned Javed Khan to lead an independent review of smoking. I am immensely grateful to him for his excellent work and I am proud that he has led us to this legislation. The title of his report, “Making smoking obsolete”, is the right mission for us to deliver on, especially given this Government’s commitment in 2019 to a smoke-free Britain.
One of the most important problems Javed Khan identifies is the dual impact of tobacco and nicotine. First, it is incredibly damaging to the health of individuals. As we have heard from so many right hon. and hon. Members, no amount of tobacco is safe. Secondly, it is corrosive of personal liberty and agency. Smoking remains the biggest single cause of preventable illness and death in this country, causing, as we have heard, some 80,000 deaths a year. Smokers are 36% more likely to be admitted to hospital and to need social care 10 years before non-smokers. It causes one in four cancer-related deaths. Behind each of these statistics is an individual life, a family and a community impacted by poorer health. It is therefore only right that we take robust action to protect future generations from these harmful products.
As Javed Khan rightly highlighted in his report, the public are often led to believe that smoking is a personal choice, whereas the reality is that nicotine is a highly addictive drug that corrodes personal agency. Four in five smokers start before the age of 20 and remain addicted for the rest of their lives. As we have heard, many people want to give up smoking, and we have heard some personal stories in the House about just how hard that has been, and how many people, sadly, do not succeed. Many struggle to break free from addiction, and the average number of attempts of those who eventually do successfully quit is 30.
I know that some hon. Members have publicly expressed their reservations about the proposal before us, and we have heard that in this debate, but can we honestly say that this drug enhances personal liberty and freedom? It is a nonsense argument. Anyone who makes that argument is choosing to stand up for big tobacco against the interests of their constituents, and to erode people’s personal liberty and remove their freedom to choose by giving them access to a drug. This drug diminishes economic freedom, and it diminishes the wealth of individuals and of our country. Its overall impact across the country is to reduce opportunity and to drive social challenges. Indeed, if cigarettes were first manufactured today, they would obviously never get through consumer product safety testing.
Given that we are where we are and given what we know, it is of course right to protect future generations from this drug and this addiction. Freedom from pain, disease and inequality is one of the greatest freedoms there is, and whether it is tackling burning injustices, levelling up or even the big society, these missions are more than compatible with the legislation before the House. This is a world-leading proposal backed by clinical evidence and supported by a strong moral cause. As surveys have shown again and again—and, again, just recently—it is strongly supported by the general public of all ages. It is the right approach to public health, it is the right approach for our country and it is more than worthy of the support of this whole House.
Daisy Cooper (St Albans) (LD)
First, I want to put on record my thanks to the public health Minister the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and the chief medical officer Sir Chris Whitty, who spent time answering my questions and those of some of my colleagues. It was a very collegiate exercise and I am grateful to the right hon. Lady. It would be good to see more of that.
The Government proposals on vapes are an absolute no-brainer and are consistent with Liberal Democrat party policy that was adopted at our conference last year, including the ban on single-use vapes on environmental grounds. Parents and teachers in St Albans are particularly concerned about the insidious marketing of vapes to young people: the colours, flavours and packaging are designed to appeal to children. Earlier in the debate the shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting) talked about children gathering in toilets, desperate to use their vapes. I am aware, unfortunately, of one example in my constituency where children have gathered in toilets not just to use the vapes but to take them apart to use as containers for smuggling in more dangerous substances, thereby using the vapes as a new gateway drug. I therefore entirely support the Government’s proposals on the regulation of vapes.
The question of a so-called smoking ban on those aged 15 and younger, stopping them being sold cigarettes, is not so straightforward, however. For Liberal Democrats there will be a free vote on this Bill; there are some good liberal arguments to be made both for and against it. I will be supporting the measures in the Bill, but some of my colleagues have remaining liberal and practical concerns. For example, in 30 years’ time how does somebody prove they are 46 and not 45 without a driver’s licence or a passport? How can we prevent abuse at retailers, too? I hope the Government will be providing more reassurances to colleagues on these issues.
Sammy Wilson (East Antrim) (DUP)
Does the hon. Member accept that that difficulty puts the onus on the retailer, who is meant to distinguish between a 45-year-old and a 46-year-old, and if they do not do that or they do so incorrectly, they could find themselves faced with a fine? Is that fair?
Daisy Cooper
Colleagues across the House have genuine concerns about that point. I know from engagements in my constituency that a number of retailers already suffer attacks when challenging people wishing to buy other age-related products, so I hope the Government will offer reassurances about what they intend to do to tackle that.
As I have said, I will be supporting the measures in this Bill, but coming to that decision was a bit of a journey for me. My first reaction on hearing of the Bill before it was published was indignation, because the measures are just a drop in the ocean in terms of what is needed to tackle cancer. One in two of us will get cancer at some point, yet the Government have missed their targets to provide fast cancer treatment every year since 2015 and have dropped their 10-year cancer plan. What we need is research in rare cancers, outdated cancer scanners updated, cancer nurses and efforts to tackle waiting times. It would perhaps have been better if the measures in this Bill had been a single clause in a much broader Bill. To be honest, I am frustrated that so much energy is going into this Bill, which could be described as low-hanging fruit, rather than into producing a much more ambitious plan to tackle cancer more broadly. We need to see more ambition in this area.
My second reaction was the raising of my liberal hackles. Liberals are not libertarians; we do not object to all bans. Liberals support bans as a last resort, but not as a first lever. The situation here is frustrating, however: it is a bit rich that the Government are bringing this Bill forward when they have simultaneously been slashing public health budgets, including for smoking cessation programmes, since 2015. Even with the new money the Government have put into smoking cessation programmes, the funds still fall far short of 2015 levels. We also know that smoking rates among young people have dropped very quickly; they are now down to 1% and continue to drop.
Liberals do sometimes back bans when a particular product or practice causes excessive harm, and that is why I have decided to back this ban. Fundamentally, I asked myself a simple question: is this going to help reduce the overwhelming harm caused by the significantly dangerous and addictive practice of smoking? The answer is yes, it is. We know that smoking is dangerous and highly addictive. We know that smoking is the UK’s biggest preventable killer, causing around one in four cancer deaths, including 64,000 in England alone. We know that 75,000 GP appointments each month are taken up by smoking-related illness. We know that smoking costs the economy £17 billion a year through smoking-related lost earnings, unemployment and early death. We know that it comes at enormous cost to our NHS, and we know that smoking rates in pregnancy vary hugely, with as many as 20% of pregnant women smoking in some parts of the country, increasing the chance of stillbirth by almost 50%. That is an incredibly stark health inequality.
Some people have suggested it could be contradictory for a liberal to support a ban on tobacco for 15-year-olds and younger while wanting to legalise cannabis, but let me say to them that they are wrong. It is entirely consistent for a liberal to want to make harmful products illegal—harmful products such as nicotine in cigarettes, skunk and products with high THC levels that can cause psychosis—while simultaneously wanting to have a legal regulated market for less harmful products such as vapes for nicotine and cannabis products with low and regulated THC levels.
In conclusion, do I think this measure is the first or best thing that the Government should be doing to tackle cancer? No. Do I think this measure is particularly ambitious? No. But do I think it is a useful step that will help us to tackle the dangerous health impacts of smoking addiction, to improve population health and to take pressure off the NHS? Personally, I do.
Madam Deputy Speaker (Dame Rosie Winterton)
I remind colleagues to stick to the guidance of seven minutes, because otherwise I will have to impose a time limit, and it might not be seven minutes, which would be annoying for everybody.
Sir Jake Berry (Rossendale and Darwen) (Con)
I start my speech by saying that there are some good parts of this Bill. The banning of disposable vapes and preventing children from starting smoking or vaping is something that anyone with a brain—there are perhaps more of them on the Government Benches than on the Opposition Benches—would support. I will address my remarks to whether banning all children who are now 15 from ever smoking is the right way to stop them smoking, as well as talking about whether any Government have a mandate on removing personal liberty.
I am sorry to see the hon. Member for Ilford North (Wes Streeting) leaving his place, because I was about to address some remarks to him. It is unfortunate for the quality of debate to label someone standing up to ask whether this measure will be effective as someone who wants children to smoke. I am an ex-smoker and I do not want children to smoke; I just want to pass decent laws in this House to ensure that we can reduce the number of young people smoking. That is why, when I look at this ban, I question whether it will work.
I put it to the Secretary of State that 20% of young people say they have tried cannabis. Those are not my statistics, but those of the Office for National Statistics. That is twice as many as the number of young people who say that they have tried tobacco, I think within the past 30 days. If bans worked—cannabis is banned—no child would ever have tried cannabis. It is illegal not just for those who are 15, but for all of us, whatever age we are. I went to Aintree this weekend to enjoy the grand national. I was amazed that people were walking around at one of the most heavily policed events in the UK openly snorting cocaine. It is a class A drug, and the police were doing nothing about it. If bans worked and the police enforced them, no one is this country would take drugs. I therefore question whether banning people who are now 15 from ever starting smoke will work. To me, the answer is no.
I will move on to the mandate for any MP or any Government in this place to seek to bring in such a measure in advance of a general election. If Members go to Washington and have a look at the Korean war memorial, they will walk past thousands of names—it is an extraordinary memorial—and at the end there is a bold statement: “Freedom is not free”. All the freedoms that we enjoy in this country have not been given to us; they have been fought for. People have died to ensure that we keep those freedoms.
What we are really talking about today is removing from a group of people in our society—they may be young now, but do not forget that, at the general election after next, some will be 18 and banned from smoking, while some 19-year-old voters will be able to smoke—the right ever to have the agency to make their own decisions. If we believe in freedom, we must accept that people have to be free to make bad decisions as well as good ones. If we live in a society where the only decisions that we are free to make are those that the Government tell us we are free to make, we might as well live in a socialist society—we may as well live in Russia or China. For me, freedom means the freedom to get things wrong.
Andrew Rosindell (Romford) (Con)
My right hon. Friend is making some extremely valid points. Freedom with responsibility and freedom of choice are surely what the Conservative party should stand for. We can think of all kinds of reasons to ban all kinds of things, but surely the choice of the individual should be paramount. It is not for Government to dictate to individuals.
Sir Jake Berry
My hon. Friend is quite right. That is the legal position under the law in this country if we have capacity, no matter how bad the decisions we make. Constituents have contacted me about elderly relatives who are making poor financial decisions, but because they have capacity they are free to make those decisions, albeit bad ones in some cases.
Sir Jake Berry
I will not. I have given way once and want to stick to my time. I will not support the Bill, because I believe in freedom.
My second point is about mandate. The Prime Minister does not have a mandate to bring forward this legislation, and no Labour or Liberal Democrat MPs—in fact, no MPs in the House—have a mandate to vote for it, because it was not in our manifestos. We are just months away from a general election. If people believe that this measure is so important, they should put it in their manifestos. The Conservative party could put it in our manifesto and let people vote for it.
The powers that we have in this House of Commons are not ours; they are lent to us by our constituents between general elections. We are quite rightly getting to the point where we have to return those powers to our constituents and try to persuade them that we have done a good enough job to get them back. Before we start giving away their freedoms and liberties, let us at least give them the opportunity to have a say.
There is one addiction in this country that I am even more concerned about than the addiction to nicotine: the addiction of the Government to telling people what to do. I want to live in a free society where I am free to make both good and bad decisions. As people go through the Aye Lobby to support the Bill this evening—I shall be going through the No Lobby—I ask them to cast their mind back to the last time we were all washed through the Aye Lobby together on a wave of health and science and righteous hope to keep people safe, which was during the covid pandemic.
I am proud of furlough and all sorts of things, but I regret closing schools. It was the wrong thing to do, but I was washed along on that wave. I opposed some of the covid proposals. People should look back to that and think, “That was the last time we took people’s freedoms away from them. Did we always get it right?” In my view, the answer is no. We got lots of things right, but we also made lots of mistakes. As people march through the Lobby, they should think about whether in fact they urgently need to support the Bill or whether it should wait until after a general election—we may have a different Government then, if polls are to be believed—when the British public will have at least had the question put to them.
The addiction of our Government to telling us what to do goes beyond whether we should smoke. During covid, they determined who we could go to bed with, whether we could sit in the park and read a newspaper, and whether we could go to work. We are now told how we can heat our homes and whether we can drive an older diesel car in London. Unfortunately, we live in a country where those freedoms—those freedoms that are not free—are being eroded every single year of our lives. That is not something that I am comfortable with, and it is not something that I am prepared to support.
There are good bits to the Bill, but we cannot allow the fact that good bits of legislation have been annexed to this terrible legislation, which in my view will not work, to force us to support it. The Government could bring in the vaping measures on their own, and I would support them. I just do not support the creeping ban on tobacco. When people reach the age of 18 in a free society, they must be free to choose for themselves.
I will finish with this. If Members find themselves in the No Lobby tonight—I hope I will see a few colleagues in there—they should keep in their mind that freedom is the sure possession of those alone who have the courage to defend it. In my view, by voting no tonight, we defend the freedoms of our constituents and our country. It is the right thing to do, and I look forward to seeing as many colleagues in there as possible.
Mary Glindon (North Tyneside) (Lab)
It is right that the Government bring forward this legislation, but I remind the House that Labour first proposed outlawing the sale of cigarettes to the next generation over a year ago. It is good to see the Government playing catch-up.
Fresh and Balance, the award-winning north-east regional programme dedicated to tobacco control, has found that 73% of adults in our region support the Government’s proposals. Its director, Ailsa Rutter, said in support of the Bill’s progress:
“Most people who smoke get addicted young… This is about giving our next generation a life free of a cancer-causing addiction which…ends-up killing 2 out of 3”.
It is very concerning that the Government are estimated to be seven years behind their 2030 smoke-free target, and not on course to meet it in the most deprived areas of our country until 2044.
I want to concentrate on one of the best tools to help smokers quit, which can contribute to the smoke-free target: vaping. Colleagues may know that I am a strong advocate for vaping as a way for adults to quit smoking. I am also an officer of the all-party parliamentary group for responsible vaping. As such, for the past few years I have worked directly with the industry to promote vaping as an alternative for those who want to give up smoking. I grew up in a household where both parents smoked, but in recent years I have seen so many relatives and friends, including my late husband, make the switch from being heavy smokers to using—I stress this point—safe vaping products.
Every minute, someone is admitted to hospital due to smoking. Someone dies from a smoking-related death every eight minutes, and more than 6.5 million adults still smoke. Although it is not risk-free, vaping is 95% safer than smoking. However, I would never advocate that someone who did not smoke, or who had never tried to smoke, should start vaping. I stress that vapes are a tool for helping smokers to quit. It is unequivocal that under-18s should not use or have any access to vape products. Youth vaping is a major area of concern. It is shameful that in 2021 the Government voted down a Labour amendment to the Health and Care Bill.
The rise in young people using vapes is of great concern to the legitimate vaping industry in this country. Everyone realises that something needs to be done to stop this trend, especially as existing laws are not being enforced. One in three vapes sold in UK shops is estimated to be illicit, so it is imperative that the Government act against the illegal vapes market. The industry itself has put forward many good proposals to prohibit the sale of vapes to minors, halt the illegal market and support the view that vaping should be a tool for smokers to quit. The industry produced a set of proposals to amend the Tobacco and Related Products Regulations 2016, to ensure that packaging and marketing are regulated and not aimed at children.
I would like to share the view of the UK Vaping Industry Association, in the hope that its observations may be considered as the Bill progresses. A major concern is that the impact assessment report by the Department of Health and Social Care fails to consider the potentially detrimental effects of restriction on current vape users and smokers looking to switch. It is important that the regulatory measures are thoroughly assessed to ensure that they do not inadvertently hinder smoking cessation efforts and lead to an increase in tobacco-related harm. I support the industry’s call to include a vape retailer and distribution licensing scheme in the Bill. The industry has developed a comprehensive framework for such a scheme, which is designed to deal effectively once and for all with the issue of under-age and illicit vape sales, a situation the industry believes will only get worse given the predicted rise in black market sales as a result of the proposed ban on disposable vapes.
I make a plea for the Government to consult more closely with the industry than they have done in the past to ensure that a workable regulatory and legislative change can be made. It is worth reminding the House that, according to the Office for Health Improvement and Disparities, the best estimate shows that e-cigarettes are 95% less harmful to our health than normal cigarettes and, when supported by a smoking cessation service, help more smokers to quit tobacco altogether.
Mark Eastwood (Dewsbury) (Con)
I thank my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) for his speech and for mentioning the word “freedom”. It is really important that we do that. I am not coming at the debate from a libertarian perspective—more of a practical one—but, in essence, I agree very much with the majority of what he said.
As an ex-smoker, I share the Prime Minister’s aim of reducing the prevalence of smoking. I never want to see anyone, especially young people, pick up this dangerous habit. It is therefore with some sadness that I rise to explain why I do not expect to follow him into the Lobby on this vote. My great reservation is that the Bill is impractical and could easily make things worse through unintended consequences. There are 5 million users of vaping products, and there is a substantial risk that restricting the use of vapes will lead to them moving back to smoking, increasing the burden on our health system.
Vaping is recognised by Public Health England as 95% safer than tobacco use. Late last year, a study by Brunel University London revealed that if half the number of adult smokers switched to vaping it would save the NHS more than £500 million a year. The potential restriction on the flavours of vapes, which the Bill gives Ministers the power over, could also have unintended consequences, as stated in the Department of Health and Social Care’s own impact assessment. Restricting vape flavours would mean around three quarters of the 1 million adults who vape could be affected in some way.
A further study, published by Bristol University, considered the impact of removing all flavours on non-smoking young people and adult smokers using vapes as a quit aid. The study found that as a result of the flavour ban, more adults would be at risk of smoking tobacco cigarettes. Flavoured vaping is a smoking cessation tool. I can testify to that from my own experience, having chosen mango flavour over the unpleasant tobacco flavour on offer in the market.
Furthermore, the illicit cigarette share of the market is officially 11%, up from 8% five years before, and has been on an upward trend over the past decade. Far higher levels of illicit produce can be found in constituencies containing less affluent areas. Dangerous, illegal and untaxed nicotine products are also easily and widely available across the country. During a test purchase exercise I attended in my constituency, we found 21 retail outlets selling harmful, illicit or counterfeit cigarettes; illicit prices as low as 35% to 45% of legal prices; illegal vapes available in up to 24 ml tank sizes, when the legal limit is 2 ml; and British packaging and safety requirements on products not followed.
The consequences are that people buying unregulated cigarettes and vapes, particularly counterfeit ones, are risking their health greatly. The profits generated are taken by criminals rather than legitimate taxpaying businesses. No excise is paid on these illicit products, illegal distribution networks are deeply embedded into the black market and the dissuasive effect of high taxation is evaded. Although penalties have been increased, the huge disparities between those for tobacco smuggling and those for smuggling drugs will continue to attract criminal gangs, because it is a relatively low-risk form of organised crime. I believe that, sadly, the funding surge for trading standards that was announced earlier in the debate will not be sufficient to tackle those issues.
Furthermore, nothing in the Bill will help the 6.4 million existing smokers. Indeed, by treating heated tobacco products and certain types of vapes in the same way as cigarettes, it decreases the chance that those who smoke will switch to a less dangerous alternative. I would have preferred the Government to focus on the Smokefree 2030 ambition that was aimed at those existing smokers.
Finally, I believe that the Bill is unenforceable and will put undue pressures on legitimate tobacco and vaping retailers. Those points were raised with me recently by shopkeepers at a parliamentary Association of Convenience Stores event. All the shop owners who spoke to me were genuinely concerned about the violence and verbal abuse to which they would potentially be subjected for trying to enforce the age limits set by the Government, and they also felt that they would lose more revenue to shops in their areas selling illegal vapes and cigarettes.
While I believe that the Bill is well intentioned, it risks having an effect that is the reverse of what it is trying to achieve, and that is why I will reluctantly vote against it.
Rachael Maskell (York Central) (Lab/Co-op)
Let me first put on record that I worked in respiratory medicine for 20 years before coming to this place, and every single patient I treated regretted being where he or she was. Let me also put on record my thanks to Javed Khan for his excellent report. It is important for us to follow the science and the facts in this debate, and to ensure that we take the harm reduction approach that is so necessary.
The Bill is both bold and the right thing to do. Smoking kills one person every five minutes in the UK, and kills 7.69 million people globally every year. It is a leading cause of preventable death and disability and is responsible for one in four cancer deaths, alongside heart and circulatory diseases and strokes. We must do everything we can to prevent the tobacco industry from exploiting another generation to max out its profits, leaving people financially impoverished and in poor physical health.
Public health teams need the resources that are necessary to support adults into a smoke-free future, and I echo what the hon. Member for Dewsbury (Mark Eastwood) said: we need a focus on resourcing to achieve that. In my constituency 9,100 people continue to smoke, and they deserve better. We need a targeted approach, because passive smoking is still costly to people’s lives. We know that smoking in pregnancy is harmful to the unborn; we also know that it targets the very poorest in our society, driving greater health inequalities, and affecting people with mental health conditions as well. It is urgent, indeed imperative, for the Government to turn their attention to addressing the inequalities that are seen in all areas of healthcare.
Let me now turn to the issue of vaping. York’s schools survey showed that 19 % of children had tried vaping, while 5% in the city vaped regularly. Schools are battling to stamp out the practice. While much of the detail in the Bill will be set out in secondary legislation, I urge the Government to go toe to toe with the approach taken on tobacco products: plain packaging, health warnings, and no designer products, attractive flavours, descriptions or colours. When it comes to sales, the approach should be no less stringent, putting products out of sight and out of mind. The aim must be to create a vape-free generation too. I urge Ministers to address the reasons why Gen Z have turned to vaping on a large scale, to develop the interventions that are needed to help them make better choices, and to expose the blatant exploitation by vape companies that profit from the creation of a new generation of addicts. We are yet to know the extent of the translation of non-nicotine vaping to nicotine-based products, but researchers are examining the relationship between vaping and moving on to tobacco products, and it is extremely worrying. Clearly, the industry has worked out the correlation. To profit, it needs the next generation to be addicted to its goods—to nicotine—so non-nicotine vapes must be seen as the first step for those moving into forms of nicotine addiction.
Where I believe the Bill falls short is in its approach to adults taking up vaping. As the Minister recognises, vapes are seen as an important public health measure to stop smoking, so there must be greater ambition to prevent people over 18, as well as those under 18, from starting vaping, yet the Bill is silent on that. We know that vapes are not harm free, and I urge the Minister to broaden her ambition for a nicotine-free generation by instituting vaping cessation programmes through a public health model.
Where people are allowed to vape should be no different from where they can smoke. Indeed, people who already have poor respiratory health are impacted by vaping. Therefore, let us make things simple by introducing one set of rules for public places such as bars and so on, and for private vehicles where they are children..
May I urge the Minister to look again at the enforcement proposals? I support investment in strengthening local authorities’ trading standards teams. The team in York have just seized 1,000 vapes, worth £13,000. They need funding and the tools to do their work. I question the paucity of the fixed penalty notice, which is just £100. This is not a sufficient deterrent for illegal traders, and I urge the Government to increase the amount and review it annually. Placing that in secondary legislation would enable more flexibility.
That takes me to my last point about where I believe the legislation falls short. A vaping company came before the Health and Social Care Committee. It promoted its products through a relationship with Blackburn Rovers. The arguments it used for doing so mirrored those that the tobacco industry has propagated for decades. We saw right through them—we tested their reasoning and they failed at every turn. There must be an outright ban on all forms of vaping advertising for nicotine and non-nicotine products, and it should be no less stringent than the ban on tobacco advertising. We must legislate for a complete advertising ban, and I trust that the Minister will look at that when bringing the Bill into Committee.
The reason why I sound the warning bells is that the limitation on the available science does not mean that there is none. The Health and Social Care Committee has met academics at the University of London who have undertaken a study of 3,500 samples of tissue to show that vaping can cause changes in epithelial cells in the oral cavity. They want to look at lung tissue, but access is available only via a bronchoscopy. They observed DNA methylation changes, which provide a very early indication that cells will grow more quickly and are biomarkers for early identification of the onset of disease, such as cancer. In researching the impact of smoking on tobacco users, the researchers have also demonstrated the impact of vaping. This powerful, peer-reviewed research is the first of its kind. I urge the Minister to read the paper by Professor Martin Weschwendler and Dr Chiara Herzog.
Smoking kills, and while vaping may be less harmful than smoking, it is not without significant risk. We cannot use ignorance—the excuse used by past Governments—as a reason for getting this wrong. We must follow the science, be on our guard and recognise that where people are being exploited, it is the duty of this Parliament to protect them. This industry is driven by a profit motive—one of exploitation. It is our job to protect our constituents.
Craig Whittaker (Calder Valley) (Con)
Everyone would like to see a cessation of smoking. People stopping for good, let alone starting at an early age, would bring long-term health benefits to the nation as a whole. Sadly, the problem is that this Bill will not be the vehicle to achieve such an ambition. It is a Bill written by non-smokers for smokers, and it is so out of touch with the cause that they want to cure that it will miss its target by a very long shot. First of all, the Bill does not ban smoking; it only stops the sale of tobacco to 18-year-olds if they turn 15 this year. We heard today from the Secretary of State that 100,000 children already start smoking every year. The sale of tobacco is already banned for those children.
The Bill is based on the premise that children today still ask their mate’s older brother to buy them some cigarettes from the corner shop, like they did back in the 1980s. They do not. The vast majority of regular smokers today only ever buy their cigarettes from the corner shop when they have run out of illicitly bought cigarettes. If people do not believe me, they should pop into any pub in the UK and ask the smokers whether they buy tax-paid cigarettes from the supermarket and the corner shop. I guarantee that the vast majority do not. In every community there are avenues to buy illicit cigarettes at a fraction of the average price of £15 for a pack of 20 cigarettes from the corner shop.
A recent poll of 12,000 adult smokers found that the illegal tobacco market remains resilient in the UK in spite of the number of overall smokers declining year on year. On that basis alone, the illicit market is increasing. The study found that 76% of those 12,000 smokers bought tobacco in the last year that had not been subject to UK tax, with nearly one in two smokers having no objection to buying non-UK-duty-paid tobacco from family, friends, colleagues or shops. The poll also revealed that 9% of smokers who buy tobacco through social media or websites advertising cheap tobacco do so at least once a month.
Evidence from around the world shows that when we put further restrictions on people, smugglers and gangs take over where the Government have left the market. South Africa banned the sale of tobacco during the pandemic and it is now struggling with the gangs and smugglers who cover 93% of the market there. In Australia, as mentioned earlier, there has been a rise in the number of young people smoking, and retailers there have been fire-bombed when corner shops have refused to stock illicit tobacco. Children do not buy £15 packets of cigarettes either; they buy illicit tobacco from the same sources in the community—the smugglers and gangs.
The Secretary of State said that the Bill allocates £30 million to trading standards. That is a drop in the ocean. Trading standards is not just a sick department; it needs life support to come anywhere near to achieving the task it already needs to achieve. That £30 million still leaves it with a shortfall of £78 million on its budget in 2009. Spending on trading standards in 2009 was £213 million. This year it was frozen at £102.5 million, and between 2009 and 2016 the number of trading standards officers fell by 56%. The Chartered Trading Standards Institute has warned that cuts have created a “postcode lottery” of provision and called for an urgent review of how trading standards are resourced.
Andrew Rosindell
My right hon. Friend is making some extremely important points. He seems to be saying that, however laudable and well intentioned the Bill is, it is impractical and unenforceable because there is insufficient funding for trading standards to make it happen in reality.
Craig Whittaker
That is exactly what I am saying. The Government’s aim to create a generation of smoke-free people as time progresses just will not work. It is not working now when it is already banned for those 100,000 young people who take up smoking every year. In 2021, trading standards seized just over £7.8 million in illicit tobacco. This is from the UK Government’s own guesstimate that illicit tobacco accounts for more than 16% of the market, resulting in a loss of £2.8 billion—billion, not million—in tax and duty.
We have heard that the Bill is based on the New Zealand model. New Zealand does not have an illicit tobacco problem like we do here in the UK. It is 2,500 miles away from the nearest big trader, Australia; the UK is 23 miles away from the continent. The two countries cannot be compared. The New Zealand model has now failed, and it has performed a U-turn, as we have heard. Instead, the New Zealand Government continue to support initiatives to provide people with practical tools and support to help them to quit, including by ensuring the provision of effective services to stop smoking, providing access to alternative products to help smoking cessation, and promoting social media marketing campaigns to stop smoking and vaping.
The Bill provides little guidance or support on cessation to those who already smoke. I myself was one of the 6.4 million smokers here in the UK, but I stopped smoking just over a year ago. I found very little help or support from the Government, despite all the hype around what is being done. In fact, I tried virtually every product on the market to give up smoking—even hypnosis—and the only one that eventually made me give up was heated tobacco. That product, however, is not included in the Bill as a cessation tool. Instead, its sale to young people is to be banned. Even the Kiwis recognised what a great cessation tool it is and did not include it in their ban. Instead, they put it in their arsenal of tools and recognised its benefits for cessation. In Japan, where 18.6 million people smoke, 25% of ex-smokers quit using heated tobacco, and Japan is already seeing the health benefits through its health system.
Similarly, more than half of the ex-smokers in the country with the lowest smoking rate in the world, Sweden, have quit using something called snus, which is already banned here in the UK. Ironically, the Government have put all their eggs into the vaping scene for cessation but 30% of those people who vape still smoke cigarettes. Not only that, but although Public Health England refers to alternative nicotine delivery devices, such as vaping products, the Bill does not include heated tobacco, which is delivered via just such a device.
To summarise, the Bill is not cut out for the Government’s ambitions. It follows a failed model that was devised in New Zealand, which does not have the UK’s issue with illicit tobacco. We will depend on a morsel of cash going to an incredibly stretched trading standards, which is operating on a budget that is half what it was 15 years ago, to police and enforce the policies in the Bill. The legislation underestimates the scale of the illicit tobacco trade already in the UK and will promote it even more in future. It also fails to promote cessation to the current 6.4 million smokers in the UK, and fails to recognise the many more products for people to use to quit that are better than cigarettes, such as heated tobacco. It fails on every level.
Finally, if the Government, and indeed this House, were serious about stopping people smoking, why not just set an arbitrary date in the future when smoking, in respect of either partaking or selling, will be banned completely? That will give us time for serious investment in cessation and will also give a serious amount of time to invest in stopping the illegal gangs and smugglers.
Several hon. Members rose—
Madam Deputy Speaker (Dame Rosie Winterton)
I remind colleagues that if they go quite a long way over the guidance, it does mean that others will have less time to speak. The guidance was seven minutes.
Alex Cunningham (Stockton North) (Lab)
I draw attention to my role as a vice chair of the all-party parliamentary group on smoking and health, an APPG that supports this Bill and in particular the commitment to creating a smoke-free generation by raising the age of sale for tobacco. This will be the most impactful public health intervention since the introduction of smoke-free legislation under the last Labour Government. The Bill is particularly welcome after years of Government inaction on tobacco, which has put us well behind schedule for achieving the Smokefree 2030 ambition. According to Cancer Research UK, we are currently not on track to be smoke free until 2039, which is almost a decade later than planned, and it will be even later for the most deprived.
I welcome the new funding committed to local tobacco control activity and national mass-media campaigns, which will go some way towards fixing the damage done by more than a decade of cuts to public health funding. Those cuts have fallen disproportionately on local stop-smoking services, which are a vital component of our strategy for reducing smoking rates. I am pleased that the Government have now recognised the importance of such services.
Since the legislation to raise the age of sale progressively by one year every year was announced, tobacco manufacturers have argued that it will be burdensome to business. They have also paid for advertising urging retailers to lobby against the legislation. Despite this, a survey by NEMS Market Research for ASH shows that more than half of a representative sample of retailers are supportive of such action, compared with only a quarter who are opposed.
Of course, the tobacco industry has form on trying to use retailers to lobby against tobacco laws. The Tobacco Retailers Alliance, a trade body 100% funded by tobacco manufacturers, funded the “save our shops” campaign against the display ban and the “no to plain packs” campaign against standardised cigarette packaging. Both campaigns used exactly the same argument now being used to campaign against raising the age of sale: that it will put a terrible burden on small businesses, that it will be impractical to implement and that it will increase illicit trade. Both campaigns were exposed as being fronts for the tobacco industry, and the subsequent legislation was successfully implemented by retailers. Indeed, a 2022 survey by NEMS Market Research for ASH found that the vast majority of small retailers report no negative impacts on their business due to the display ban or plain packs.
My region, the north-east, has been hit particularly hard by the tobacco epidemic, with 117,000 deaths from smoking since the turn of the century and thousands more added each year. That is not to mention the thousands more living with tobacco-related illnesses. As in every other region, this suffering is concentrated in the most deprived groups and areas. Although around 13% of adults in the north-east smoke, the figure rises to 21% of adults in routine and manual occupations, 28% of adults in social housing and 41% of adults with serious mental health conditions.
In the north-east, we are fortunate to benefit from the incredible work of our regional tobacco control programme. Fresh was set up in 2005 in response to our region having the country’s highest smoking rates. As a result of dedicated and sustained collaboration and investment from local authorities and the NHS, smoking rates have fallen further and faster in the north-east than anywhere else in the country—13.1% of the adult population now smokes, compared with 29% less than 20 years ago. The north-east is a prime example of what can be achieved with an effective regional tobacco control programme. Fresh is now funded by both the local authorities and the integrated care board, and that regional funding model is repeated in Greater Manchester. I encourage other regions to follow suit.
Children are especially vulnerable to second-hand smoke, which greatly increases their chance of developing a host of illnesses. The Royal College of Physicians has estimated that smoking by parents and carers is responsible for around 5,000 children being admitted to hospital each year, primarily with respiratory conditions. That is why I tabled a private Member’s Bill in 2011, aided by the British Lung Foundation, to ban smoking in cars carrying children. Despite the strong public health case for the measure, it was not initially welcomed by the Government or the Opposition, and it took a long, hard campaign to get it over the line. Four years later, in 2015, legislation banning smoking in cars carrying children was put on the statute book with strong cross-party and public support.
Alex Cunningham
That is an interesting question. There have been only a handful of prosecutions because the legislation has played an important role in people changing their behaviour. YouGov’s 2008 polling for ASH found that banning smoking in cars was supported by less than half of all smokers. The proportion had risen to 62% by the time of my private Member’s Bill, and to 82% after the ban came into effect. The lesson to be learned is that support has grown significantly over time for the tougher regulation of tobacco. After measures have been put in place, support continues to grow, particularly among smokers. We have come a long way in our attitudes to smoking since I became an MP in 2010. I have enjoyed campaigning on the issue, but I look forward to the Bill becoming law before I step down. Not only will the legislation prevent future generations from acquiring this terrible addiction; it offers the most direct path to making smoking truly obsolete in our society.
Adam Afriyie (Windsor) (Con)
I would like to point out three things at the outset. First, I used to be a smoker. I was probably one of the earliest adopters of vaping in the UK—certainly I was among them. Secondly, I am a member of the all-party parliamentary group for responsible vaping, whose chair will doubtless speak today. Thirdly, I draw Members’ attention to my declaration in the Register of Members’ Financial Interests. I chair an advisory board to a company that may or may not be doing vapes.
Here in the UK, we have been incredibly successful in our smoking cessation policies thus far. In fact, we are the envy of the world with our rates of smoking cessation. Yes, we are behind target, and yes, according to the Khan review, we might not hit the 2030 mark, but we have been incredibly successful. I have travelled around the world talking about our success. People ask how we have done it, and I explain that the industry did it: it came up with a fantastic device called a vape. Initially it was all a bit dodgy and shaky; people were mixing liquids in Manchester in their baths and it was all very complicated. We got a grip on it, now there is regulation, and provided people are vaping legally, it is safe and usable. Millions of smokers have stopped smoking by using vaping devices. It is a huge success story.
The thing that makes me smile the most is the number of children who smoke. Back in 1982, 13% of 11 to 15-year-olds—secondary-school kids—smoked. I remember it, as I was around then—many of us remember it—and everyone used to smoke behind the bike sheds. In 2003, 9% smoked, which was good progress. By 2010, only 5% of schoolchildren smoked. Today, only 1% of schoolchildren smoke. That is a record of success. It is not a huge disaster that suddenly needs a radical change of policy to resolve the issue. In my view, it merely requires upping the ante on enforcement and messaging, rather than a draconian approach.
I welcome the Bill in two ways. First, the measures on vaping are pretty strong and pretty good. Most Members would agree that we need to look at packaging so that it is not marketed to children, and we need to look at flavours. We do not need to look at the flavours themselves; I urge the Secretary of State to look at the descriptors in the relevant part of the Bill rather than the flavours themselves as a regulatory issue. It does not matter to a smoker who wishes to quit whether the flavour is called blueberry or anything else. All that matters is that the flavour exists. It does not matter if it has a reference number and a plain package. What matters is that the flavour exists—for example, mango, which was used by my hon. Friend the Member for Dewsbury (Mark Eastwood); I tended to use blueberry—to encourage smokers to shift, but it does not necessarily need to be named on the pack, which could be marketed to children.
There is another key issue on the vaping measures in the Bill. It is unbelievable, but the entire tobacco industry is ready to open its chequebook to pay for Trading Standards and enforcement. The entire vaping industry, including vaping associations and retailers, is ready to say, “We don’t want these cowboys in the industry. We want to drive them out as much as you, because they give us a bad name and it encourages nanny-state politicians to meddle and interfere, stopping us doing our lawful trade.” A vast sum of money is available from the industry to be used by the Government, hopefully directly through Trading Standards, so that Trading Standards does not just have a few million here and there but has hundreds of millions of pounds and hundreds of new staff who can do their job and drive the cowboys out of the industry, and we can ensure that we see an end to all the practices that have been mentioned today.
Bans do not work. I am not going to make a high-principled speech about freedom, but frankly bans do not work. Bhutan and Malaysia tried it, but it did not work. Australia got close to doing it with some very complicated legislation, but it did not work. Guess what? Smoking rates went up, including smoking rates among kids. New Zealand had a really good stab at it, and then said, “Nah, it’s unconstitutional and it’s probably not going to work as well.” Bans do not work, so the idea that we, in the United Kingdom, would now be at the vanguard of that is ridiculous.
For goodness’ sake, our policy as it stands is working. We just need to do it faster, make more money available for enforcement and get on with changing the descriptors to ensure fewer people are smoking, particularly our children. Nobody wants our children to smoke. Nobody wants people to die. The false argument I have heard today that anybody who does not agree with the generational ban is somehow evil and wants people to die really upsets me. We should not resort to that sort of language.
The main reason why I cannot support the Bill is the generational smoking ban. I would perfectly happily support the rest of the Bill, but I really cannot support that ban. If the Government had been bold enough to say, “Right, we are going to ban smoking below the age of 21”, I would have had huge reluctance but I would have said, “Yeah, fair enough.” Why? Because we would have been treating people the same. The Bill is making a huge constitutional change by saying that two adults will not be treated the same. It is inequality under the law. Even in Malaysia, their Attorney General said, “We can’t do that”, and they are not nearly as civilised as we are here. Several other countries have come to the same conclusion.
I do not know how we have got into this state. It is so unnecessary. There are so many more important things to be doing in the world at the moment, yet now we are in this place. If this Bill somehow gets through with Labour’s support—of course, Labour always love bans; I get that and that is fine. Forgive me for being political, but it is ridiculous to have our Prime Minister, who has enough things to deal with, putting through a Bill, with Labour’s support. Why on earth do that at this stage?
Andrew Rosindell
I agree wholeheartedly with my hon. Friend. Surely this should be something that should evolve? As he has highlighted, the statistics show that very few young people now smoke, so we should let things gradually evolve rather than impose them. After the New Zealand example, is it not clear that a ban simply will not work?
Adam Afriyie
I could not agree more.
To conclude, I cannot vote for a Bill that treats adults unequally in law. The Bill creates a precedent in the United Kingdom of treating people differently—adult human beings; citizens—and of inequality under the law. I cannot support that. We are making a huge political mistake. I hope that even at this late stage we can make some amendments or change the way the legislation works. We could at least say that there is a condition—that we will bring the Bill into law, but that it can be enacted by a future Government only if smoking rates are not, for argument’s sake, below 3% by 2035. In that way we have the political win—we have got the Bill though and it is legislation—but the measures are not actually enacted.
Several hon. Members rose—
Madam Deputy Speaker (Dame Rosie Winterton)
Order. I have nothing against interventions, but I suggest that if colleagues take interventions, they should still stick to the guidelines.
Helen Hayes (Dulwich and West Norwood) (Lab)
I rise to speak in support of this important Bill. Smoking is entirely harmful and there are no benefits. Cancer Research UK is clear that tobacco remains the single biggest cause of cancer in the UK, causing an estimated 125,000 deaths per year—one person every five minutes. On average, smokers lose 10 years of their life expectancy and face lifelong health complications.
Despite the protestations of tobacco companies, smoking also has a detrimental effect on our economy. Action on Smoking and Health estimates that the overall cost of productivity losses and health and care needs caused by smoking costs the UK a staggering £17.3 billion every year.
We have come a long way in recent decades in reducing smoking rates. The last Labour Government led the way on smoking harms, raising the legal smoking age to 18, banning cigarette advertising in shops and introducing the transformative ban on smoking in enclosed public spaces and workplaces. It is now hard to recall just how society ever thought that smoke-filled restaurants, pubs and tube carriages were remotely acceptable.
Helen Hayes
I will not give way at this stage, I am afraid.
It is still the case that more than one in 10 adults—around 6.4 million people—are smokers. I wish to pay tribute to my constituent, Gower Tan. Gower began to smoke at the age of 13. His father was also a lifelong smoker and died early at the age of just 66 from lung cancer. This was devastating for Gower and his family and led him to give up smoking at the age of 40. Gower has since become a tireless campaigner for Cancer Research UK—first as an ambassador and more recently as part of the staff team. Gower and his family know as well as anyone the pain and heartache that smoking can cause and the deep sorrow that comes from knowing that the death of a loved one was preventable.
Like my hon. Friend, the shadow Secretary of State, I fully support the Bill’s measures to ban smoking for anyone born after 2009, freeing future generations from the health impacts of tobacco. I also welcome the Bill’s urgently needed measures to regulate advertising and restrict the availability of vapes to children and teenagers. We on the Labour Benches have been calling for action on this for a long time. Last year, I introduced a ten-minute rule Bill on the advertising of vapes to children. One in five 11 to 15-year-olds in England used vapes in 2021, and under-age vaping has dramatically increased by 50% in the past three years. Five years ago, vaping was not a significant concern, but now it is raised with me in every school that I visit. Teachers are routinely having to manage the disruption in the classroom that addiction causes.
Vaping has a really important role in smoking cessation and that role should not be undermined by this legislation, but although vaping is far less harmful than smoking, it is not a harmless activity. Last year, 40 children were admitted to hospital with vaping-related issues. There is evidence of respiratory harm and impacts on mental health and concentration levels.
We can see the strategy of the vaping companies. They are seeking to secure future demand for their products by getting children addicted today. It is frankly absurd for e-cigarette manufacturers to claim that they are not targeting children. In displays across the country, brightly coloured advertising for vapes mimic popular brands and characters. Flavours such as gummy bears, skittles, tutti-frutti and cherry cola are clearly designed to appeal to children and vapes are being openly promoted to children on social media.
Although I support the Bill today, it would be remiss of me not to ask what has taken the Government so long. They have had repeated opportunities to introduce new regulations on the marketing of vapes. My hon. Friend the Member for City of Durham (Mary Kelly Foy) put forward an amendment in November 2021 to the Health and Care Bill to ban the branding of vapes that appeal to children, while the Electronic Cigarettes (Branding, Promotion and Advertising) Bill introduced last year would have banned e-cigarettes and vaping products from being advertised to appeal directly to children. These delays will have led to more children experimenting with e-cigarettes and becoming addicted to recreational vaping.
Today, we have a genuine opportunity to stops the harm of nicotine addiction and free future generations from the health impacts of smoking. We on the Labour Benches are clear that we will put the health of children and young people first. A Government who cannot command the support of their own MPs for a flagship piece of legislation should surely step aside, call a general election and allow someone else to do the job.
Alexander Stafford (Rother Valley) (Con)
I wish to declare almost an opposite interest: I have never smoked a cigarette or a cigar in my life. I have never even put one to my very lips, yet I am against the Bill. That is not because I have any vested interest in the tobacco lobby or because I am a smoker or an ex-smoker; it is because I am a lover of freedom, a lover of choice and a lover of information. To me, that is vital.
I am neither one of the older Members nor one of the younger Members of the House, but I remember that throughout my time at school the evils of smoking were drummed into us. I do not think that any Member of the House, or any person in this country, does not know the evil of smoking, including health degradation and damage to lives and families, because it is drummed in every single step of the way—as I think it should be, because smoking is wrong.
I do not like smoking, and I wish people would not do it, but if we believe in freedom of speech, independence of mind and people making informed choices, we should let people do what they want as long as they have the facts before them—and we do provide the facts. The NHS stop-smoking policies have done an amazing job over the past few decades of ensuring that everyone knows the facts, so no one can say when they start smoking or vaping that they do not know the full implications of what they are doing—they do. We know that they do because, as has already been said, the number of young people smoking has absolutely collapsed over the past few decades. My hon. Friend the Member for Windsor (Adam Afriyie) correctly mentioned that only 1% of schoolchildren smoke. That 1% statistic is terrible and represents far too many children, but compared to what it was, it is really good news.
As I said in my earlier interventions, children generally do not smoke anymore, so that is not where the battle is. I believe that the battle against smoking has been won—we are just fighting the last rearguard action—which is why I think the Bill is fundamentally wrong. It is fighting yesterday’s wars, not tomorrow’s wars. The vaping aspect is incredibly important and is what we must focus on. We and the Government need to focus our attention on super-strength vapes and marketing to children. That is incredibly important, and I am glad that the Bill goes some way towards rectifying that. The ban on the free distribution of vaping products to under-18s is also great news.
However, we are dividing our time between that and focusing on a dying industry in a bizarrely puritanical way by stamping out some people’s choice and freedom. Who is to say that, in a few years’ time, a 21-year-old cannot celebrate their graduation with a cigar? If they want to, why not? Why shouldn’t someone celebrate the birth of a child with a cigar, or maybe with a pinch of snuff? Who are we to say that that is not their choice to make? Who are we to say, “You shouldn’t celebrate in this way”?
I have many vices, Madam Deputy Speaker. I like a glass of beer or a pint of wine every now and again. I know in my heart of hearts that they are wrong for me and probably limit my health, but I drink them. I eat burgers and chips, accepting that they are fundamentally life-shortening. But do they make my life better? Do I enjoy doing it? Yes, and I do so in the full knowledge of what I am doing. This is the crux of the matter: we are talking now about cigarettes, cigars, snuff or shisha, but what is to stop us from saying tomorrow or the next day that burgers, red wine and all the little things that people sometimes enjoy in moderation—that make life worth living—are bad for them? Sometimes people want that bit of enjoyment, but we sit here and say, “No, you cannot have that choice; we know better and we are taking that choice away from you.”
As long as everyone has the knowledge about what tobacco products do, we should give them the choice—that is terribly important. I am also confused by the fact that, once again, we are using a sledgehammer to crack a nut by banning all tobacco products. How many people in this country do snuff, say? Not many, so why are we impinging on their liberty? There is not an epidemic of children taking snuff at school, so why are we banning it? Snuff does not represent a massive health risk or have a huge impact on the NHS, yet we are banning it—that is crazy. We are banning things that are not having a huge impact on the economy or the health of our nation, and that concerns me greatly.
A country that has gone through this process is New Zealand, which banned tobacco sales. However, it then overturned the ban. If the policy was such a success, why did New Zealand not double down on it and go further? My biggest issue with the measure is the rolling age of consent, which is fundamentally discriminatory. Adults are adults, and they make their own choices and own their failures. A 28-year-old does not know better than a 29-year-old; someone of 18 years and one day does not know any better than someone of 17 years and 364 days. We are creating cases in which people are unequal before the law, and that is wrong.
Also, let us not kid ourselves: we know that having a rolling age of consent is completely impractical and unworkable, and it will have to be got rid of. Let us be honest: we are not going to have a situation in 10 or 20 years’ time where a 34-year-old is ID’d at a tobacconist or a newsagents and told, “You look 33, sir.” “Oh, thank you very much for flattering me.” It is going to be banned outright, and we know that. This is the thin end of the wedge. It will create inequality in the law, cut down on freedoms and fundamentally make life that bit harder for everyone.
Many years ago, as has been described, this place was a bastion of puritanism. There were so many roundheads fighting the King many years ago in the civil war, but I say that at the moment there are too many roundheads in this Parliament—too many naysayers, too many people banning things. What we need is a few more cavaliers: a few more people trying to enjoy bits of life while making informed choices. For that reason, I oppose the Bill, although it does contain some good bits about vaping. We should be fighting the next battle, which is fully against vapes, rather than wasting our time fighting yesterday’s battles.
Liz Twist (Blaydon) (Lab)
I would like to start with some figures from my local authority area and my constituency. Smoking prevalence is currently 9.9% in my constituency—that is 6,600 people who are smoking. The total cost of smoking to the constituency is estimated at £73.2 million: a productivity loss of £42 million, social care costs of £28 million, and healthcare costs of £2.9 million. The constituency spends £22.4 million on tobacco annually, and the average smoker spends £3,000 a year on tobacco.
Across Gateshead, the rate of smoking during pregnancy was 10.9% in 2022-23, compared with 8.8% nationally. The smoking rate among adults in different occupations showed that the more deprived areas were smoking more than those in other areas—as always, deprivation comes into these things. There were 688 lung cancer registrations between 2017 and 2019, and we know that smoking causes more than seven in 10 lung cancer cases. In 2019-20 there were 2,707 smoking-attributable hospital admissions in Gateshead. There were 825 emergency hospital admissions for chronic obstructive pulmonary disease, and we know that smoking is a key determinant of COPD cases. As such, I welcome the measures in the Tobacco and Vapes Bill, which will take us one step closer to a smoke-free future, and I am pleased to see that my party has pledged to support those efforts.
Creating a smoke-free generation will radically level up the health and wealth of our nation, especially in regions such as the north-east. The north-east has traditionally had a higher prevalence of smoking than the rest of the country, although we have made very significant gains in narrowing that gap thanks to the tireless efforts of local councils and NHS trusts working together, not to mention Fresh, our brilliant regional tobacco control programme. Despite that progress, though, our communities still suffer terribly as a result of smoking. As I have said, in 2019-20 there were over 2,700 smoking-attributable hospital admissions in Gateshead—where my constituency is based—and 825 emergency hospital admissions for COPD. Between 2017 and 2019 there were just over 1,000 deaths resulting from smoking in Gateshead alone. Ending smoking for the next generation will safeguard them from the suffering that has afflicted previous generations.
However, we need to do much more to ensure that smokers in the most deprived groups are not left behind as we move towards a smoke-free future. The disparity between different groups is even more extreme for people with mental health conditions, with smoking rates as high as 26% for those with depression and anxiety, compared with 14% of the general population. Calculations by Action on Smoking and Health show that at the current rate of decline, smokers with a mental health condition will not achieve smoke-free status until after 2050, around 20 years later than those without a mental health condition. This Bill is a major step in the right direction and will have a profound positive impact on the health and wellbeing of the next generation, but we must go further to tackle the health inequalities that continue to afflict the most disadvantaged in our communities.
Brendan Clarke-Smith (Bassetlaw) (Con)
I believe it is a noble cause to encourage people to give up smoking or not to take it up in the first place, because we know that smoking is a very unhealthy habit and it is very costly, so I do appreciate the good intentions behind the Bill. There are some things in the Bill that I do agree with, but unfortunately I cannot support it, and I am going to outline why. It is basically about trusting adults to make their own decisions in life and to choose their own approach. I believe that should be our approach, and there have been some very good contributions so far on why that should be the case. Of course, all societies have rules and we have to live by them, but I believe that these rules are unnecessary.
This legislation will not stop children from smoking per se. It is aimed at them once they reach adult life. That takes me back to when I was a teenager, and I remember an elderly lady on one of the tills at a local supermarket used to accept seeing a set of car keys as an acceptable form of ID. Unsurprisingly, a lot of my friends started to own a set of car keys many years before they owned cars. However, I think we all appreciate the importance of preventing under-age sales. We need the robust enforcement of that, and of course prevention of the illegal tobacco trade, which not only deprives the Treasury of funds but can put people at risk of some very dangerous products. The same applies to vapes, and I have been working with the authorities locally to clamp down on places that sell them. I remember that once upon a time it was the pupils who hid behind the bike sheds to smoke, and then I remember as a teacher that, after the ban came in, which included staffrooms, it would normally be the teachers hiding there and trying to cadge a cigarette.
Labour Members have mentioned some of the previous bans that have come in and some of the actions the Labour Government took. I am old enough to remember when the ban on tobacco advertising came in, and there was of course an exemption for Formula 1. We have spoken a lot about vested interests. The boss of Formula 1 was of course a major Labour donor at the time, and it did secure that exemption. I would ask them whether they believe it was right to take its cash, and whether it was right to give that exemption. I would be very interested to hear the shadow Health Minister’s view on that later.
To take the point made by my right hon. Friend the Member for Calder Valley (Craig Whittaker), would a cut-off date for all cigarettes or smoking be easier to enforce than the current proposal, and why should some adults have fewer rights than others? We must also appreciate the role of vaping. As has been pointed out, Sweden is a world leader in this. It is down to 5.6%, and when a country gets down to the 5% target it is classed as smoke free. Yes, it used things such as snus, which was outlawed throughout the rest of the European Union. It had special exemptions, and I believe an opportunity has been missed over the years to use that to cut down on the number of smokers, but vaping has of course provided a highly effective alternative.
However, a principle is at stake today, and what I really want to speak about is the principle of one group of adults having rights that are different from those of other sets of adults. We can compare this to the right to vote over the years, whether under the Representation of the People Act 1918 or the further Act in 1928. Going back to 1884, 40% of men, mainly the poorest in society, did not have the right to vote. Later, when the vote was extended to all men over 21, women could vote only if they were over the age of 30, or if they or their husband had land with a rateable value of £5 or more. It was not until 1969 that the voting age was lowered to 18. I remember being elected as a councillor in Nottingham at the young age of 22, and it was not until 2006 that the age limit for that was changed to 18. Again, there were adults at that time who had different rights.
People have been treated differently on the basis of their religion over the years, such as whether they were a Catholic or a Protestant in the 1600s. We have had the Race Relations Act 1965, where we outlawed people being treated differently on the grounds of their colour, race or national origin. Then we had equal marriage, of which we have just celebrated 10 years, another example of where adults are equal before the law, to love who they wish and marry who they wish. I believe we are moving towards freedom, and that is a good thing: it is about giving more rights and more equality, not restricting it. The point is that the direction of travel has been about giving adults, whatever their background, the right to live their lives within the law as they wish so long as they are not impinging on the rights of others. That is the right direction, and the right thing to do. As Margaret Thatcher once said,
“when people are free to choose they choose freedom”.
But what next? A ban on alcohol, or a ban on takeaways? I declare an interest in both of those, but both of them are bad for us when not done responsibly. But we are adults, and these are our choices; these are not the state’s choices. We need to get back to trusting adults to make their own decisions in life. I do not like banning things as a rule—yes, there are always cases that we can make, but I do not believe the case has been made here yet.
We have already witnessed other nations dumping this idea, including New Zealand, and I do not believe the legislation in its current form will pass the test of time. I believe it is unenforceable. I absolutely support the intention to move towards a smoke-free generation, but I believe there is a better way, and that is why I will be voting against the Bill.
Sir Simon Clarke (Middlesbrough South and East Cleveland) (Con)
It is a pleasure to be called in this debate, although I confess it is one that has depressed me, because this is fundamentally illiberal legislation. If I am in the House for any reason it is because I believe in liberalism—in the ability of people to make better choices for themselves than can the state.
It strikes me that we are witnessing an encroaching tide whereby ever more of our liberties are taken away from us—the speech by my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) was very good on that. We are fortunate in Britain to live in a country where we do not get our rights from the state; we have them inalienably from birth, and it is only the things that we proactively proscribe that we cannot do, but we are adding more and more things to that list.
I say that as someone who is totally clear that smoking is a terrible idea, and I would not recommend it to any young person. I have spent a lot of time with Mr Jonathan Ferguson at James Cook University Hospital in Middlesbrough and have seen the pioneering work he has done on lung cancer. It is absolutely crystal clear that smoking damages your health and damages your wealth and is an antisocial habit in so many ways, but—and it is a big but—I do not believe it is my right to tell my fellow citizens that they cannot do it, any more than it is their right to tell me that I cannot have a glass of red wine with dinner. These are not things that the state ought sensibly to be proscribing.
I actually think we have reached a relatively sensible point with regard to smoking legislation. Not allowing smoking in public places where it can impinge on others is very reasonable and sensible, and I do not think anyone would want to go back to the situation before the 2006 legislation. However, whether we smoke at all in private should be up to us, not the state. We risk creating a huge philosophical as well as practical problem, which will undoubtedly lead to further rights creep as the years go by, because it is likely that the health lobby—the interventionist lobby, as the shadow Secretary of State put it in his speech—will use this as a logic to allow them to move into other fields, and what will our ability then be to resist that argument if we have conceded it here today? So there is a profound philosophical problem with this.
I also believe that it will in practice be a nightmare for shop workers up and down the country to be asked to enforce this. It will place them in an invidious position, which is likely to lead either to them facing real trouble in their shops or, frankly, to them passing the buck and ignoring the law, and making a mockery of its existing at all.
Steve Brine
On the “what next?” point, when I was Public Health Minister, we brought in the sugar tax with the soft drinks industry levy. That encouraged the industry to reformulate drinks and took quite a lot of sugar out as a result, because industry followed that trend. If we reformulated processed food to take a lot of salt out and saved a lot of lives from stroke, would that be a good or a bad thing?
Sir Simon Clarke
That would arguably be perfectly sensible, but it is different from a ban. The point is about the degree of harm. I strongly support the ban on illegal drugs, but I do so because cocaine, heroin and the like wreck lives and destroy communities. Tobacco does not do that, but we already have enough difficulty enforcing the existing bans that we have in place, which already stretch our resources to the utmost. Frankly, as we all know, we all too often fail to enforce those bans. Adding a new ban risks creating something that will be unworkable from the outset, while creating a huge black market in which criminal enterprise will thrive. Meanwhile, the state will have forgone the tax revenues—some £10 billion or £11 billion a year—that are ploughed back into our public services, including the health service, to combat the effects of smoking. That revenue simply will not be there anymore. We will likely still have people smoking, but we will have offset many of the revenue streams that allow us to combat it.
I simply do not understand how a Conservative Prime Minister thought it appropriate to bring forward legislation that is the opposite of why we are sent to this House, which is to defend and uphold the principle of individual choice and individual liberty. As we have heard, where this legislation has been introduced, it has already been repealed, as in New Zealand. I fear that in this country we will face a choice in the years ahead: either eventual repeal because the legislation does not work or, as my hon. Friend the Member for Rother Valley (Alexander Stafford) said, an outright ban, because of the sheer unworkability of trying to ascertain in practice whether the person in front of you in the queue is aged 39 or 40. We will doubtless simply see a Labour Government move towards an outright ban to make the situation simpler, tidier and neater. That would be a real red line, but we would have forgone the ability to make the principal case against it.
Daniel Kawczynski (Shrewsbury and Atcham) (Con)
My right hon. Friend says that drugs destroy lives, but tobacco does not. What about the people who are dying from emphysema and long-term lung cancer? Many families in the United Kingdom are seeing their relatives die a long, lingering death as a result of using tobacco.
Sir Simon Clarke
With respect to my hon. Friend, I said that those drugs destroy communities. There is a profound difference. The ripple effect of illegal drugs is to prompt real social harm to others, because those habits are so destructive that people steal and rob to fund them. Tobacco does not do that. It is obviously extremely bad for people, but it does not drive patterns of behaviour as destructive as those associated with crime. That is a fundamental difference, and it is why we should focus our efforts on stopping those trades, rather than on banning something that has been legal for hundreds of years. We all recognise it carries real medical harms, but it is not, I submit, our job to try to take it away from people. We should rely on education and the tax system, but we should not rely on legislation to tell other people what to do when they are grown adults in a free country.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I rise in support of the Government’s Bill. One of the first speakers this afternoon was my hon. Friend the Member for Bosworth (Dr Evans), who talked about his first job in respiratory medicine. My first job as a doctor was in adult respiratory medicine, too, and I spent a lot of time looking after patients with chronic obstructive pulmonary disease, intermittent claudication and lung cancer, and that taught me that smoking causes not just premature death, but substantial, debilitating, miserable disability that can go on for many years. I therefore support the Government in doing all they can to reduce the number of smokers.
Some people have talked today about the freedom for an adult to choose to do what they want, but we already make changes to what adults can do. We already restrict their freedoms. For example, we tell adults that they must put a seatbelt on when they get in the car. They must wear a helmet when they ride a motorcycle. They cannot drink alcohol before they get in a car, and they cannot drive down the motorway at 150 mph. So we already make restrictions for people’s safety on that basis.
I do think that gradually increasing the age is inelegant, as my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health and Social Care Committee, put it, and will be challenging to enforce. But the alternative—to ban smoking outright—would be difficult, because it is an addictive substance. If we banned an addictive substance overnight, we would criminalise those already addicted. By doing it in advance and gradually increasing the age, we will instead not criminalise people for being addicted, because they will not get addicted in the first place, at least in principle.
I want to focus most of my remarks on vaping. I have been campaigning on vaping for some time, because I am concerned about the snowballing number of children who are addicted to it. Indeed, last year I introduced a ten-minute rule Bill to try to ban disposable vapes, which have been the most attractive vapes to children and cause the most environmental damage. At the time, 1.3 million vapes a week were being used—it is now up to 5 million. They are almost impossible to recycle in practice because the lithium batteries are difficult to recycle, and the nicotine gets soaked into the plastic, which makes that difficult to recycle as well.
I understand the need for adults to have something to help them stop smoking, but vapes are not just a stop-smoking device; we should look at them as an alternative addiction. Earlier in my campaigning, when I spoke to the industry, I said, “What is it with all these flavours?” I was told, “Well, the thing is, if someone tries to stop smoking using nicotine gum, they use the nicotine gum—or something—as a stop-smoking device. So they go from smoking, to gum, to nothing. If we give them vapes that taste of tobacco or are bland, they go from smoking, to vaping, to nothing. If we give them cherry cola-flavoured vapes, they go from smoking, to vaping cherry cola, to vaping mango and to vaping blueberry. They remain one of our customers and continue to use our product.” The industry is trying to create a new generation of addicts to make itself billions of pounds.
I can understand why the industry wants to make the money, but the way it is doing so is, in my view, immoral. In particular, its marketing of these things at children is immoral. A grown-up may wish to have a cherry cola-flavoured vape, but he or she does not need to have a unicorn milkshake-flavoured cherry vape shaped like SpongeBob SquarePants. That is why the flavours are important, and I welcome the Government’s measures to deal with flavours, colours, shapes and packaging.
What are the risks of vaping? As others have said, education is really important on that. For our children, in the short term, its powerful addiction causes problems with concentration, with some having to leave lessons because they cannot cope until the end of a double lesson without vaping. In some cases, as we have heard, it causes chest symptoms and can cause collapse. In the long term, the simple answer is that we just do not know.
A recent University College London study showed that DNA methylation—modification of DNA—occurs in people who vape. Does that show that vaping causes cancer? No, it does not. Time will tell us that, but it suggests at least that it might. That is why we must be extremely careful with our children. Adolescents will always experiment with substances because it is in the nature of adolescence to experiment with boundaries, but we need to ensure that we take as much care of them as we possibly can.
In particular, I welcome clause 10, which will allow the provisions to be extended to other nicotine products. The industry is making billions of pounds, and it will continue trying to flex to try to keep people addicted to nicotine. We can see that today. A search on the internet shows that Tesco is selling 20 nicotine pouches for £6.50. Those tiny pouches of up to 12 mg of nicotine—about 10 cigarettes-worth—are placed under a person’s gums and will release those 10 cigarettes of nicotine over an hour. They are sold in flavours called “Ice Cool”, Bergamot Wildberry”, “Mocha” and “Elderflower”. Does the House see a pattern here? That will be the next thing, and that is why I welcome the clause, which will allow the Government to reflect, if they want, on new forms of nicotine use.
I have some questions for the Minister. The Health Act 2006 prevents smoking in enclosed public spaces, on public transport and in certain other areas. Why has that not been extended to vaping? Also, as I was walking through Westminster the other day, I saw a big red Transport for London bus advertising vaping—something I have written to Sadiq Khan about. I wonder whether the Government plan to extend vaping regulations not just to what the package looks like but to the advertising itself.
Dr Johnson
I will not, because I have only a minute left.
The hon. Member for York Central (Rachael Maskell) mentioned the advertising at Blackburn Rovers; again, sports advertising while children are watching is not helpful.
I have a final question for the Minister. Given that this is urgent, we are seeing so many children starting vaping and we want to stop people smoking as soon as possible, why are we waiting to bring in the regulations? Why not bring them in to affect children more quickly?
Giles Watling (Clacton) (Con)
Like my hon. Friend the Member for Windsor (Adam Afriyie), I was a smoker for many a year. I gave up some 30 years ago and, as I said in an earlier intervention, it was one of the hardest things I ever did. I wish to God that vaping had been available to me then to help me off what would now be a £45-a-day habit. I certainly disagree that people do not steal to support such a habit, as it is extraordinarily expensive.
As we all know, banning things tends to drive things underground. As far as I have heard, no one has mentioned the prohibition of alcohol in America and what that led to. I consider myself a libertarian Conservative, and I think that the best Government should interfere in the market the least, and spend our taxpayers’ money only when they really need to. As always, the growth of the state is little more than good news for bureaucrats. No one in Clacton has ever looked at issues locally and told me that the solution was new taxes and over-convoluted legislation.
However, this is about not dogmas but practicality. It is about not ideology but pragmatism, science and economics. There are a number of measures in the Bill that I support. The banning of disposable vapes seems timely, given the ecological damage they cause, going to landfill and being strewn across our streets in countless millions. Revisiting the legal age of vaping and smoking seems to be a logical response to the worrying fact of under-age people navigating their way towards addiction through vapes. I am pleased that the Government have listened to me on the subject of nicotine pouches, which my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) mentioned.
Let us consider what the science of public health and the recent economic facts have taught us: vapes are cheap, available and attractive to many. That is why smoking has dramatically decreased. The recent tax on vape liquid may be regressive if vaping costs start to gain parity with normal cigarettes. The free market has done its job and has given the public a cheaper and healthier alternative. I would be deeply worried about the unintended consequences of monkeying around with that.
We also need to step out of this place and consider what works on the ground. No one currently needs a licence from their local authority to sell vapes or nicotine products. That means that trading standards teams are often a skeleton crew. Do we think a complex and incremental age-increasing ban is enforceable with such weak enforcement? It is not. I do not buy the argument that we pay for expanded teams via increased fines. We do not increase staff headcount based on speculative, one-off cash injections from fines. If we want to clamp down on the very real issue of illegal cigarettes and the under-age sale of cigarettes and vapes, we need a licensing scheme that properly funds trading standards, rewarding responsible business owners and going after the villains.
I could support a ban on selling these products to those under 21, 18 or whatever. Such a ban could hit the Government’s laudable goal of killing off under-age consumption by getting the sale out of teenage years entirely. That is simple and impactful, and is preferable to a law that puts the shopkeeper in the firing line, having to interrogate people and turfing out the 22-year-old, while questioning the 24-year-old and supplying the 25-year-old. That is clearly nuts. I have spoken to retailers in Clacton, and the generational nature of the ban is quite frightening for many. To many it seems like a charter for confusion and confrontation. It also might criminalise people inadvertently.
There is a way forward. There are bold steps we can take with under-age addictions, without damaging the health advancements that the free market has allowed us to make. I believe that licensing is the answer.
Chloe Smith (Norwich North) (Con)
Fifteen years of experience of leading and scrutinising complicated legislation tells me to be cautious with the Bill. I strongly admire its aims, but I have some questions to set out as to whether it will work.
With direct knowledge of cancer and deep commitment to cancer awareness, I want people to smoke less. As we have heard, smoking causes around one in four of all UK cancer deaths. Tobacco, especially cigarette smoking, is the single most important and, as we have heard, preventable cause of ill health, disability and death in this country. I agree with the Bill’s hope of reducing that suffering. I also desire the Bill’s aim to realise an economic saving on healthcare, named as more than £3 billion in the impact assessment, and a productivity gain of £24 billion over 30 years. My hon. Friend the Member for Winchester (Steve Brine), the chair of the Health Committee, is right that we should be taking the long-term view and looking for the gains from prevention. For all that to be possible, however, the legislation has to work.
I am joining today’s debate—I shall keep it concise, Madam Deputy Speaker—because I care very much about politics and democracy working. As I stand down from Parliament this year, this is one of the final pieces of draft legislation for me and it is a significant proposition, so I will raise some points that are all intended to be thoughtful and are based on five terms of constituency work and ministerial experience in six Departments. In one of my past roles, I had to undo legislation that I had helped to implement, because it did not work.
The age-of-sale mechanism in the Bill is the untested thing. It would be the first of its kind in the world, but that accolade would come only because a few have tried and failed to carry support. The Bill as a whole has an imperfect evidence base—that is clear throughout its analysis, in particular because we do not yet have the full data picture about the effects of vaping—so what is in front of us today is inherently risky and theoretical. It is also possible that it may be divisive by asking one group of adults to live under rules different from those for another. I understand that the Malaysian equivalent was challenged on equality grounds and I would be really interested to know what lessons the Minister has drawn from that.
It is legitimate to be worried that something so novel may be unfair on retailers. The British Independent Retailers Association points out that the quite sophisticated enforcement needs of the mechanism fall on its members. As the Association of Convenience Stores adds, the
“proxy purchasing of any age-restricted products is extremely difficult for retailers to detect and prevent.”
Indeed, the deterrent in the Bill for proxy purchasing is just £50, if a person caught and pays promptly. After my right hon. Friend the Chancellor’s efforts at the latest Budget, that is actually only the cost of about two or three packets of cigarettes. I am therefore concerned that the design of the proxy-buying deterrents in the Bill could be fatally impractical for what is trying to be achieved. Let us put that in really super-practical terms. A person’s friend, a year older, may well be able to go into a shop or online and get two packets and let their friend have one, and the cost of their doing so adds up in the end to only three or four packets for themselves. We ought to give considerable thought to that.
The British Retail Consortium says that a better policy is needed on ID. I agree. I was surprised that the impact assessment says nothing about the impact of individuals needing to provide ID throughout their life, instead of just up to the age of adulthood. The document, of course, does deal with the costs to retailers of checking ID, but it is silent on the burden of asking a particular group of adults to have to prove their date of birth for life. I am talking about those who are or look, and would continue to be or to look, just above the age stated in the Bill. Healthy or unhealthy, right or wrong, they have every right to buy cigarettes and would remain in possession of that right, but they would have to prove it for life under the Bill.
When I took the Bill that became the Elections Act 2022 through the House, we were rightly questioned hard about the notion of asking adults to bring identification to polling stations. We acknowledged up front that not everyone holds a driving licence or a passport, and ensured that other forms of ID were available, given the importance of people’s democratic rights. This is a slightly different point and I am not making a direct comparison, but for the purposes of retail, free ID—for example, the CitizenCard—is already available. However, it needs to be renewed every few years, and a new requirement in the Bill means that it would need to be used for life. I think the Government should have more reassurances to give law-abiding people than silence.
I said that I strongly admired the aspiration of the Bill. For the sake of all those who are entangled in a lethal addiction, I would like to see smoking stop in this country, so I am not standing here on ideological grounds. I am making sensible points about whether the Bill is going to work. We have had—rightly—a wide-ranging, reflective and constructive debate, but good intentions and heroic ambitions are not enough. If we are to do something very novel and use the power of legislation to do it, we need to have confidence that the legislation is workable. I hope that my fellow legislators will rise to the challenges that are presented by this idea, and will scrutinise it carefully.
Gareth Johnson (Dartford) (Con)
There is clearly a fair amount of agreement in the House about what we are trying to achieve. No one is suggesting that smoking is anything other than very bad for people’s health, and no one is suggesting that we should encourage anyone to smoke. We know that, for instance, it poses specific dangers to children. There is common ground—a common goal—when it comes to where we want to end up with the Bill. However, I believe that a generational ban is the wrong approach. There is a general assumption in the House that we ensure that laws apply equally to all adults, but the Bill turns that general assumption on its head by creating bizarre, absurd circumstances in which people will be unable to enjoy the same rights as others who are a day older than them.
No other country in the world has implemented such provisions. Many have considered doing so—New Zealand, Malaysia and Australia have been mentioned—but all of them have decided not to. Either they have all got it wrong and we have got it right, or that is not the case, and I doubt that it is the case. This is a classic instance of the “nanny knows best” approach to politics, which is incredibly patronising, and will be increasingly patronising, to adults.
One of the absurdities of what is, as I have said, an absurd piece of legislation has not been mentioned so far. The snuffbox by the Principal Doorkeeper’s chair is paid for by him, so that Members of Parliament who wish to partake of the snuff can do so. In future, any MP who enters the House, and who is currently 15 years old or younger, will not be able to do that; indeed, the Doorkeeper will be committing a criminal offence if he or she provides snuff for that MP.
We all want to reduce smoking rates, but this Bill is not the way to do it. The way to do it is through education and the provision of alternatives such as vapes. The Government’s “swap to stop” scheme was brilliant—thousands of people have given up smoking as a consequence of it—and many other Government initiatives have been tremendously effective in helping smokers to quit. I pay tribute to the Government for all those achievements, but we should nevertheless look at what is happening in other countries. It is a shame that my right hon. Friend the Member for Calder Valley (Craig Whittaker) is no longer in the Chamber. He mentioned Sweden, and it is because Sweden has been enthusiastic about allowing people alternatives to tobacco that it currently has the lowest smoking rate in the world and, moreover, the lowest rate of lung cancer in the world. It is not a coincidence. Although I accept that there are difficulties with making comparisons between different countries, Turkey and Indonesia, where smoking rates are increasing, are two of the countries that have completely banned vaping. In her opening speech, the Secretary of State rightly mentioned that the smoking rate among young people in Australia is currently going up. In Australia, vapes are banned—that is not a coincidence either.
Vaping helps adult smokers to quit and thereby saves lives. We all want the same thing: fewer smokers. In order to achieve that, we need to ensure that our legislation is flexible. I am grateful to the Secretary of State for agreeing that a consultation on flavours will take place, which is very important. I was going to table an amendment to make sure that that happened, but there is no necessity to do so now because of her commitment to the House. Flavours are important, because what often happens when smokers give up smoking and start vaping instead is that, a couple of weeks down the line, they get a bit fed up with the vaping they are carrying out, so they either go back to tobacco or switch to a different flavour. Therefore, having a variety of flavours is very important. I totally concede that having a zingy bubble gum flavour vape is wrong. We should not have any kind of marketing that makes vaping attractive to children, but we should have a choice for adult smokers who wish to switch to vaping.
We have two types of vaping going on in this country at the moment. First, there is the vaping that is being carried out by smokers who want to stop smoking, and who are vaping as a substitute for the tobacco they were previously consuming. Secondly, there is the other kind of vaping: children using it for fun. We need to tackle that robustly, but we do not need to throw the baby out with the bathwater.
When carried out by adults, vaping saves lives and relieves the burden on the NHS. If we care about the NHS—I am sure that everybody in this Chamber does—allowing for vaping to take place as an alternative to smoking must be the right way. There is a danger that this House could send out a perception that vaping is just as bad as tobacco. If it does that, many people will think, “What’s the point in vaping? I might as well smoke instead if they are as bad as each other.” They are not as bad as each other. Vaping is considerably safer than consuming tobacco, although we do not want children who are non-smokers to take it up.
Siobhan Baillie (Stroud) (Con)
This is quite basic for me. I see the Bill as an opportunity to change the life chances and the life course of thousands of children in the Stroud district, with my two little girls included in the mix. It is not perfect, but it enhances the chance for their little lungs and healthy bodies to grow up to be strong adults.
Like many, I am intuitively against banning things and state interventions. I have concerns about the implementation, practicalities and enforcement of the Bill, but I am less interested in hearing colleagues slagging off each other to help sell books, and more interested in the really spirited debate we have had and in challenges from people such as my right hon. Friend the Member for Norwich North (Chloe Smith), because the amendments that could be tabled for forthcoming debates will help us.
At the heart of this legislation is this great Parliament using the knowledge and evidence that tobacco causes harm, which has built up over decades and decades. When we know that smoking cigarettes is addictive, expensive and limits life chances, particularly for the poorest, why should we accept the status quo and hope for a natural evolution? We know that smoking affects life opportunities and that youngsters are still smoking, despite everything we have done so far and those awful pictures on cigarette packs. When we know all of that, why would we not want to do more?
On the health of the nation, the NHS clearly needs reform. I know that politicians get shot down in flames for saying that, but it is the reality. The combination of an ageing population and the billions of pounds provided year after year in taxpayers’ cash, which is never enough, means that serious change is required. So, notwithstanding my concerns about this legislation, I view the measures in this Bill as part of a genuinely bold and preventive strategy that we have not seen before. This is from a Prime Minister who is known to be characteristically thoughtful and into the detail, the data and the evidence, so I applaud the PM for taking a battering on this in order to try to do the right thing and prevent known harms to children and to young people’s futures. Children in Stroud, in Gloucestershire and beyond will benefit from this Bill as they are growing up.
All six Gloucestershire MPs have the joy and benefit of meeting our health experts on a regular basis. They give us a hard time and we give them a hard time; they are rarely really happy with the Government on all bases, but they have told us that this policy is one of the most important public health interventions that any Government can make. The health experts also wrote to us to say that they wholeheartedly support the plan to create a smoke-free generation. They said:
“The legislation is needed, and proportionate. Smoking is the leading cause of preventable ill health and death and the major driver of differences between rich and poor…In Gloucestershire, the smoking prevalence in the most deprived quintile of the county is 22% and as many as over 30% of those in routine and manual employment”.
That is about 25,000 people in our little county. The doctors went on to say:
“Furthermore, smoking is the leading cause of 10-20 year reduction in life expectancy in people with serious mental illness, of whom 38% of those in our county are addicted to tobacco. Progression towards a smoke free future will significantly improve the health and well being of those currently in the most adverse circumstances, with nearly 26,000 tobacco dependent households in the county”.
A note to the self-proclaimed freedom fighters: we all love freedom, but addicts are not free. They have very limited choices. Two thirds of those who try smoking will go on to continue to smoke for the rest of their lives. That was my bit, by the way, about the freedom fighters. It was not our learned doctors who said that. They did, however, say:
“This legislation has the potential to avoid the 4,653 hospital admissions and 690 premature deaths in Gloucestershire which occur as a result of smoking. Whilst this is a novel policy, there is no reason to think it cannot be successfully implemented.”
I do not accept that the UK cannot implement the policy. They went on:
“The legislation will have a profound impact on society, as transformative as smokefree legislation was more than a decade ago. It is possible to conceive of a future where smoking no longer addicts and kills thousands of people every year.”
I would like to thank Dr Charlie Sharp, our former chief exec Deborah Lee, Dr Richard Makins, Sheema Rahman, Professor Mark Pietroni and the many others who gave me the most structured and sensible part of my speech. They know, because they see this stuff every day. My mum is a nurse, and she sees it. We can do this, so let us not talk this Parliament and this country down when it comes to implementing tricky things. I am looking forward to the next stages.
Matt Warman (Boston and Skegness) (Con)
My dad used to smoke 60 John Player Specials a day. When he died in 2009, the last 20 years of his life had been blighted by heart attacks, by strokes and by dementia—the things that we know now, and we knew then, are exacerbated not by free human choice but by the fact that smoking is an addiction. Nobody chooses to smoke 60 cigarettes a day. Addiction forces them to do so, and it hits the poorest hardest. Tobacco ruins lives. Smoking takes away the rational, free, human choices that so many people in this Chamber have defended today. Defending smoking is not defending rational, free, human choices; it is defending addiction, which is the very opposite.
Every day when we come to this place, we should ask ourselves one question: how can I as a Member of Parliament, how can we as a Parliament and how can the Government do things that make the lives of our constituents better, healthier, happier, freer? Most of the time, I think that Parliament and the Government should get out of the way. There are even days when I think that what we can do most is not say anything. However, we have to ask ourselves: what are the things that government can do? There are some things that only government can do.
I will let you into a secret, Madam Deputy Speaker. The Ronald Reagan quote that
“The…most terrifying words in the English language are: I’m from the government, and I’m here to help”
was a joke. Ronald Reagan was being slightly glib when he said that. The real most terrifying words in the English language might perhaps be that there is no government—that there is no operation above our individual choices to protect us, to give us security, and to fulfil the single most important function of government: security. Security in terms of health is just as important, because the Government exist to make people’s lives happier and healthier.
People might think that Governments are a necessary evil, or that they are a brilliant thing that can expand ever greater, but whatever we think, we do not improve people’s lives by getting out of the way all the time. Tobacco does not have some unique special status. We should ask ourselves why, as a Parliament, we have agreed that it is right to have speed limits, seatbelts and motorcycle helmets yet somehow people make a different argument for tobacco. That just does not make sense.
Some people will say that this Bill is not perfect, and they are right because nothing is, but if people vote against this Bill, or even abstain, they must demonstrate how it would make the current situation worse, and I cannot see a single example of how it would do so. Some might say that it makes some shops unviable; well, if the viability of a business depends on tobacco, I do not think that it is good for this country for that to be a viable business. Some will say that it fuels the black market. That does not seem to me to be an argument at all. We do not legalise crime for fear of it being driven underground; we in the Conservative party put 20,000 extra police officers on the streets. We fund what we need to do to tackle it.
Many have said that the problem is a 34-year-old in a shop being told, “I am terribly sorry, but you’re not 35.” The reality of this approach, and why it is the right approach, is that by the time today’s 14, 15 or 16-year-olds are 34 or 35, it simply will not be viable for those shops to be selling tobacco. It is a way of driving something—a bad thing—out of our society. That can only be a good thing.
An addicted life is not a free life. The spurious grounds cited for objecting to this Bill have not demonstrated what needs to be demonstrated: that this Bill would make things worse. The social contract that gives us legitimacy in this place is a balance. We have done some things recently that have tested that balance, and today we have a chance to show the 60% or so people who support this Bill that we are on their side. Government should not always be allergic to doing things that are popular, because when push comes to shove, yes of course people love freedom, but to exercise that freedom, people need to be alive.
I come back to where I started—to my dad. The last 20 years of his life were scarred by strokes, heart attacks and dementia, all exacerbated by smoking. That was not a free life; it was a life destroyed by addiction for precious little pleasure and a lot of money. We need the freedom to live longer, healthier, happier lives, with fewer people dying needlessly. That is what this Bill can do for us today.
I cannot understand why someone would vote against it. I cannot understand why they would be indifferent to it. What we should do, surely, is answer the question in front of us as best we can. I cannot help but think that if someone is voting against this today, they cannot see the human wood for the ideological trees. We have the answer. For all the high-flown arguments about the nanny state, the beginning and the end of this debate should be very simple: will people live longer, healthier, happier lives? Will they be alive? The Bill will deliver that. I commend it to the House.
Maggie Throup (Erewash) (Con)
As a former public health Minister, and a current vice-chair of the all-party parliamentary group on smoking and health, I am delighted to speak in this landmark debate today and to support the measures in this Bill. Today, the UK takes another significant step towards becoming smoke-free, which will safeguard the health and wellbeing of millions of people across the country from the threat of smoking-related diseases.
I begin by taking Members back more than 60 years to the start of this marathon debate—not that many of us can remember 1962. This was a time when leading political figures such as Harold Wilson and Tony Benn openly smoked during interviews; when we were told that our doctor’s cigarette of choice was a Camel; and when a young American actor named Ronald Reagan, whom my hon. Friend the Member for Boston and Skegness (Matt Warman) has just mentioned, appeared in glossy ads encouraging people to send special Christmas cartons of Chesterfields to all their friends instead of a traditional card.
1962 was also the year when the UK’s relationship with smoking changed. A crucial report published by the Royal College of Physicians shed light on the devastating consequences of smoking and urgently called on the Government to tackle smoking. This seminal report paved the way for numerous groundbreaking reforms, including health warnings on packs and a ban on smoking in public places.
In more recent years, Government policy to tackle the rise of smoking has largely focused on increasing tobacco duty. However, although a packet of 20 king-size cigarettes has risen from £1.68 in 1990 to around £17 in 2024, taxation alone has not solved the problem, with 12.9% of the overall population, and 14% of the population of my Erewash constituency, still continuing to smoke.
The impetus for the Government to act now through new legislation to create a smoke-free generation cannot be clearer. Smoking is the UK’s single biggest preventable killer. It causes 15 different types of cancer, and it is linked to cardiovascular disease, strokes, diabetes and dementia, as well as reducing life expectancy in Derbyshire by an estimated eight years.
Smoking puts huge pressure on the NHS, with someone being admitted to hospital with a smoking-related condition almost every minute in England, resulting in 400,000 admissions every year. Tobacco use in England costs billions of pounds in lost productivity and in health and social care costs. ASH estimates that the total cost of smoking, including productivity loss, social care costs and health costs, is £91.8 million in my Erewash constituency.
The Tobacco and Vapes Bill represents a bold and necessary response to this public health crisis, and it is a direct result of the review that Javed Khan carried out while I was public health Minister. The measures he proposes will, without doubt, save tens of thousands of lives and save the health system billions of pounds, and they will save an entire generation, including in Erewash, from addiction.
Regardless of party politics, as my hon. Friend the Member for Boston and Skegness said, we all enter this place with the honourable intention of making life better for the people we represent. I recently met students from Dovedale Primary School in my constituency, and we discussed the idea of increasing the age of tobacco sales by one year every year. The students unanimously backed this measure. By supporting this legislation and ensuring that children turning 15 or younger this year, including all those Dovedale Primary School students, will never be legally sold cigarettes, we have a golden opportunity to deliver on that promise of making life better for our constituents. If we do not, how could we ever again go into schools in our constituencies and look those children and young people in the eye?
Another objection raised by critics of the Bill and by tobacco manufacturers is that the cost of smoking to the public finances is far less than tobacco tax revenues. This is just not the case. Lost productivity, healthcare costs and social care expenditure paint a stark picture of the true cost of smoking to the public finances. ASH estimates that, in 2019, lost productivity in England due to smoking cost £14 billion, in addition to a £3 billion cost to the NHS and social care. Tobacco excise tax revenues for the whole UK were under £9 billion in 2019, so the financial burden imposed by smoking far outweighs any tax revenues raised by tobacco sales.
As I have already mentioned, the Khan review outlines that vaping is an effective tool to help people quit smoking. Although I agree with that analysis, many young people are being given these nicotine products and are becoming addicted. This is all down to a clever ploy by tobacco manufacturers. Today, the vaping industry is applying similar tactics to those used by big tobacco in 1962. Vapes are increasingly being marketed as fashion accessories, and the Bill will tackle this directly be regulating the packaging of vaping and nicotine products, which will also reduce the appeal and attractiveness of vaping and nicotine products to children and young people. Can the Minister confirm that the Government have considered a total ban on the sale of tobacco and vaping products within a defined radius of schools, as I am sure that would have a huge impact?
Finally, on the illicit vaping market, our efforts to combat smoking and vaping must extend the legal market to tackle that side of things. We have all heard stories of criminal gangs exploiting the market and selling vapes containing synthetic Spice. Only last week, King’s College London published a report by Dr Caroline Copeland that outlined the fact that so-called zombie drugs have been found in fake vapes. Once again, may I ask the Minister what she is doing to tackle that dangerous aspect of the vaping market?
To conclude, this is our 1962 moment. As parliament-arians, we have an opportunity to end smoking once and for all, ensuring that future generations are protected. Some may argue that now is not the time to legislate on this matter. I say, if not now, when? The Tobacco and Vapes Bill is the single biggest public health intervention in a generation, and 66% of adults across Great Britain support the legislation. Now is the time for colleagues across the House to back the Bill for the sake of public health, the economy and our NHS.
Nick Fletcher (Don Valley) (Con)
I have spent four years in this position, and as with most things in life, the more time we spend doing a job, the better we get at it. I feel that is true in this place, and I hope that the Whips on the Front Bench agree.
My understanding of what it means to be a legislator has been on a steep learning curve. How I look at policy has changed during my time here. I have concluded that, as an MP who is guided by his Christian faith, I should apply to all policies three simple tests: is the policy Conservative, is it needed and is it enforceable? I applied those tests to the Bill. On the first test, sadly I do not think the policy is Conservative. I understand banning drugs. I understand banning drinking and driving. I understand banning smoking in pubs. But to ban the use of a legal product for someone born in 2009, but not for someone born in 2008, seems a little too far overreaching.
The policy also creates the nanny state that I and many others speak about, which has so many implications. Where does it end? Obesity is killing as many people as smoking, so are we to ban McDonalds, KFC, Dunkin’ Donuts and chocolate? Alcohol is another killer. Do we ban that too? What about driving accidents? Do we ban motorbikes and fast cars? What about fires? Do we ban candles? What about Scotland’s law on supposed hate speech? Someone’s words offend, so we ban free speech. On the first test—is it Conservative?—sadly, I think not.
The next test is whether it is needed. I believe that the Prime Minister’s intentions are honourable. Smoking kills many people many years before their time. Often they suffer a slow and painful death. I am campaigning hard for a new hospital in Doncaster, so I visit Doncaster Royal Infirmary fairly often. One of the saddest sights is patients standing outside the hospital, often in their dressing gowns, in all weathers, smoking. It is a bizarre sight. They are there to get better, yet they are sadly killing themselves at the same time. I am sure this is replicated across the country. Smoking is not a nice habit. It costs a fortune, and it results in bad breath, clothes that stink, yellow teeth and yellow fingers. At one time, many people thought that it was fashionable to smoke, but we are all clear now that it is not. Is this Bill needed? Let us just say I can understand why many think it is.
Thirdly, is it enforceable? That is another difficulty with the Bill. As I have said before, we are quick to make legislation but often we are simply not enforcing the legislation we already have in place. Many of our streets have issues with the use of banned substances and illegal activities. The use of cannabis is often ignored, even though we can smell it on many streets. Prostitution is illegal but that is often ignored. Quad bikes on our streets may not be ignored, but they are often difficult to deal with. Are we going to spend time prosecuting shop assistants for selling cigarettes to a 35-year-old when their 36-year-old friend can still buy them? I think not. I understand the hope that by then the 35-year-old will not want to smoke, but banning something often creates an unregulated black market, often turning law-abiding citizens into criminals, which is never a good thing to do.
As far as my three tests go, this legislation only really passes one of them, and I therefore struggle to support it. To go back to my first point, is the Bill Conservative? More importantly, is it more evidence of the creation of the nanny state? I believe so. If we take more and more decisions away from adults, then more adults will continually rely more and more on the state to make decisions for them. That is not a good thing and sadly will only create more powerful Governments and weaker individuals.
This thought reminded me of a video I watched recently, and I want to read what the gentleman in it said—his words, not mine:
“My grandfather walked 10 miles to work every day. My father walked five. I’m driving a Cadillac. My son is in a Mercedes. My grandson will be in a Ferrari. But my great grandson will be walking again. Why is that? Tough times create strong people. Strong people create easy times. Easy times create weak people. Weak people create tough times.”
Many will not understand, but we have to raise warriors. Nanny states do not raise warriors; they create weak individuals. As the man said, weak individuals create tough times. I want a society to help raise warriors as I believe, going forward, we are going to need as many as we can find, smokers or not.
Finally, is it Christian to support or not support the Bill? I am sure there are arguments on both sides. But we start each day in this place by saying the Lord’s prayer. We ask our Lord,
“lead me not into temptation.”
We do not ask Him to take temptation away. No, I think our Lord wants us to be warriors too, to be able to withstand the many temptations this world offers. I also think He wants us to make decisions, not sit on the fence. I therefore cannot abstain, which I believe would be the easy option.
I will therefore be voting against the Bill, not because I want young people to smoke—I do not—but because I want them to be warriors who can say no to the many temptations they may face. I want to educate them to rely on themselves to make the right decisions, and not to rely on the state to make decisions for them.
Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. There are more people here than I was expecting, so I hope we can limit our remarks to about five minutes each, please.
Bob Blackman (Harrow East) (Con)
I rise to support the Bill and to make two declarations. First, I chair the all-party parliamentary group on smoking and health. The group’s objective is to encourage people who smoke to give up and young people not to take up smoking at all in the first place, which the Bill aims to achieve. My second declaration is personal. I do not want anybody else to go through what I went through, which was seeing my two parents dying of cancer—a smoking-related disease. I well remember my late mother, at the age of 47, gasping for her last breath. She had been smoking since she was 12. At the time, smoking was almost encouraged by doctors and the medical fraternity, as the implication was that it was a good thing to do.
I want to see a smoke-free generation. We have the opportunity to achieve that now. New Zealand was going to be at the forefront of this effort, but has decided not to go ahead, which means that we can now be in the vanguard of creating the first smoke-free generation in the world. However, the stakes could not be higher. Research from University College London says that 350 young people between the ages of 18 and 25 take up smoking every day. That means that 50,000 young people have taken up smoking since the Government first announced their proposals. They will face a lifetime of addiction and early death as a result.
Relatively few people in my constituency smoke—the numbers are way below average rates. None the less, smoking-related diseases accounted for 1,300 hospital admissions in the year before the pandemic. People suffer the same inequalities as a result. Some say that if we implement these measures we will not have the taxation coming into the Treasury, but in 2023, smoking cost the economy £21 billion. That is more than double the revenue that the Government get from tobacco levies. Some say that people who die early are doing us a favour by not being an imposition on the national health service. That is absolutely outrageous. We want people to live longer and healthier lives.
Let me make this clear for all those who believe in freedom of choice. I am a dyed-in-the-wool Conservative and I believe in free choice, but the only free choice that a person makes if they take up smoking is to take that first cigarette, because after that they are addicted for life; the craving is there. Although most adult smokers want to give up, the reality is that it takes 30 attempts to succeed. Only one in 10 smokers achieve that each year. Therefore, if a person smokes, they will die a horrible death, probably as a result of a smoking-related disease.
This Bill has the opportunity of creating a smoke-free generation and of making sure that young people do not get addicted in the first place. If they wish to take up smoking when they are an adult that is their choice—their free choice—but, importantly, this Bill does not criminalise those people who smoke at the moment for either purchasing or using tobacco. The legal obligation will be on the retailers not to sell tobacco to those who are underage.
Like many people, I am concerned about the number of young people taking up vaping. The reality is that we do not yet have the evidence of what that will do to their lungs in the future. We know that it will get them addicted to nicotine, which is the most addictive drug known to man or woman. Once they are addicted to some form of nicotine, the temptation is to go further. We do not know what damage is being done to people’s lungs by the delivery mechanism of vaping, but medical evidence on that will emerge. It is important that we take action now rather than waiting to see what happens.
There is clear public support for these measures. Sixty nine per cent. of the public, including more than half of all smokers, back the Prime Minister’s age of sale proposal. There is support for the Bill across the political parties. The majority of people who vote for each of our parties across the Chamber support this proposal, and that should not come as a great surprise, because no one wants to see their children or grandchildren become addicted.
Sadly, big tobacco is fighting back. Tobacco companies have even attempted to classify themselves as allies of public health. Philip Morris International threatened to take legal action against the Government to delay the legislation. I am not sure what it thinks it is saying with its new corporate slogan, “Delivering a smoke-free future” when its whole aim is to get people addicted in the first place. The other reality is that big tobacco has been trying to get many of its products, such as heat-not-burn and cigars, exempted from the Bill—exemptions that would undermine the Bill before it even takes effect. Those products still contain tobacco and harmful products, and still cause damage to people’s health. We cannot allow those exemptions to happen. Another thing that we should change is the current exemption for cigarillos from standardised packaging laws—maybe we could consider that as the legislating take place.
The other reality that I want to mention is the discrepancies between Scotland, Northern Ireland, Wales and England. Scotland has a clear requirement for retailers to identify people by their age. I welcome that, as it is the right thing to do. As it stands, the Bill does not appear to require that in Wales or in England. I hope that we can amend the Bill as it goes through Committee to allow the provision that exists in Scotland —we should support what they have done there—to apply in England, Wales and Northern Ireland.
I know that you require me to sit down, Madam Deputy Speaker, but this is a subject that I have been passionate about for rather a long time. The reality is that the smoking ban back in 2007 was led from the Back Benches. Indeed, many Labour Ministers voted against the tobacco ban—
Bob Blackman
Including the Deputy Prime Minister. From that ban through to the 2015 progress on tobacco control, such measures have consistently come from the Back Benches. In fact, colleagues from across the House have helped to implement many of them. I am delighted that the all-party parliamentary group’s recommendations have been included in the Khan review. I thank the Prime Minister for going even further than what we asked for, which was a rise in the age of sale to create a smoke-free generation by raising the age of sale by one year every year. The reality is that tobacco control measures have consistently passed through this Chamber and the other with overwhelming support from across parties every single time they have been proposed. I am confident that this Bill will be no different.
Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I must impose a time limit of five minutes.
Vicky Ford (Chelmsford) (Con)
The Bill sets two important principles crashing against each other: on the one hand, the principle of personal freedom, and on the other, the responsibility of a Government to act on public health. We are really lucky to live in a country that treasures personal freedom, and we should be careful of bans that take freedoms away.
However, smoking is the biggest preventable killer and costs the NHS and the economy billions every year. Most people who smoke wish that they had never started in the first place—that they had never had that choice—and I agree with them. I have lost weight, Madam Deputy Speaker, because I took a decision six months ago to give up alcohol, but that was far easier than giving up nicotine. People value the choice to make silly decisions. When they were told that they should not eat an easter egg all in one go, there was a public backlash. Given that this is about personal choice, I think it right that this be a free vote.
However, when I thought about the free vote, I realised that this does not really affect me; it affects young people, who have a right to be heard. That is why I wrote to secondary schools in my constituency to ask young people for their views. I am really grateful for the detailed feedback from three of those schools. I will not mention which schools, because they gave me their confidence and I do not want them to get in trouble with their peers.
One group reported back that the general consensus was that a ban was a good thing, and another said that they had mixed views. A third group sent me detailed comments from every single year 12 and 13 student of politics. In that group, the number of students supporting the Bill’s measures was more than double those who did not. The majority is even greater for the part of the Bill about vapes than for the part about tobacco. The children commented that the brightly coloured flavoured vapes are targeted at young people. They also worry about the environmental impact, especially of disposable vapes, and would like to have stronger limitations on disposable products than on reusable ones. They recognised that vaping can help adults to quit smoking and raised the concern that stronger restrictions on vapes may cause some adults to return to smoking, but they are also concerned about the lack of knowledge of the long-term impacts of vaping, especially for young people. Other students pointed out that fixing a set date of birth for those who are able to buy tobacco seems somewhat arbitrary, feels unfair and could be difficult to enforce, especially as those people get older. Some raised concerns that younger people will still obtain products—both vapes and cigarettes—from older people or from illegal sources.
All the groups commented on the need for enforcement measures, wisely pointing out that just passing a law in this House does not necessarily change behaviour. I was pleased that the Health Secretary said that local authorities will be able to keep the proceeds of fines in order to enforce this law. Some students were also concerned about the challenges that enforcement will pose to retail workers—the Government’s new proposal to introduce a specific offence of assaulting a retail worker may go some way to addressing those concerns. The final point, which I thought was really important to mention, was that some young people were concerned that if these products are banned, other items that are potentially even more dangerous will take over.
All those points have been mentioned individually by many colleagues in today’s debate, and every single one of them was considered by the young people in my constituency. I was deeply impressed by the thought they gave to the matter: they value freedom and choice, but when asked for their views, the majority of the young people of Chelmsford who responded said that they would support the measures in the Bill. It was not a unanimous opinion, and I respect those who did not agree, but in a democracy, the majority views are those that prevail. Therefore, out of respect for the majority view of the young people in my constituency—who will be affected by this Bill much more than any of us—I am going to vote for the Bill today, because it is their views on the Bill that will matter.
Richard Graham (Gloucester) (Con)
What a fascinating afternoon of different speeches. As my right hon. Friend the Member for Chelmsford (Vicky Ford) has just indicated, there are two very different ways of approaching the Bill. It is very much a personal matter: tonight’s vote is not whipped, and therefore all of us will have our different perceptions, but I start by saying that we are not all here—as one Member said—to try to prevent restrictions on human activity. I do not see that as the reason I was sent to this House, but surely we were all sent here to try to achieve a better future for the children and grandchildren of our constituents. Once we have all agreed on that, we can discuss whether a ban on children smoking now that will, in time, mean a ban on everyone smoking is a wonderful way of preventing what is not a liberty but an addiction, or whether taking away that freedom is just a slippery slope towards taking away all other freedoms.
Of course, although we cannot measure precisely the future damage of allowing people to carry on as they have been—being able to do themselves considerable damage—we know that the NHS calculates that the current financial cost of smoking is £17 billion a year. For those of us who are also concerned about the size of the state, the use of resources, the productivity of the NHS, and the ability of our constituents to have elective surgery when they want it and to see doctors when they wish to, this is surely a huge opportunity to make a massive difference—not just to future generations’ potential to avoid addiction to tobacco, but to their ability to get the health services that they want at a cost that this country can afford. That is the crux of what we have been discussing today.
It is very interesting to me that all the doctors in the House and all the health professionals in our constituencies—as my neighbour and hon. Friend, the wonderful Member for Stroud (Siobhan Baillie), has highlighted in Gloucestershire—are absolutely united that this is one of the single most important and useful interventions that this House could make. It is a huge credit to this Prime Minister that he has set out a vision with clarity and pursued it with determination, and is absolutely clear that were this House to vote this Bill through, it would be part of whatever legacy he leaves in the future, as a politician keen to make a difference.
I believe the idea that, on the contrary, encouraging worse health outcomes should continue because it somehow benefits people’s freedoms would be a valid one only if the whole business of smoking was harmless and largely cost-free, and we know that that simply is not the case. We have heard the data and the calls: 75,000 GP appointments a month, 690 premature deaths in the Gloucester Royal Hospital alone, and every minute of every day a new patient somewhere in a hospital in the UK because of smoking. We cannot argue that the freedom to smoke and to be addicted comes cost-free, and I cannot imagine opposing a Bill that supports better health and better life outcomes. For the libertarians, it will in fact help to reduce the size and cost of the state. Therefore all these things are fundamentally Conservative goals. In fact, they are not even just Conservative goals, but surely human goals that all of us in this House can share.
In all this, we do not need to think too much about a nanny state—none of us is keen on the phrase “nanny state” or the concept—but how many people here would stand up and vote to take away safety belts in cars, or suggest that everyone could drive motorbikes without a helmet? I believe that what may seem like a slight increase in bureaucracy will, in a few years’ time, be seen as so obvious that we will all be astonished there was any opposition at all. I believe strongly that protecting children, just as we banned children from being chimney sweeps in generations gone by, by banning them from smoking for future generations is exactly what a progressive Conservative Government should do. This Bill, if passed, will be one of the most far-reaching laws that this Government and this Parliament have made. I am absolutely convinced—
Anna Firth (Southend West) (Con)
I support the Bill’s aim to create the first smoke-free generation. It is bold and visionary, and I support it.
I want to use my time to make four short points. It will not surprise you, Madam Deputy Speaker, that the first one concerns the new city of Southend. My vision is to make the city of Southend safer, healthier and wealthier for all, but the incidence of smoking in Southend is a real barrier to that vision. In 2022, the rate of smoking in Southend was estimated to be over 14%, which is 1.5% higher than the national average. What is even more concerning is that the 2022 figure is 3% higher than the 2021 figure. Although it is laudable that smoking rates have been consistently declining in the UK for the past 40 years, the reality is that in some of our coastal cities—and, sadly, Southend is one of them—the rates are still too high and are even rising. I am delighted that the Prime Minister has sought to tackle this issue, and anything that makes the next generation of Southenders healthier certainly has my backing.
I am delighted that the Bill tackles vaping. As we have heard, recent research shows that nearly a quarter of children use vapes, with more than 10% in secondary schools describing themselves as regular users. Vaping is much more concerning because we simply do not yet know the long-term effects, but what we do know is alarming. We know that vaping-related hospital admissions almost doubled in 2022, with 32 of those cases involving children. Bearing in mind that cigarettes were once considered to be perfectly safe, as we have heard, I believe it is simply not responsible to fail to act to stop young people becoming hooked on these products.
However, like others I have a number of concerns about how the Bill will work in practice. There are only 5,000 trading standards officers around the country. How can such a small number ensure that the ban on the sale of these products is enforced? Just as importantly, as this Bill is currently drafted, if someone were to go abroad on a trip and come back with a pack of 200 Marlboro Gold—apparently only £37 at the current duty-free rate—there is nothing to stop them smoking them or giving them to others because they have not bought them, so that has to be tackled as well.
Like my right hon. Friend the Member for Chelmsford (Vicky Ford), I have engaged with my local students. My last cohort of work experience students, all with an interest in politics, were very interested in this policy. Students from Westcliff High School for Girls, Southend High School for Girls, Southend High School for Boys and the King Edmund School all support the aim of the Bill, but they too raise a number of intelligent concerns. They want to know how shops that already sell illegal and unregulated nicotine products will be dealt with when they add illegal vapes. They want to know how people well into adulthood will be identified for nicotine products—how will shops tackle that? They strongly support the banning of disposable vapes, particularly for environmental reasons, but they are much more concerned about cracking down on the under-age vaping that is already happening than banning future vape purchases. Finally, they raised considerable concerns about the potential for a black market in nicotine products. They pointed out the prevalence of unregulated products cut with even worse substances in the illicit drug market, and they fear we might be opening the door for this to happen with nicotine products as well.
I support the principle of the ban. This is about protecting the long-term health of young people in our country and I will be voting for it, but we must address the real concerns expressed by the very young people the Bill has been introduced to protect.
Steve Double (St Austell and Newquay) (Con)
I am not naturally inclined to want to ban things—I lean towards the Government intervening as little as possible and only when absolutely necessary—so I have thought long and hard about this Bill and whether to support it, and I have come to the conclusion that I will vote for it tonight.
The first reason for that is that although I have heard the arguments put forward by some today about freedom, the simple fact is that people who are addicted to nicotine and smoking are not free. I have seen many people suffering with the addiction through their life and trying to give up smoking, and any notion that somehow people who are addicted to smoking are free is nonsense. If we can ever help people to avoid becoming addicted to smoking and nicotine, the Government should take action. The Bill tries to address that issue in a sensible and pragmatic manner and in the right way.
I have also heard it said today that somehow smoking is a matter of personal choice and freedom and it does not really affect anyone else. I would challenge people who say that to go and talk to any family—we have heard stories about this in the Chamber today—who have lost loved ones through long and painful deaths as a result of their smoking. There are victims of smoking beyond the person directly involved, in their family.
Smoking also puts huge pressure on our health systems and damages our economy. These are prices we all have to pay for the addiction to smoking that so many struggle with. When I read the statistic that 75,000 GP appointments a week are directly as a result of smoking, I was astounded. I am sure that all of our inboxes are full of messages from constituents saying they are struggling to see their GP, so we can see that a great difference would be made if we freed up that capacity in primary care. For those reasons I think it is right on this occasion for the Government to intervene.
On the point about shop workers having to check the age of someone in their 30s or 40s to establish whether they are eligible to buy tobacco, the reality is that it will not happen because the whole point of the measures is to stop people smoking in the first place. We know most people start smoking when they are young, and by helping them to avoid ever starting when they are young we just will not have people in their 30s and 40s wanting to buy cigarettes. That is the point.
I also welcome the measures in the Bill on vaping. I have been incredibly concerned about the way vaping has taken hold of particularly young people in our country. I understand and acknowledge that it is a useful tool to help people to get off cigarettes by taking up vaping instead, but the reality is that it is now about so much more than that in our country. It is shameful how some of the vape manufacturers have deliberately tried to get young people addicted to vaping, so that they are locked into being their customers for the rest of their lives, just as the tobacco industry has done for too long. I therefore welcome the measures the Government are taking to try to make vaping less attractive to young people. I suggest that we need to go further. If we say that the main aim of vaping is to help people to get off smoking, why do we not also ban vapes for anyone born after 1 January 2009? If they will not ever smoke, they will not need vaping to get off smoking. That is one way we could go further to improve this Bill and prevent young people from ever taking up vaping in the first place. That would be incredibly welcome.
We do not know the long-term damage that vaping is doing to people. We are starting to see some of the evidence coming forward on the number of young people who end up in hospital as a result of vaping. I am deeply concerned that, just as with tobacco if it was being licensed today—with all that we know about the damage it does to people’s lives—we probably would not license it or approve it for sale. I am concerned that we do not yet understand the long-term impact of vaping, and it will reap a damaging effect on young people’s health.
The Bill is not perfect, but I acknowledge and respect the Prime Minister’s aims in coming forward with something that is bold and will address this important issue in our society. I am happy to support the Bill this evening.
James Grundy (Leigh) (Con)
I rise in an unusual position, because I smoke like a chimney, but I will give the Government the benefit of the doubt tonight, even though I have concerns about the enforceability of some of the Bill’s measures.
Those who are regular readers of the Leigh Journal—I realise that my audience might not include too many of those—will know that I have written repeatedly about the problem of illicit and illegal tobacco and vapes in Leigh. The simple truth is that there is real concern that a lot of these products are a means to money launder for the gangs who cause the heroin problem in Leigh and for the people smugglers. I have spoken in the Leigh Journal about how Leigh was one of the end points of an international smuggling gang based in the Balkans that used illicit tobacco and vapes as part of their criminal enterprise.
Some people have spoken today about how they do not think the Bill is right and will not support the Government. I will support the Government, but I will complain about the Bill too, because the Government must go further. If someone is selling illegal tobacco and vapes, they should be held accountable. If someone was selling beer or spirits made out of turpentine or toilet water, for example, people would be outraged and there would be a demand for action, but that is happening day in, day out and week in, week out with illegal and counterfeit tobacco and vapes. Some products are made illegitimately to copy “legitimate” products in sweatshops in the far east, and some vapes contain up to 10 times the legal limit of nicotine. As some colleagues with medical knowledge have spoken about today, we simply do not know what damage that will do to young people.
The way we should go further is through a mechanism that we already have to license shops, which is the alcohol licensing scheme. We should expand that scheme, which is run by local authorities, to tobacco. It should be an alcohol and tobacco licence, so that someone cannot apply for one or the other, but has to apply for both. If someone is caught selling a dodgy £2 vape to a 14-year-old, they should have their licence taken away so that they can no longer sell alcohol either. I guarantee that that would basically clean up the system, because nobody will take the risk of selling a dodgy £2 vape to a 14-year-old and risk the loss of their ability to sell alcohol to a much wider pool of people. Those who do will, I suspect, be the organisations that are fronts for the drug dealers and people smugglers. We should also trigger an automatic investigation by His Majesty’s Revenue and Customs into those people and follow back the chain of the dodgy vapes and dodgy tobacco to find out who they are. Not only should we take away their licences so that they cannot sell alcohol and tobacco; we should fine them, and not £50 as said earlier, but £10,000. Let us really go for this and teach those people a lesson, because the black market in tobacco and vapes already exists, and it is costing the Treasury millions. It is funding other criminal activity such as heroin dealing and people smuggling, so it must come to an end.
My only criticism of the Government with regard to the Bill is that it does not go far enough. We need more robust regulation, because a giant black market in tobacco and vapes is already there. It needs to be done through the existing licensing system for alcohol, and it needs to have concrete outcomes that will shut down the dodgy shops and cut off a source of funding for the dangerous criminal gangs who also operate in heroin dealing and people smuggling.
The Government have the right intention. I have doubts about some of the detail, but I will give them the benefit of the doubt. However, I urge them to strengthen the legislation; it would be to the benefit of us all if they did so. Let us deal with these criminal gangs while we deal with this public health issue, because I am afraid the two are deeply intertwined.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
It is a pleasure to respond to the debate on behalf of the Opposition. We have heard powerful contributions from Members on both sides of the House in favour of the Bill to bring an end to the smoking epidemic and crack down on vaping companies that are preying on kids. I thank the right hon. Member for Bromsgrove (Sir Sajid Javid), my hon. Friends the Member for Stockton North (Alex Cunningham) and for Blaydon (Liz Twist) and the hon. Members for Winchester (Steve Brine), for Harrow East (Bob Blackman), for Erewash (Maggie Throup), for Boston and Skegness (Matt Warman) and for Stroud (Siobhan Baillie) for their moving contributions on the harms of smoking and the importance of the Bill. Let me also thank my hon. Friends the Members for North Tyneside (Mary Glindon), for York Central, (Rachael Maskell) and for Dulwich and West Norwood (Helen Hayes) for the excellent points they made about the growth in vaping.
We have also heard opposition to the Bill. The right hon. Member for Rossendale and Darwen (Sir Jake Berry) cited the example of people openly taking class A drugs in public without reprimand as evidence that bans do not work. I dare say that he made more of a point about the decline in policing and local enforcement under his Government than about age-of-sale legislation. To the former Prime Minister, the right hon. Member for South West Norfolk (Elizabeth Truss), I simply say that if wanting to stop future generations from getting addicted to products that may eventually kill them makes us the health police, then the health police we are.
There is no argument about the harm that tobacco does to the people of this country every day. Smoking is the single biggest preventable cause of ill health. It leads to 80,000 deaths a year in the United Kingdom, and it is responsible for one in four cancer deaths and more than 70% of lung cancer cases. Smokers lose an average of 10 years of life expectancy. As we have heard, smoking is not a free choice; it is an addiction. Raising the age of sale will help to reduce pressure on the NHS by improving health and wellbeing.
My constituent Eric knows that too well. He is one of thousands of constituents whose lives have been put at risk by smoking. Like the vast majority of smokers, he began smoking when he was a child, at age 14. It was not until his 50s that he was able to give up cold turkey, at the request of his daughter, who urged him to do so on behalf of his newborn grandson. Eric has suffered a heart attack and stroke, and he lives with hypertension, high cholesterol and COPD. As he said:
“COPD is an incurable, mortal disease and makes getting around harder and harder for me.”
The experience of people like Eric is why the last Labour Government took radical action with the smoking ban in 2007: a defining public health achievement. It is also why, while in opposition, we welcomed the Khan review and proposed the generational smoking ban a full 10 months before the Prime Minister made his announcement at his party conference.
There is wide support for the Bill from everyone in the NHS, in the wider health sector and among the general public. The only people who seem to be fighting it tooth and nail are the tobacco companies and Conservative Back Benchers. The former Member for Blackpool South called it “health fascism”, and the former Prime Minister, whose chief of staff worked for Philip Morris and British American Tobacco, has called it “unConservative.” What is it about the tobacco industry that some Tory MPs love so much? Every year the NHS bails out big tobacco to the tune of billions. The Prime Minister might not feel he has the strength to take on those vested interests and whip his MPs to vote against them, but he can rest assured that if they cannot get it over the line, Labour will.
As welcome as this Bill is, the Government have had 14 years to take stronger action on smoking. Four years ago, the Government said that their ambition was a smoke-free Britain by 2030, but they are currently estimated to be at least seven years behind their Smokefree 2030 target and not on course to meet it in the poorest areas until 2044. The generational smoking ban will help us get there, but it will not help the 6 million to 7 million adults who already smoke.
As many Members have said, stop smoking services have faced savage cuts. The number of smokers who quit through stop smoking services has dropped from 400,000 a year in 2010 to around 100,000 today. Does the Minister regret not doing more to bring down smoking rates over the past 14 years? The Government have belatedly committed more funding to stop smoking services, but the uplift in funding that the Minister offers will not take us back to the number of people setting quitting dates that we achieved in 2010. What assurance can she offer that her measures will get the Government on course to hit the 5% smoke-free target by 2030?
The Bill is strong on tackling the take-up of cigarettes and vapes by young people, but it does little to help those already addicted to quit. Recently, a school in my constituency had to apologise after handing out a leaflet to a child that suggested smoking as a self-help measure. Does the Minister agree that it is scandalous that the myth that smoking reduces stress and anxiety still persists? Does she agree that her Bill should include a requirement to make tobacco companies include information to dispel that myth in their products?
The Bill also includes a range of powers to tackle youth vaping, which Labour welcomes. For years, Labour has been warning about the explosion of young people getting addicted to nicotine with products that look like teddy bears and sippy cups, and come in flavours like unicorn shake. That is why Labour voted to ban the marketing and branding of vapes to children in 2021. Once again, Labour leads and this Government belatedly follow. In the meantime, an estimated 255,000 more children aged 11 to 17 have become addicted to vapes, according to ASH survey data. Does the Minister regret taking so long to wake up to this issue?
According to the Chartered Trading Standards Institute, while youth vaping has soared, so has the number of illegal products flooding our market, as many Members have raised. Up to one in three vapes sold in shops is estimated to be illicit, which means that children are being exposed to vapes that contain heavy metals, antifreeze and poster varnish, as well illegal levels of nicotine getting them hooked for life. Will the Minister explain how she expects to bring in effective new regulations on vapes when her Government are barely in control of the black market now? Does she agree that a cross-Government strategy is needed to tackle the smuggling of potentially dangerous products into our country? Has she considered giving the MHRA new powers to screen products before they come on the market? Will she confirm that her Bill will provide powers to tackle not just the sale but the import of dangerous products?
To conclude, after 14 years of the Tories, healthy life expectancy has dropped for the first time in modern British history. Labour supports this Bill but, after 14 years of failure and with the NHS in crisis, we regret that it marks a last desperate attempt of this Government to rescue a legacy on public health. For 14 years they have played politics with public health, putting off prevention measures, knowing that taxpayers tomorrow will pay the price. But the country is paying for this now. Labour will always put public health first, prioritise prevention to ease pressure on the NHS, improve access to smoking cessation services and take on the tobacco and vape companies that are profiting off people’s health.
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
I want to start by thanking the many lung cancer and asthma charities, particularly ASH, for their advice, research and support. I personally pay tribute to the chief medical officer for England for his commitment to making the strongest possible case for this life-changing legislation, and to Health Ministers across the UK for their collaboration in what will be a UK-wide solution for future generations.
I was very disappointed with the hon. Member for Ilford North (Wes Streeting), who opened for the Opposition. I have said it before and I will say it again: I like the hon. Gentleman. He once said on air that that was death to his career! Why would he have said that, Madam Deputy Speaker? But I am really disappointed today, because he was not listening. My hon. Friends had some very sensible questions about consultation, and they raised very serious points about flavours for vapes and how they might help adults to quit. He was not listening; he was making party political points. In fact, he barely said anything sensible about the legislation. All he did was talk politics. I appreciate the fact that Labour Members have been whipped to support the Bill. On my side, colleagues are trusted to make their own decisions on something that has always been a matter for a free vote. [Interruption.] He sits there shouting from a sedentary position, political point-scoring yet again.
The hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) raised a very serious question about stop smoking services. I can tell her that the Government have allocated £138 million a year to stop smoking, which is more than doubling. The Government’s commitment to helping adults to stop smoking is absolutely unparalleled.
I thank the hon. Member for East Renfrewshire (Kirsten Oswald) for her support for the Bill, and for the collaborative approach of the Government in Scotland in their work bringing forward this collaboration among all parts of the United Kingdom.
I pay particular tribute to my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health Committee for his excellent speech and his strong case for long-term policies that will prevent ill health and thereby reduce the pressures on the NHS, which is so important. He asked when we will see the regulations and the consultation on vaping flavours, packaging and location in stores. It is our intention to bring forward that consultation during this Parliament if at all practicable.
I thank my right hon. Friend the Member for Bromsgrove (Sir Sajid Javid) for his tribute to Dr Javed Khan for his excellent report into the terrible trap of addiction to nicotine. My right hon. Friend made the point that it is simply not a free choice, but the total opposite.
I thank the Liberal Democrats and their spokesman, the hon. Member for St Albans (Daisy Cooper), for saying that they will support the Bill on Second Reading. I am not quite sure where they are going on the smoking legislation, but I am grateful for their support on vaping. I hope to be able to reassure them during the passage of the Bill.
The case for the Bill is totally clear: cigarettes are the product that, when used as the manufacturer intends, will go on to kill two thirds of its long-term users. That makes it different from eating at McDonald’s or even drinking—what was it?—a pint of wine, which one of my colleagues was suggesting. It is very, very different. Smoking causes 70% of lung cancer cases. It causes asthma in young people. It causes stillbirths, it causes dementia, disability and early death. I will give way on that cheery note.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
I thank the Minister for giving way. I draw the attention of the House to my entry in the Register of Members’ Financial Interests as a practising NHS consultant addiction psychiatrist. Does my right hon. Friend share my concern that what we have heard from the libertarian right today is a false equivalence between alcohol and bad dietary choices, and smoking, and that moderate alcohol and moderate bad eating are very different from moderate smoking, because moderate smoking kills. It means that people live on average 10 years less and it means less healthy lives. Does she agree that this is not about libertarianism but about doing the right thing, protecting public health and protecting the next generation, and that is why we should all support the Bill?
Dame Andrea Leadsom
I am grateful to my hon. Friend, who makes such a powerful point and speaks with such authority. Similar points were made by my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who as a paediatrician spoke with great expertise on this matter. It is absolutely true: it is a false choice. It is not a freedom of choice; it is a choice to become addicted and that then removes your choice.
Every year, more than 100,000 children aged between 11 and 15 light their first cigarette. What they can look forward to is a life of addiction to nicotine, spending thousands of pounds a year, making perhaps 30 attempts to quit, with all the misery that involves, and then experiencing life-limiting, entirely preventable suffering. Two thirds of them will die before their time. Some 83% of people start smoking before the age of 20, which is why we need to have the guts to create the first smoke-free generation across the United Kingdom, making sure that children turning 15 or younger this year will never be legally sold tobacco. That is the single biggest intervention that we can make to improve our nation’s health. Smoking is responsible for about 80,000 deaths every year, but it would still be worth taking action if the real figure were half that, or even a tenth of it.
There is also a strong economic case for the Bill. Every year, smoking costs our country at least £17 billion, far more than the £10 billion of tax revenue that it draws in. It costs our NHS and social care system £3 billion every year, with someone admitted to hospital with a smoking-related illness almost every minute of every day, and 75,000 GP appointments every week for smoking-related problems. That is a massive and totally preventable waste of resources. For those of us on this side of the House who are trying hard to increase access to the NHS and enable more patients to see their GPs, this is a really good target on which to focus. On the positive side, creating a smoke-free generation could deliver productivity gains of nearly £2 billion within a decade, potentially reaching £16 billion by 2056, improving work prospects, boosting efficiency and driving the economic growth that we need in order to pay for the first-class public services that we all want.
I know that hon. Members who oppose the Bill are doing so with the best of intentions. They argue that adults should be free to make their own decisions, and I get that. What we are urging them to do is make their own free decision to choose to be addicted to nicotine, but that is not in fact a choice, and I urge them to look at the facts. Children start smoking because of peer pressure, and because of persistent marketing telling them that it is cool. I know from experience how hard it is, once hooked, to kick the habit. I took up smoking at the age of 14. My little sister was 12 at the time, and we used to buy 10 No. 6 and a little book of matches and —yes—smoke behind the bicycle shed, and at the bus stop on the way home from school. [Interruption.] Yes, I know: I am outing myself here.
Having taken up smoking at the age of 14, I was smoking 40 a day by the age of 20, and as a 21st birthday present to myself I gave up. But today, 40 years later—I am now 60, so do the maths—with all this talk of smoking, I still feel like a fag sometimes. That is how addictive smoking is. This is not about freedom to choose; it is about freedom from addiction.
There is another angle. Those in the tobacco industry are, of course, issuing dire warnings of unintended consequences from the raising of the age of sale. They say that it will cause an explosion in the black market. That is exactly what they said when the age of sale rose from 16 to 18, but the opposite happened: the number of illicit cigarettes consumed fell by a quarter, and at the same time smoking rates among 16 and 17-year-olds in England fell by almost a third. Raising the age of sale is a tried and tested policy, and a policy that is supported not only by a majority of retailers—which, understandably, has been mentioned by a number of Members—but by more than 70% of the British public.
Tim Loughton (East Worthing and Shoreham) (Con)
If I had known that my right hon. Friend was such a keen smoker, I would not have recruited her to the Conservative party at the tender age of 18 when we were at university.
I have always taken a free-choice approach to health matters, and as shadow Children’s Minister I had to lead on both the tobacco advertising ban and the public smoking ban. We were wrong to oppose them. Who would now think it remotely normal for people to be able to smoke around us in restaurants and other public places? Does my right hon. Friend not agree that in a few years’ time this measure will seem just the same as banning smoking in public places, and people will ask why we did not do it earlier?
Dame Andrea Leadsom
As I have said ever since I met my hon. Friend at the age of 18, he is always right. I can never disagree with him.
I want to say a few even more furious words about vaping. It is just appalling to see vapes being deliberately marketed to children at pocket-money prices and in bright colours, with fun packaging and flavours like bubble gum and berry blast, and with the vape counter right next to the sweet counter.
Sir Jake Berry
Before my right hon. Friend gets too furious about vaping, may I ask her to clarify two points on smoking? First, she said that because of the addictive nature of nicotine, it is extremely important that we stop people smoking from the age of 15. I do not support that, but if it is so important, why are we not starting at 17? It is already illegal for 17-year-olds to smoke. What is the magic of 15? If we really believe in the policy, why delay? Secondly, she spoke about her own experience, and I am a former smoker myself. She started smoking at 14, and I started smoking at about 14 as well. It was illegal when I started smoking at 14, but it did not stop me. I am a lawbreaker—how shocking. Why does she think that this ban on people starting smoking when under age will be different?
Dame Andrea Leadsom
I am grateful to my right hon. Friend for raising those really important points. As I will come on to, we will be putting £30 million of new money each year into trading standards and our enforcement agencies to clamp down on enforcement, and we are making it illegal to sell cigarettes to anybody turning 15 this year. He asks why. It is precisely because we are trying to bring in the Bill with a decent amount of notice so that people can prepare for it, precisely to protect retailers and allow all the sectors that will be impacted to be able to prepare.
I come back to the area where I am seriously on the warpath: targeting kids who might become addicted to nicotine vapes. I went to Hackney to visit some retail shops, where I saw the vape counters right next to the sweet counters. I saw that it is absolutely not about me—it is not about trying to stop me smoking. It is about trying to get children addicted through cynical, despicable methods. Sadly, for too many kids, vapes are already an incredible marketing success. One in five children aged between 11 and 17 have now used a vape, and the number has trebled in the last three years.
Kirsten Oswald
I am grateful to the Minister for giving way as she ploughs through all of this. I wonder whether she can share her views on the advertising of vape products on sports kits and via sports facilities.
Dame Andrea Leadsom
The hon. Lady is aware that there is already very restrictive advertising for smoking and vaping. We are very concerned that some advertising is breaching advertising standards regulations, and I will write to retailers specifically about that.
Parents and teachers are incredibly worried about the effect that vapes are having on developing lungs and brains. The truth is that we do not yet know what the long-term impact will be on children who vape. Since I was appointed, I have done everything I can to ensure that this Bill will protect our children. The Government’s position is clear: vaping is less harmful than smoking, but if you don’t smoke, don’t vape—and children should never vape.
We will definitely make sure that people who smoke today continue to have access to vapes as a quit aid, which will absolutely not change, but we cannot replace one generation that is hooked on nicotine in cigarettes with another that is hooked on nicotine in vapes. That is why we are using this Bill to take powers to restrict flavours and packaging, and to change how vapes are displayed in shops. To reassure the Chair of the Health and Social Care Committee and my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry), we plan to consult on that before the end of the Parliament, if practicable. The disposable vapes ban will likely take effect in April 2025—those regulations have already been published.
These are common-sense proposals that strike the right balance between helping retailers to prepare, giving sufficient notice and protecting children from getting hooked on nicotine, while at the same time supporting current smokers to quit by switching to vapes as a less harmful quit aid, supported by £138 million a year. Our approach is realistic for those who smoke now and resolute in protecting children. I am convinced that, just like banning smoking in indoor public places and raising the age of sale to 18, these measures will seem commonsensical to all of us in 10 years’ time. In decades to come, our great-grandchildren will look back and think: why on earth did they not do it sooner? I urge all right hon. and hon. Members to vote for this Bill as the biggest public intervention in history. I commend the Bill to the House.
Question put, That the Bill be now read a Second time.
Tobacco and Vapes Bill (First sitting)
Tuesday 30th April 2024
(1 week, 2 days ago)
Public Bill CommitteesRead Full debate Tobacco and Vapes Bill 2023-24 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 30 April 2024 - (30 Apr 2024)
The Chair
I will begin with a couple of preliminary announcements. Hansard would be grateful if Members could email their speaking notes to hansardnotes@parliament.uk. Please switch electronic devices to silent. It goes without saying, and I can see that nobody is intending to do otherwise, but tea and coffee are not allowed during sittings. Date Time Witness Tuesday 30 April Until no later than 10.05 am Cancer Research UK; Action on Smoking and Health; Action on Smoking and Health Scotland Tuesday 30 April Until no later than 10.40 am British Heart Foundation; Asthma + Lung UK Tuesday 30 April Until no later than 11.10 am Department for Education’s Secondary Headteacher Reference Group; National Association of Schoolmasters Union of Women Teachers Tuesday 30 April Until no later than 11.25 am Age UK Tuesday 30 April Until no later than 2.30 pm Local Government Association; Association of Directors of Public Health Tuesday 30 April Until no later than 2.50 pm Fresh and Balance North East Tuesday 30 April Until no later than 3.10 pm British Retail Consortium Tuesday 30 April Until no later than 3.40 pm The Chartered Trading Standards Institute Tuesday 30 April Until no later than 4.00 pm Laura Young, Centre for Water Law, Policy and Science, University of Dundee Tuesday 30 April Until no later than 4.20 pm Professor Linda Bauld OBE, Bruce and John Usher Chair in Public Health, University of Edinburgh Tuesday 30 April Until no later than 4.50 pm Professor Robert West, Professor Emeritus of Health Psychology, University College London; Professor Ann McNeill, Professor of Tobacco Addiction, King’s College London Wednesday 1 May Until no later than 10.25 am Chief Medical Officers for England, Wales, Northern Ireland and Scotland Wednesday 1 May Until no later than 10.55 am NHS England Wednesday 1 May Until no later than 11.25 am Royal College of General Practitioners; Royal College of Paediatrics and Child Health Wednesday 1 May Until no later than 2.40 pm Royal College of Physicians; Royal College of Surgeons Wednesday 1 May Until no later than 3.00 pm Mental Health Foundation Wednesday 1 May Until no later than 3.25 pm Medicines and Healthcare products Regulatory Agency Wednesday 1 May Until no later than 3.45 pm Inter Scientific Wednesday 1 May Until no later than 4.25 pm Professor Anna Gilmore, Director, Tobacco Control Research Group, University of Bath; Dr Allison Ford, Associate Professor at the Institute for Social Marketing and Health, University of Stirling; Dr Rob Branston, Senior Lecturer, University of Bath.
We will first consider the programme motion. We will then consider a further motion to enable the reporting of written evidence for publication, and a motion to allow us to deliberate in private about our questions before the oral evidence sessions. In view of the time available, I hope we can take these questions formally without debate.
Ordered,
That—
(1) the Committee shall (in addition to its first meeting at 9.25 am on Tuesday 30 April) meet—
(a) at 2.00 pm on Tuesday 30 April;
(b) at 9.25 am and 2.00 pm on Wednesday 1 May;
(c) at 11.30 am and 2.00 pm on Thursday 9 May;
(d) at 9.25 am and 2.00 pm on Tuesday 14 May;
(e) at 11.30 am and 2.00 pm on Thursday 16 May;
(f) at 9.25 am and 2.00 pm on Tuesday 21 May;
(g) at 11.30 am and 2.00 pm on Thursday 23 May;
(2) the Committee shall hear oral evidence in accordance with the following Table:
(3) proceedings on consideration of the Bill in Committee shall be taken in the following order: Clauses 1 to 27; Schedule 1; Clause 28; Schedules 2 to 4; Clauses 29 to 55; Schedule 5; Clauses 56 to 81; new Clauses; new Schedules; remaining proceedings on the Bill;
(4) the proceedings shall (so far as not previously concluded) be brought to a conclusion at 5.00 pm on Thursday 23 May. —(Dame Andrea Leadsom.)
Resolved,
That, subject to the discretion of the Chair, any written evidence received by the Committee shall be reported to the House for publication.—(Dame Andrea Leadsom.)
Resolved,
That, at this and any subsequent meeting at which oral evidence is to be heard, the Committee shall sit in private until the witnesses are admitted.—(Dame Andrea Leadsom.)
The Chair
We are now sitting in public again, and our proceedings are being broadcast. Before we hear from the witnesses, do any Members wish to declare their interests in connection with the Bill?
Bob Blackman (Harrow East) (Con)
I chair the all-party parliamentary group on smoking and health.
Bambos Charalambous (Enfield, Southgate) (Lab)
I do not know whether it is an actual declaration, but I did the Cancer Research 10k fun run in February—the winter run.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I am an NHS consultant paediatrician, and a member of the Royal College of Paediatrics and Child Health.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)
I am a practising psychologist, and I also chair the all-party parliamentary health group.
Mary Glindon (North Tyneside) (Lab)
Sir George, do we have to declare our memberships of any groups? I am a member of the all-party parliamentary group for responsible vaping.
The Chair
We will now hear oral evidence from Michelle Mitchell, the chief executive of Cancer Research UK, Deborah Arnott, the chief executive of Action on Smoking and Health, and Sheila Duffy, the chief executive of ASH Scotland. To begin with, I will call on Michelle Mitchell.
Michelle Mitchell: First, thank you for your openness and transparency, Sir George. It is also important to declare whether anybody giving evidence has associations with the tobacco industry; I have none. The principle of accountability and transparency is also important for the people who are giving evidence.
Smoking is the biggest cause of death, ill health and disability. It is the biggest cause of cancer in the UK. It has a huge impact on preventable deaths, the economy, productivity and of course families and loved ones. Cancer Research UK supports the legislation to create the first ever smoke-free generation and to stop young people developing addictions, risk, ill health and, of course, cancer. We believe that the rights and entitlements of current smokers are reasonably unaffected. We urge you through your considerations in Parliament to pass the legislation, as does the public, 73% of whom support the legislation.
The Chair
Witnesses may wish initially to introduce themselves or to make a presentation. I am open minded about that. I call Deborah Arnott.
Deborah Arnott: My name is Deborah Arnott. I am chief executive of Action on Smoking and Health. I have held that position since May 2003, so this is my 21st year. I have been around for a lot of tobacco legislation, and it is really impressive to see where successive Governments have brought us.
I do not know whether you want me to go on and make some key points. Would that be helpful?
The Chair
Yes.
Deborah Arnott: One thing I would say is that people have said, “Well, why do we need this? Smoking rates are going down.” The evidence is clear: if you take the foot off the pedal, smoking rates do not continue to fall. We have seen that around the world and, in recent years, we have seen that in the UK too. Indeed, our 2024 survey of 11 to 17-year-olds found that smoking rates have pretty much flatlined since before covid. The UCL smoking toolkit study is finding the same thing with adults and in particular with young adults. The smoke-free generation policy is vital to make smoking obsolete. That is the Government’s ambition, and I think it is one that everyone here shares.
I can provide you with the full youth and adult survey data, but we are still working on the detailed analysis. I was asked whether I could also talk a bit about the surveys of retailers we have done. We have published some of the data and some of this data is in addition. For many years, tobacco industry-funded trade bodies have campaigned against successive legislation, against tax increases, against the display ban and against plain packaging. ASH wanted to find out what retailers themselves thought. We commissioned NEMS Market Research to survey representative samples of managers or owners of independent shops selling tobacco. It is particularly important to understand the experiences of our small shopkeepers, as they are the ones who will have the most difficulty implementing potential legislation.
The latest survey, which was conducted in January and early February and spoke to 900 retailers in England and Wales, showed that more than half—51%—support raising the age of sale every year, with only a quarter opposing. Some 79% support fixed penalty notices for breaches of age of sale regulations, which are in the legislation, while 13% were opposed to that. Some 71% support mandatory age verification, with only one in five opposing, which is really important. The legislation does include mandatory age verification for Scotland, but not for the remaining nations of the United Kingdom. That is important because it is about creating a level playing field. It means that anyone going in to purchase tobacco knows that they will be treated the same whatever shop they go in to, which makes it easier for retailers and customers.
I was here when the smoke-free laws were being debated. There was a lot of opposition from the tobacco industry, which said those laws would be unenforceable, and that we could not stop people smoking in public places. Raising the age of sale by one year every year is a very incremental measure. Banning smoking in public places, and particularly in pubs and clubs—those of you who are old enough will remember just how smoky those places were—was a much more dramatic change. Despite that, we actually saw 98% compliance in England in the eight months after the legislation was implemented. Why? Because the measure was popular, just as this legislation is, and because it was underpinned by a good communication strategy, with clear signage in premises and guidance to business. That is what we need for this legislation. If we have that, I do not think there will be difficulties in enforcing the legislation. That is clearly what retailers think, too.
The Chair
Thank you. Finally, I call on Sheila Duffy. Unnecessary though it may seem, I ask each of our witnesses to state your name and title for the record—you could do it now, Sheila. The other two witnesses could do it later.
Sheila Duffy: Thank you, Sir George. My name is Sheila Duffy. I am the chief executive of ASH Scotland, which is one of four ASH organisations within the UK. We very much welcome this proposed legislation. These are strong and necessary measures. Tobacco is the most addictive lethal substance openly on sale, and these measures will incrementally clear tobacco from the shelves. However, it is a long-term measure. You cannot do just one thing with tobacco; we know that. You have to have a strategic, comprehensive programme of measures.
Circumstances in Scotland are different in some respects: our cessation services are in the health boards; we have a register for tobacco and vaping products; and we have fines for under-age sales. We in Scotland are particularly concerned about the huge rise in youth vaping, which has been driven particularly by the promotion and easy availability of cheap, brightly coloured, sweet-flavoured e-cigarettes. Moves are being made in Scotland—not, I hope, derailed by recent political changes—to end the sale of single-use disposable vapes, but we need to do more to create an environment that drives health for the next generation. Scotland committed to creating a generation free from tobacco in 2013, with an endgame target of 2034. I would urge you to introduce the strongest possible measures, close loopholes and resist the arguments and blandishments of multinational corporate industries whose interest is profit, not the health of your constituents.
The Chair
Thank you. I now intend to take two questions each from the Opposition spokesperson and the Minister. Given that we have very restricted time, I impress upon the witnesses that they need to be very brief in their answers.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
Q
Preet Kaur Gill
My second question is on the point that Sheila raised. Clause 61 gives the Secretary of State powers to regulate on packaging, vaping or nicotine products. Clause 62 makes regulations for the Secretary of State to have powers on substances that may be included and the flavour of vaping. Do you believe that the measures in the Bill to prevent vapes appealing to children are likely to work, and where can we learn lessons to ensure their effectiveness?
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
Do you want me to ask both questions now?
Dame Andrea Leadsom
Could you talk us through ASH’s assessment of the economic cost to the UK economy of smoking? Secondly, what is your view on the importance of restricting vaping for children?
The Chair
Can we start with Sheila Duffy, please?
Sheila Duffy: In terms of a complete ban, you are talking about a ban on retail distribution of tobacco. The hope is that we will put it out of sight and out of fashion for the generation growing up. My preference is always to look at the product and the industry, rather than the consumer, so we need to maintain other issues like good fiscal policy, high price and tax.
On packaging and flavours, we know that the tobacco industry sold the sizzle on tobacco—it sold the image, it sold how it made people feel and it sold the very short-term-felt attractions and benefits. In the 1950s, people were recommended smoking to appear glamorous, to appear rugged and confident and to clear their chests in tuberculosis hospitals, and we did not know at that time how devastatingly harmful it was to health and how many years of life it would rob people of.
We must learn the lessons. It is the sizzle. It is the packaging, the marketing, the promotions that we must get on top of with vaping products, because that has driven the interest among young people, and the exponential —the doubling, tripling of regular use among children that were not smoking. There is a link between regular vaping and moving on to smoking, which I can send you the evidence for.
In terms of the economic cost, the World Bank looked at this years ago. Tobacco is not good value for any economy because the long-term costs are huge. What you are talking about is privatising the profit but socialising the costs, and that is a huge burden on the NHS and a huge burden on people’s lives. It undermines their health and the health of their families.
The final question was on the importance of restricting e-cigarettes for children. Well, let us learn the lessons from tobacco and let us take some strong steps to stop the next generation becoming addicted. I note that the devices mainly being used under-age and by children are of the highest permitted nicotine level. They are advertised with bright colours—cartoon characters in some places. They are absolutely all over social media and there is money going into influencing. These are being targeted. We are not talking about medicinal use. We are talking about recreational products, which are addictive and health-harming. We have to get on top of this.
The Chair
In view of the pressure on time, I ask the two other witnesses, if they agree with what has already been said, to say so and then make any additional points that need to be made. Obviously, if you do not agree, that changes the nature of it.
Deborah Arnott: I agree with the points being made. On the costs of smoking, the Minister has cited our figures to date—thank you for that. We have done a lot of work on this. New figures will be published next week, so we will give an update on those and on what additional costs we think there are, other than the ones that have been taken into account by the Government so far. That will be available for the Committee, too.
Dame Andrea Leadsom
Q
Deborah Arnott: I would rather not summarise it now, but it will come very quickly and we can provide it to the Committee in advance of publication, so the Committee will get the full details.
The Chair
Thank you.
Deborah Arnott: I would like to go on to talk about Preet’s question about clauses 61 and 62, and I would also like to talk about clause 63, because they are the ones that are absolutely crucial to prevent vapes from appealing to children.
I do not know whether I am allowed to do this, but I will show the Committee these things. This is a completely reusable vape and this is a completely disposable vape. They look almost identical and they are the same price. The disposable vapes ban being implemented by DEFRA will get rid of disposable vapes—
The Chair
Can I interrupt you there? The rules do not allow the use of props.
Deborah Arnott: Okay, sorry. I will share them with Committee members afterwards.
The Chair
We will overlook the fact that you have already used them.
Deborah Arnott: Sorry—I apologise. But they are just as attractive and just as cheap. Children do not vape because they are disposable; they vape because they are cheap, attractive and available. That is what we have to address.
When it comes to flavours, clause 62 is quite a difficult clause to implement. That is why the clause says that the Secretary of State will have to specify in regulations
“how the flavour of a product is to be determined.”
This is not as easy as it sounds. The federal Government in Canada—Canada has probably the best-funded enforcement authority, in Health Canada, which has a whole directorate on tobacco and vapes—banned confectionary and dessert flavours in 2018. However, their regulations do not ban the flavours themselves; they just ban the descriptors, because that is the easy bit. They are still working on how to determine vape flavours and nearly six years on they have still not succeeded in doing so.
That has to be done with care, whereas clauses 61 and 63, which relate to product appearance, packaging and labelling, are much easier to implement and that work can be done much more quickly. Under these clauses, we could get rid of the bright colouring, cartoon-like imagery and promotional names such as those Caroline has mentioned—Unicorn Shake—or sweet names such as Gummy Bears or Banana Milkshake. Those are the things that we can get rid of easily. We need to work very carefully on the regulations to prohibit flavours to make sure that they are effective, but let us get rid of the descriptors now.
The Chair
Thank you. Michelle Mitchell—again, could you just make additional points that have not already been made?
Michelle Mitchell: I am Michelle Mitchell, chief executive of Cancer Research UK. I agree with the points that have been made. I will particularly respond to the question about age and potentially the postponement above 18.
The first thing that I will say is that two thirds of people die as a result of smoking. We cannot be complacent about smoking rates among younger people. Of course good progress has been made, but we cannot be complacent. We do not want to postpone people starting smoking; we want to prevent them from starting smoking. We have seen how addictive smoking is and we have seen the impact of previous increases in the age through legislation, with a 30% reduction in the number of people smoking previously between the ages of 16 and 18 when the legislation was introduced. I think that point stands strongly.
I have a prop, which I will not use, given the Chair’s views, but it would indicate, if I was allowed to use it, the tar that goes into somebody’s lungs just from smoking 10 cigarettes a day for one year. That creates damage for families, affects the productivity of the economy, impacts the NHS in a costly way and destroys lives. Strong legislation, applied with the recommendations around the legislation, is supported.
Rachael Maskell (York Central) (Lab/Co-op)
Q
Dr Johnson
I want to ask about the passive effect of vaping. We know that if you are proximal to someone vaping you can smell the blueberry flavour, or whatever it is. Do you have any evidence on the passive health effects of vapes?
The Chair
Could we start with Michelle Mitchell, please?
Michelle Mitchell: I think Deborah is going to pick up on vaping.
Deborah Arnott: Actually, I think that question is best put to Professor Ann McNeill, who you are seeing this afternoon. It is a really technical question and needs to be answered by a scientist. In principle, though, as Michelle has pointed out, what cigarette smoke has in it—tar, nicotine and carbon monoxide—is much more harmful than any passive effect from vaping. It may be unpleasant, with the flavours, but that is something else.
The Chair
Is that the settled view of all three of you?
Michelle Mitchell: Yes.
Sheila Duffy: I just want to add to it, please. Scotland already has legislation on the books, which was fully debated and passed in the Scottish Parliament in 2016. There are three final sets of regulations to be enabled, which would allow closing down displays of vaping products in shops, on billboards and on bus shelters; ending sponsorship, which speaks to the issue of local sports clubs and so on; and stopping free samples. Scotland has the powers in law to introduce those regulations. I would hope that the Scottish Parliament and Government would move ahead with that, because it is complementary to the measures being discussed here.
In terms of aerosol and heated tobacco product aerosol, there is conclusive evidence of aerosol particulate matter, which is similar to that which has been extensively researched for air pollution, so we could expect to see similar effects. There is specific research going on, I believe in Italy, on vapour and ultrafine particles, which move differently from larger particles. We can send you further information and background on that.
I will add that, much as I respect Ann McNeill, her background is in psychology, and you probably need to be looking at air quality research. There has been some work done on that, for which I will send you references.
Michelle Mitchell: We are also happy to provide a literature and evidence review of the leading science on this issue from around the world.
The Chair
Thank you. I will take two more questions, from Kirsten Oswald and Bob Blackman.
Kirsten Oswald (East Renfrewshire) (SNP)
Q
Bob Blackman
All three witnesses have given support for the Bill. You have already suggested one change that could be made in terms of age verification, similar to the system in Scotland. Are there any other changes that you think should be implemented that could make the Bill stronger? One of the concerns that many of us have is that we get only a limited number of chances to deal with this challenge in primary legislation, so we need to get in as much as we can to make sure that we achieve the smoke-free England that we all want to see.
The Chair
We have five minutes left and I do not think there will be time for any further questions. I may have missed it, but I am not sure whether anybody responded to Rachel Maskell’s points. In responding, could you cover those as well?
Deborah Arnott: Can I just confirm, Rachael, that your question was about public health messaging, restrictions and smoke-free laws?
Rachael Maskell
Including where people can vape, yes.
Deborah Arnott: To go to that one first, I think it is really important—the chief medical officer has said this too—to make the distinction between smoking and vaping. Smoke-free laws were implemented after very strong evidence about second-hand smoke causing lung cancer and heart disease. We do not have that for vaping. It is important that regulations are in place, and we are seeing that—you cannot vape on public transport or aeroplanes or in most workplaces, and that is fine—but making it legislative implies that it is equivalent to smoking.
On the point about displays and promotion, our surveys show that children are most aware of the promotion of vapes in store and online, and that is where the priority has to be in strengthening the legislation. Restrictions on how products are displayed, and the packaging and labelling stuff that we have already talked about, are really important.
In terms of additional measures, on the vaping side, there is one thing that I would say is vital. At the moment, clause 63 does not allow for a change in the product requirements set out in the Tobacco and Related Products Regulations, following on from the EU tobacco products directive, which was designed in 2013, over 10 years ago. We need the Government to have powers to change the general product requirements, not just ones related to branding, and that is the other amendment on vaping that I think is really important. There are other things, but I have possibly run out of time, so we can share those with the Committee separately.
The Chair
That would be helpful, thank you. We are up against the clock, but is there anything additional that either of the other two witnesses want to say very briefly?
Sheila Duffy: Thank you for your time. ASH Scotland supports an increasing European movement towards SAFE—smoke and aerosol-free environments—for the sake of health. I would say, on the evidence base on tobacco, that we have 100 years of scientific evidence, and it took 30 to 60 years to see the heaviest health impacts from tobacco. We should be more cautious about e-cigarettes as recreational products. The World Health Organisation, in its call to action in December last year, suggested that they should be carefully handled as cessation products, not as a whole-population approach. We would support ambient advertising and sponsorship being closed down. In terms of what further the UK Parliament could do, use the powers you have to regulate things like social media and be very aware of the massive commercial influences on thinking, which far outweigh any resource that small third-sector advocacy organisations can bring.
Michelle Mitchell: We need to keep our eye on the big prize. We have talked about the evidence and statistics relating to smoking. This would be a world-leading piece of legislation, and we urge you in Parliament to pass it in full with the scope recommended by the Government. I think you would be leaving an incredible legacy of health, wealth and a healthy country for future generations.
The Chair
Thank you very much. Apologies that it was all a bit rushed, but the nature of these things is that we have to use the time as effectively as possible. On behalf of the Committee, I thank the witnesses for their helpful evidence and guidance. We very much appreciate it.
Examination of Witnesses
Dr Charmaine Griffiths and Sarah Sleet gave evidence.
The Chair
We will now hear oral evidence from Dr Charmaine Griffiths, the chief executive of the British Heart Foundation, and Sarah Sleet, the chief executive officer of Asthma and Lung UK. We have until 10.40 am for this session. Could I ask the witnesses to introduce themselves and give their titles for the record? Then we will move into the questions.
Dr Griffiths: Good morning. My name is Dr Charmaine Griffiths and it is my privilege to be chief executive of the British Heart Foundation.
Sarah Sleet: My name is Sarah Sleet and I am the chief executive officer of Asthma and Lung UK.
Preet Kaur Gill
Q
The Chair
We will also take the Minister, and then we can answer both sets of questions together.
Dame Andrea Leadsom
I am also interested in the impact of smoking and vaping on children’s hearts and lungs in particular. I would very much appreciate hearing the professional assessment of you both of the particular vulnerability of children’s lungs and hearts, as compared with adults. I know that the Opposition spokesman and I share that grave concern, as do a number of colleagues. My second question is: do you expect the smoke-free generation policy to stop young people starting smoking?
The Chair
I do not know which order you want to take the questions in.
Dr Griffiths: I am happy for us to do a double act between us.
Thank you for such clear questions. In terms of inequality, we know that the burden of smoking falls unevenly. We have a third more smokers in the third most deprived areas, so it affects people’s health unequally. Heart disease is the world’s biggest killer, and there is absolutely no doubt that smoking is one of the major drivers of cardiovascular disease, so the picture is clear and very well established from an inequalities point of view.
In terms of young people, we share your concern at the British Heart Foundation. It scares me to think that, today, 350 young people will start smoking for the first time—and the same tomorrow and the day after, and the day after that. We know that a huge proportion of them go on to become long-term smokers. Tragically, we see the burden and the cost to life and quality of life that that causes, with about 15,000 deaths every year across the UK from heart and circulatory disease associated with tobacco. So, we are deeply worried about people starting, and it is not just us at the British Heart Foundation who are worried. We know that the majority of smokers wish they had never started, but nicotine is an incredibly addictive substance. Once people have started, it is incredibly difficult to stop, so we share your concern.
Just to cover two things on the biology, the way that smoking is so damaging to our hearts and circulatory system is manifold. It damages the lining of our circulatory system, causing our arteries to clog up with fatty deposits, which puts us at an incredibly high risk of heart attacks and strokes. We know that a smoker’s risk of having a heart attack is double that of someone who does not smoke. For stroke, the risk is three times greater, but if someone smokes 20 cigarettes a day, they are six times more likely to have a stroke. So, there is really clear evidence on the biology that smoking is damaging.
We are deeply worried about young people starting, which is where the power of this Bill comes in. What an opportunity to create, for the first time, a smoke-free generation, relieving tens or hundreds of thousands of people from the risk of death and disability from smoking. We, as the BHF, would urge for the Bill to be pushed through in full.
The Chair
Sarah, is there anything you wish to add to that?
Sarah Sleet: Yes, Asthma and Lung UK very much support this bill because the effect of smoking on lung disease is profound; it is deadly. Lung disease is the third biggest killer in the UK. Of the 100,000 people who die every year, 35% of those—more than a third—are, in effect, killed by smoking. Smoking is profoundly damaging to people, their children, and those who live around them. It is not just the person smoking who is profoundly affected; it is also the family living around them.
We know that smoking drives health inequalities and is also a cause of health inequalities. We know that smoking is responsible for half of the gap between those with the best and worst life expectancy. If you really want to tackle health inequalities, you need to tackle smoking as your first port of call. It is the biggest single driver of health inequalities. People with lung disease are most exposed to that health inequality. We really support driving this forward and support everything that the BHF have said.
The Chair
Thank you. Can Members of the Committee who want to ask a question indicate so.
Dame Andrea Leadsom
Q
Dr Griffiths: Thank you, and apologies if we did not cover that as clearly as we could have. Obviously, there is no such thing as a safe cigarette, there is no safe number of cigarettes to smoke, and there is no safe age to start smoking at all. We would emphasise our concern for children starting to smoke, because the damage starts as soon as you start smoking. There is no safe number of cigarettes to smoke. Combined with that, the fact that nicotine is so addictive that it leads to most people—over two thirds of those who start—becoming long-term smokers, worries us enormously. In terms of both the risk and the damage of starting smoking, the number of people who start and the fact that they go on to adopt a lifelong smoking habit caused by nicotine is of deep concern to us.
Sarah Sleet: It is worth thinking about children’s wider environment. Children who live in households where the adults smoke are four times more likely to smoke themselves, and find it much harder to give up. Children are getting into a cycle of deprivation and damage to their long-term health right from the very beginning. For children, stopping smoking availability is going to be profoundly helpful for their future lives, their ability to contribute to the economy and their overall prospects. This Bill, which tackles the issue from childhood up, will be one of the most profoundly important health interventions that you can make.
Preet Kaur Gill
Q
Dr Griffiths: As Deborah from ASH said, vapes are a fairly new product, so the research and evidence base, which we have in abundance for tobacco and smoking, is still forming for vaping. However, there are indications that it is not great for health. We are cautious and worried about the long-term implications. What we do know is that vaping can be an important cessation tool for those trying to quit smoking, and that many do want to quit, so we strongly encourage anything that stops smoking, but the people who are turning to vaping as an alternative to smoking for the first time is of deep concern to us. We do not understand the long-term health implications, but the addiction to nicotine deeply concerns us.
Sarah Sleet: We strongly agree. It is a very delicate balancing act between stopping the harm caused by smoking and looking to the long-term with regard to vaping. Quite clearly, smoking is far more damaging for adults and children. Anything that can steer people away from smoking will be healthier than continuing to smoke in the long run, but we do recognise that more attention and more research need to be put into vaping.
Rachael Maskell
Q
Sheila Duffy: As I said earlier, it is a delicate balancing act. We need to move people away from smoking, and anything that does that is a good thing, but we need to look at the long-term effects of vaping. The balancing act in the proposals around restricting access to vaping—making sure that nobody under-age gets access to vapes, denormalising them by taking them away behind the counter and so on—all of those are good measures to reduce the number of children moving on to vaping, but they need to be enforced. We need to make sure that we have the right enforcement action in place to make sure that that actually happens.
Dr Griffiths: You gave a great example of early science that causes us concern, and it perhaps will not surprise you to know that as a body that is based in science and evidence, we at the BHF take statistics incredibly seriously. We are worried that the body of evidence will grow. We would hugely support and welcome a position where vaping was available to people as a cessation tool, but absolutely would discourage anyone else from taking it up as a starting point for nicotine consumption.
Steve Tuckwell (Uxbridge and South Ruislip) (Con)
Q
Dr Griffiths: It has a huge impact, and thanks to some of the previous legislation there have been some improvements that we can measure and track with great certainty. Second-hand smoke is undoubtedly a cause of cardiovascular disease, and for those people unfortunate enough to be exposed to it, it is a serious issue. Just over 15 years ago, there was a study that looked at coronary heart disease and cardiovascular disease in men. It showed a significant uplift for those exposed to second-hand smoke on a regular basis that was roughly the equivalent in risk of smoking nine cigarettes a day. So there is a very clear basis for saying that second-hand smoke causes heart and circulatory disease.
Sarah Sleet: I would add the legislation on smoking in closed places—there was of course the legislation back in 2015 about children and smoking in cars—was based on very good evidence and was introduced for very good reasons. It proved to be a popular measure. Second-hand smoke in this context as well is an important additional factor to consider in terms of the harms balanced against the need to restrict these particular products.
Trudy Harrison (Copeland) (Con)
Q
Dr Griffiths: Not as much as we would like. That is the headline, but I do not think it will surprise any of us to know that people follow cues in their environment. That is partly what happens around them in their social environment, but I would like to draw attention to what happens in shops and convenience stores where people buy vapes. I was looking around my local convenience store, which is not far from a school, and thinking about today. It does not take a lot to look at what is happening behind the counter and see the packaging, the marketing and the highly, brightly coloured products that are clearly labelled, named and flavoured in a way to be attractive to children, whether it be cherry cola vapes or cotton candy vapes. They are things that are deliberately sweet and targeted at children, so it causes us great concern that that will be such a huge influence on so many children. We see that playing out in prevalence. I do not know if there is anything that you would add, Sarah.
Sarah Sleet: I think you are right that there is no real evidence base around this. That research should be done and we would very much like to look at. Where smoking is very prevalent—as you say, in more deprived areas—people take cues from the people around them in terms of their behaviour. I have no doubt that look to similar cues for vaping. Are people around them smoking? Is it easy to get hold of vapes? Is it completely normalised? I think we would find a very similar pattern, but we need to get that evidence.
Mary Kelly Foy (City of Durham) (Lab)
Q
Dr Griffiths: We would welcome anything that stops people smoking or beginning to vape as a starting point for their addiction to nicotine. Given the scale of the devastation that that has on people personally as well as on our NHS in terms of cost burden and all the other impacts that it has, we fully support the Bill going through in full as it is now. If there are opportunities and support for strengthening it, I am sure that we would welcome that too.
The majority of people across the UK support the Bill and would love to see a smoke-free generation. The fact that you have 51% of retailers supporting it also speaks to how powerful a moment it is. We should do anything that we can to strengthen the Bill and prevent it from being diluted. We know that the tobacco industry will be campaigning in the opposite direction to limit any restrictions that would reduce its success, so we are really mindful of that. We urge the Committee and everyone who can to protect the Bill from dilution. It can save and improve lives. It is potentially a transformative piece of legislation.
Sarah Sleet: We asked our supporters who was in favour of the Bill. Bearing in mind that many of our supporters may still be smoking or are ex-smokers, 84% supported the Bill and really wanted to see it come through. Daily on our helplines we hear people saying, “I wish I had never taken up smoking.” They are completely addicted and find it almost impossible to get out of smoking, and their health is being slowly degraded over time. They are having to come out of the workforce and retire early and potentially face death as well.
Kirsten Oswald
Q
Dr Griffiths: If the Committee is minded to strengthen anything that would prohibit people from starting vaping in the first instance, where they are not doing so as a cessation tool—I hope it is really clear that we believe that, as a cessation tool, this is a product that has its place that would help thousands of smokers give up and, ideally, prevent them from losing their quality of life or, tragically, their lives; I hope that is explicitly clear—I think that could have incredible impact. What we are worried about is people using vaping as a start and an entry point to nicotine. Nicotine is so highly addictive. You see that in the number of smokers who desperately want to give up. We have spoken to such people in abundance. Anything that helps us get to that point would be welcome.
Sarah Sleet: Nicotine, we know, is as addictive as heroin and cocaine. It is a terrible addiction. However, in terms of vaping, it is going to be quite tricky to get that balancing act right. We really need to have vaping as a cessation tool. We know it is more effective than just about anything else you can have in terms of cessation. For example, when it comes to flavouring, if you make that too difficult or make it problematic for people to switch, then there is a chance that we may have a real problem in terms of stopping smoking. On the other hand, we really do not want people to be attracted into vaping who have never smoked. I understand that that bit of the legislation is in secondary legislation and can be adapted over time; I think a lot of attention is going to need to be given to how people are actually responding and how they are behaving, and then adjusting that over time.
Angela Richardson (Guildford) (Con)
Q
Sarah Sleet: I believe that is the system in Australia—it is prescribed. I think it is a possibility. It needs to be well researched. Would it still encourage people who need to stop smoking to use it as a tool, or would it put a barrier up to using that tool? Before we move to that system, we would need some really good behavioural evidence that it is not going to be a further barrier for people. If it is not, then that could be a really good option.
Dame Andrea Leadsom
Q
Dr Griffiths: We support the Bill exactly as it is written at the moment. It is really important to recognise that, as proposed, it does not inhibit anybody who is currently a smoker from purchasing tobacco, but it does take us on a really clear and, I believe, a transformative path to a smoke-free generation.
Dame Andrea Leadsom
I understand that, but why?
Dr Griffiths: Because it is a really clear path to make sure that we move to a situation where we have a generation that is prohibited from buying cigarettes, and who are disincentivised from doing so.
Sarah Sleet: We have heard today the evidence about just how harmful and destructive smoking is, particularly for people in more deprived areas. If we really want to tackle that, we need to remove smoking as a normalised, available, legal option going forward. This seems to me a very measured and thoughtful way of introducing a smoking ban that will take hold. It is very important for our children going forward.
Preet Kaur Gill
Q
Dr Griffiths: I would observe that there is so much variation between products and how people are consuming them. I think it is quite difficult to give advice in a standard way, and that it is part of it being an emergent product and market. As we have discussed, there is no doubt that, with nicotine being so deeply addictive, it is an incredible worry that a child has a single puff on a vape, given the potency of nicotine and where we know it leads people, having seen that over generations with smoking.
I should perhaps take a moment to emphasise that we also really support the £70 million investment being allocated to public health campaigning and cessation services, as well as enforcement. You are right that we need to be really clear with the messaging of the Bill to encourage support from parents and others around children in particular. We really applaud the decision to put resourcing behind this as well. We know that effective public campaigning can be an incredibly powerful tool. We were really proud to run the “Give Up Before You Clog Up” fatty cigarette campaign way back 20 years ago, and we know even that campaign led to 14,000 smokers seeking to quit. We know public campaigning works, and it was a great thought to allocate that resource as part of this work—it will be needed.
Sarah Sleet: The variation in nicotine levels and the method of delivery, which affects the uptake of the nicotine, is undoubtedly very concerning in vapes. I am a mother of three adult children who all vape, and I am very concerned about how often they are doing that and what impact that is having. We must also remember that, from what we know at the moment, it would appear that smoking is far and away the most damaging activity, compared with vaping. There is a little bit of concern that we overemphasise the harms of vaping to the extent that people say, “Well, I might as well smoke then. I’ll do that instead.” We need to be very careful about how we have this conversation.
Dr Cameron
Q
Dr Griffiths: That is an interesting question, and I can see the clear linkage you have described, but I am not able to provide any evidence. I am very happy to go back and provide that as a follow-up.
Sarah Sleet: I am not aware of any evidence around that either.
Dr Griffiths: It is a great question.
Dr Johnson
Q
Sarah Sleet: We have heard anecdotally that people have had issues with being around vaping, but there is not any robust evidence as to whether it genuinely triggers asthma for some of those people. It is an area we want to look into a bit further, but I would say that here is a clear case of where the law is that children should not be vaping. We need to ensure that enforcement is in place, as far as possible, to prevent that from happening.
Dr Johnson
Q
Sarah Sleet: I am not aware of any serious evidence that has been gathered around this at this stage. It probably needs to be looked at.
The Chair
I thank the two witnesses for being not only concise, which enabled us to get through all the questions, but informative. I am sure we have benefited from the evidence you have given.
Examination of Witnesses
Matthew Shanks and Patrick Roach gave evidence.
The Chair
Q
Matthew Shanks: I am Matthew Shanks, the chair of the Secondary Headteacher Reference Group. I am also CEO of a MAT or multi-academy trust in Devon, Education South West.
Patrick Roach: Good morning. I am Patrick Roach. I am general secretary of NASUWT, the teachers’ union.
The Chair
We will move straight into the questions. Preet Kaur Gill will ask the first question, and then I will move to the Minister for her first question.
Preet Kaur Gill
Q
Matthew Shanks: It is an interesting question, whether vaping or smoking is more popular among children in schools. All I can say is that it has increased in the past three or four years. We see evidence of vaping; it is more difficult to catch children vaping, because of the size of the vapes, the fact that the smell is slightly different and does not set off smoke alarms in the same way, and so on. I think it is fair to say that smoking and vaping are still as popular as they were among younger children in certain areas, and vaping is being seen to be a safe alternative.
The marketing of vapes in different flavours and colours makes them akin to a progression from chewing gum for some families—with bubble gum flavours and so on. There is also anecdotal evidence of parents talking about, “If it’s grapefruit, it must be safe.” There is that evidence around it as well out there—because of the way in which vapes are marketed, and if you see them in shops, they seem safe and okay.
With behaviour, the size of vapes makes it very difficult to admonish children, because they can hide them very easily. They can look like mini hard drive sticks—I think that is deliberate targeting in how they are marketed, with the cleverness of it. Certainly in terms of behaviour, it is something else that we are dealing with, when we say to a child, a teenager, “You’ve been vaping”, but they say, “No, I haven’t”—there is nowhere for us then to go, which immediately sets up an issue.
The earlier question about toilets was interesting, because children tend to vape in toilets. It is easier for them to vape in toilets than it was for them to smoke in toilets. You just need to see people on public transport vaping—it is easy for it to dissipate and disappear quickly. So, yes, I would say that vaping is a real issue in schools for children.
Patrick Roach: I support fully what Matthew has just said. I do not think that it is an either/or; the reality is that smoking is a threat to children and young people, in terms of their health and wellbeing and their ability to participate and progress educationally, but so too is vaping.
The NASUWT, at the start of this academic year, published our own research into vaping in schools from the perspective of teachers and school leaders, and it very much reinforces what Matthew has just said, in that vaping is pretty much predominant as an activity taking place among secondary-aged pupils. But we are also seeing teachers reporting pupils vaping from as early as 10 years of age, so the primary phase is also impacted. Three quarters of teachers report a significant increase in the participation in vaping by pupils in their schools, so we are seeing an upward curve in respect of vaping activity within schools.
On the issues that have just been mentioned about the difficulty that schools have in detecting and controlling this kind of behaviour, the way in which vape products are available to pupils is that they are masquerading as hard drives, as highlighter sticks or as other things that it would be legitimate for a pupil to bring into school. This is not like a situation in which you catch a pupil with a packet of cigarettes and you confiscate it; first, you have to identify what on earth it is that that pupil has. At the end of the day, good order in schools is dependent upon there being trust and respectful relationships between teachers and students. You cannot go around every moment of every day asking pupils to turn out their pockets and then inspecting what is in them.
The reality is that we are seeing the impact of vaping not just on pupils’ health, because we are seeing pupils who are presenting as ill as a result of the overuse of vaping products—although, in fact, all of it is overuse—and therefore becoming ill in schools, but on educational participation, progression and achievement. When pupils are diving off into the toilets to vape, that interrupts teaching and learning. When pupils are late arriving at school, perhaps because they have been vaping en route, that impacts on pupils’ learning. We are also seeing bullying behaviours within schools because, quite often, vaping products are being informally circulated, exchanged or acquired. Therefore, it becomes another source of behavioural challenges for teachers and head teachers. So, from a teacher’s perspective, vaping is a serious issue within schools, and one that we are pleased that this Bill is seeking to address.
Dame Andrea Leadsom
Q
Could you therefore expand on that, in terms of the specific health impacts and, at the one end, the ability of children to concentrate on the class when they are spaced out on vapes, and, at the other end, the very real risk to children from doing something stupid with a vape that was entirely unintended, with disastrous consequences?
Patrick Roach: I very much appreciate your remarks about the research that the NASUWT has undertaken. We come at the problem of vaping from the point of view of our members in classrooms, in schools the length and breadth of the country. What do teachers need in order to be able to teach effectively and what do they believe that pupils need in order to learn effectively? They need good order in the classroom.
My perspective is not that of a medical practitioner or of someone wanting to assume that I have the knowledge about the impact of vaping on a child’s physical development. Our concern is the impact on a child’s educational development, participation and achievement. The reality is that everything you have mentioned there is absolutely right, whether it is about the way in which vaping products might be unintentionally used by pupils; or about how they seek to conceal them about their person; or, indeed, the drinking of vaping fluids, as if somehow that will get the high without necessarily being detected; or about the use of vaping products as a stimulant, which impacts not only on concentration but on behaviour and, indeed, on a child’s wellbeing in the classroom.
Matthew has already referenced the difficulty of detecting vapes sometimes, because they can dissipate very quickly; and they can also trigger fire alarms in schools. We have had plenty of examples of teachers and headteachers reporting that their school has had to evacuate the building not just on one or two occasions in a day but multiple times—five or six occasions. That is a loss of learning not just for one pupil or class of pupils but the entire school. We are really concerned about the impact of all that.
Teachers are not just concerned about a child’s educational development, though; they are also concerned about a child’s wellbeing in the round. Teachers are reporting the very damaging impact that vaping can have on a child’s mental and physical development, just as smoking can. That is one of the reasons we have spoken out—and we are pleased that the Government have responded—to say that we need to be doing more to strengthen the enforcement of rules around vaping, access to it and the availability for school-age pupils. We need to do as much as we possibly can to prevent any school-age pupil from getting access to vaping products, whether in or outside school. We are pleased that the Bill seeks to do just that.
Matthew Shanks: I absolutely echo and reinforce what Patrick has said. Also, as school leaders we are looking after teachers, but we are caring for families as well. The Bill will help families to understand that it is not okay for their children to vape. Anecdotally we have parents saying to us that they let children vape at home, because it is better than them smoking or being out on the streets; parents do not see the harm in it. It is really important that that is recognised. The banning of tobacco sale was interesting in terms of the prescription of it; I would posit that at the moment vaping is seen as safe by the general public.
Kirsten Oswald
Q
Matthew Shanks: I completely agree. The way in which vapes are marketed—the colours, flavours and so on—and the places where they are marketed suggest to people that they are safe. The fact that they are put forward as a “safe” alternative to cigarettes, the fact that parents use them and the fact that there are lots of colourful vape shops open in high streets: all those aspects promote the idea that vaping is okay.
At the same time, getting into a child’s mindset—we have all been there, as children—we like to break the rules and feel like we are pushing at boundaries. We know that it is not okay, but it is made okay. I would suggest that more children engage in vaping than in cigarette smoking, because they are not sure what the harmful effects are. That is the danger in it. I do think it leads on, because the younger children vape, but by the time they are 16 or 17, vaping might not be cool any more, so they go on to cigarettes or other things.
Anecdotally, we have heard of schools down in the south-west where people are putting cannabis into the vapes, so the addiction grows from that point of view as well. It leads to children coming out of lessons agitated. If I did not have three coffees in the morning, my agitation would be quite high. If children are not getting nicotine, as well as going through all the other things they are going through, they really do present as confrontational to staff, which makes it difficult to deal with them in classrooms and engage them in their learning. At the same time, to repeat a point I made earlier, you have parents at home who are saying, “Well, it’s okay to do.” I absolutely concur about the way it is marketed and so on.
Patrick Roach: To add to that, because those are important points: vape producers and manufacturers, and indeed those supplying vapes, are advertising freely in ways that make their products increasingly attractive to children and young people, with the way vapes are advertised and the marketing descriptors used for them. All the evidence we have, and certainly what our members tell us—our survey was of 4,000 teachers, so this is not anecdotal; it has an impact right across the system— suggests that the way those products are marketed and described deliberately seeks to entice young people to make use of them.
We believe that this is a strong Bill that very clearly sets out the societal expectations in this space, but as with any legislation, there is always scope for loopholes. If there are areas in the Bill where there is potential to further strengthen the legislation, I think the enticing way products are described, before an individual understands what they are getting themselves into, is something that needs to be considered and addressed.
From our point of view, it is about advertising, but it is also about access to these products. With the best will in the world, and no matter how they are advertised, if the products are easily available at the point of sale it makes things incredibly difficult. I remember that when I was bringing up my own children I worried about going to the supermarket with them, because they would be surrounded by candy and sweet products at the checkouts. You could not navigate your way through the checkouts. Thankfully, things have moved on: that has changed, and many parents are benefiting from those changes.
Young people are very much interacting with many of these products at the point of sale. They are in the shops that are in the vicinity of or on the route to and from school. They are being marketed in places that young people will frequent, whether that be a local café, the hairdressers or the barbers. They are in places where young people will be. They are also immediately available. The more we can do to stop the immediacy of marketing of these products and that easy availability, no matter how they are described, the better.
Dr Cameron
Q
Matthew Shanks: Absolutely: children will find any which way they can to do what they want to do. At the moment, while this is not illegal, they will gather more people to follow the crowd and go out. In my experience, the majority of children want to do as they are instructed—probably about 85%, anecdotally, over the years—but they will follow the herd. At the moment, there is a greater herd growing because of all the things we have talked about, with the marketing and colour of vapes. I can absolutely see children going out at lunchtime and spending their money on that, instead of on food. There is peer pressure to do that as well—it is taking more people with them. As Patrick said, you can see these products in the barbers, in the shops and so on.
Patrick Roach: To add to that, there are also bullying behaviours that manifest themselves. Whether a pupil is making the choice to go out at lunchtime to acquire vapes or is feeling coerced to do so, there is an issue either way. The availability of those products in the proximity of schools needs to be considered. That is a point that we would make.
Increasingly, schools have introduced systems to seek to ensure that children are being fed at lunch times, for example. We should not lose sight of that, but in some instances these products—particularly disposable vapes —are cheap as chips. I know that that is an issue of concern to the Government, and it is of concern to us and our members.
It is really important that we look at how we can ban the sale of disposable vapes entirely, because frankly no one knows what is in them, and they are incredibly cheap to acquire. Even if your parent can see what you had on Tuesday lunchtime because it comes up on their phone, how will they know if you have spent 10 minutes popping out to the local shop to acquire some vapes, particularly if they are of the disposable variety? More can be done not only to limit appeal, but to reduce the availability and accessibility of those products to young people. The more that can be done on that, the better.
The Chair
Four more people want to get in—actually, it has just gone up to five—and we have about 12 or 13 minutes left. It is unlikely that I will be able to get everybody in, but if Members put their questions as briefly as possible and witnesses respond as concisely as possible, I will try.
Rachael Maskell
Q
Matthew Shanks: Yes. I absolutely agree.
The Chair
That is really helpful.
Patrick Roach: I am not going to add to that, partly because I am here representing the interests of our members. The issue is about how we can control access to products, particularly illegal products, for school-age pupils. We therefore think that it is absolutely right that the Bill has identified the need to secure robust measures to protect the health and wellbeing of children and young people.
Bob Blackman
Q
Matthew Shanks: There are lots of campaigns that explain the harms of vaping and smoking. Sometimes people do not listen and do not engage with them. The only thing that I would say is that more people vape and smoke than take drugs, because drugs are illegal. If we are saying that tobacco is dangerous and harmful to people in our society, and our role is to protect them and educate them to see what is better, why is tobacco not illegal as well? Vaping started as an alternative to tobacco, but it is now catching on with young people. Is there a similar thing to be done with vapes? That is the view within schools on how we can help children to engage in what they should be doing at school, which is working at their education. There will be other things that have come along, but 15 years ago it was chewing gum everywhere—nicotine chewing gum was a big thing.
Patrick Roach: The reality is that schools are doing an awful lot to inform, to educate and indeed to regulate the conduct of children and young people, as well as to engage with parents and carers, but schools by themselves cannot change society. They can have a tremendous influence over wider society, but by themselves they cannot change it.
Anything that we can continue to do to educate young people about the harms and dangers of smoking and vaping, we should continue to do. Notwithstanding this legislation, that is essential, because no legislation is going to eliminate illegality. We have to continue to strive to eradicate those behaviours wherever they manifest themselves.
What other practical measures could the Bill include? I have mentioned the way in which vape products are described. We think that something could be done there. On availability—this is potentially outwith the scope of the Bill, but it could happen through other legislation and regulation—we think that the prohibition of disposable vapes is an issue that needs to be addressed.
There is also the issue of enforcement measures. There is no point in passing legislation if it is not enforced in practice. We need to ensure that the enforcement measures are absolutely robust. The proximity to schools of any retailer selling vaping products also needs to be looked at.
Mary Kelly Foy
Q
Matthew Shanks: That is happening at the moment within education, in curriculums and so on, but there is a lack of messaging around vaping, its harmful effects and its cheapness compared with tobacco. Even with the teaching of the harmful effects and the messaging compared with tobacco, there are still some families who smoke and you still see celebrities smoking. You are fighting that all the time.
It is good that we are educating young children about the harmful effects of things and the need to change, and we will continue to do that. We talk about big tobacco companies, big pharma, the global environment and so on, all within the curriculum.
Patrick Roach: The reality is that we need more space in the curriculum to do all that and to make the connections between vaping, the impact on a child’s health, and how these companies are profiteering, often from the most vulnerable. The producers of vaping products, the degradation of the environment, the way products are manufactured—all of this is very rich territory.
I would like to see more by way of permission for teachers and school leaders to engage with their pupils about the real everyday concerns that young people have. There should be more scope and space in the curriculum to do that. That is not to argue against the teaching of maths, science and languages; it is about saying that we want to produce well-rounded individuals. For us, that is the purpose of education. This is an area where educators have an important role to play.
Matthew Shanks: I would just add to that by encouraging you to visit your local schools and see what they are doing.
Angela Richardson
Q
Matthew Shanks: No, prior to now. This is very welcome, which is why we have both given our time because this is important. There was something in the papers this morning about evidence of harms of vaping for children, but it is not the headline; it is seven or eight pages in, so people will not read it.
I absolutely think that there should be more about the harm of vaping or just the unknown. You do not know necessarily what the dangers are, so therefore why would you engage in it? We talk a lot when we are doing drug prevention with children about—apologies if this offends—where the drugs come from, what the base of them is and what they contain. In the same way, you do not know what is in a disposable vape or another type of vape, so why would you put that in your body? Those are the lessons we are talking about, so we would certainly welcome more evidence to support that.
Patrick Roach: We know, from the feedback we have had from teachers as part of the research we have done, which includes both quantitative and qualitative feedback, that children are getting ill as a result of using vaping products. That is the daily reality that school leaders and teachers have to deal with.
The more that we can systematically collect and collate that data and evidence—whether that is a child who ended up being rushed into hospital because they became very ill on the school premises or, indeed, a near miss within the school—the better we will be. But the reality is, on an everyday basis, that teachers are experiencing this and having to deal with these issues and to intervene on and support pupils who are impacted physiologically by other harms of vaping products.
The Chair
A very brief final question from Dr Caroline Johnson. We have to finish at 10 past 11, so I ask the witnesses to bear that in mind.
Dr Johnson
Q
Matthew Shanks: A simple question to finish with—thank you! I think you can have both, because I would. If you look at the way cigarettes are marketed—behind a shelf with the pictures of the damage they cause—that is different from the way vapes are marketed, with their colourful packaging and excellent flavours that appeal to children. If you change the way they are marketed, you could have both, because you could still help adults with the flavourings but not make them appealing to children.
Patrick Roach: A simple answer: protect children from harm.
The Chair
I thank the witnesses for giving us a very particular perspective that we have not previously heard about on how all this impacts on teaching and the education sector in general. We are grateful for that, and I am sure the Committee found it helpful.
Examination of witness
Paul Farmer gave evidence.
The Chair
Q
Paul Farmer: Good morning, everyone. I am Paul Farmer and I am chief executive of Age UK, the charity supporting older people.
Preet Kaur Gill
Q
My second question is this. I know that over-65s are much less likely to smoke. I have a constituent, Eric, who has suffered from a stroke and has suffered with chronic obstructive pulmonary disease and is now a tobacco campaigner in his 80s. Why is this Bill important to the people Age UK works with?
Paul Farmer: Age UK fully supports the proposed legislation, and we have been working alongside the Richmond Group of Charities to highlight the significant health benefits of phasing out smoking, which will help individuals and have a wider impact on society. It will have particular benefits for the NHS, which as we know faces significant challenges at the moment.
Our job at Age UK is to think about not just the health and wellbeing of older people as they are now—I will come to your second question in a moment—but issues affecting future generations of older people. This is quite a rare opportunity for us to have a significant impact on those future generations for reasons we will look at later.
It is worth noting, however, that this Bill is heavily supported by older people. Polling shows that 69% of over-65s support it. Why is that? That goes to your second question. We know from older people and the work we are currently doing that health and wellbeing in later life is pretty much the top priority for older people. Age UK has recently published our blueprint for older people for the next few years, as we enter an election year. It is very clear from the work we have done with older people that health and wellbeing is right at the heart of what is most important for people.
Of course, that is logical: the ability to feel well, remain active and maintain our independence is a major determinant of the quality of life that we aspire to in later life. We also know that there is a huge gulf in life expectancy and life experiences between those who have the opportunity to age well and those who do not. I will not go into the points your earlier witnesses made about the importance of healthy life expectancy in detail, but that is right at the heart of older people’s considerations. It is important that we do something about the fact that healthy life expectancy for those who are most disadvantaged is quite so stark.
How does that affect smoking? As you know, smoking is a leading cause of death and disability. It is responsible for half the difference in healthy life expectancy between the most and the least affluent communities. People living in the areas with the lowest healthy life expectancy are 1.7 times more likely to smoke than those living in the highest healthy life expectancy areas. These are fundamental reasons why the intervention of this legislation will make a difference.
Dame Andrea Leadsom
Q
Could you give us a view, as an Age UK representative, of the sort of advice that older people who have smoked all their lives and are now bearing the brunt of the decisions they took would give to those who argue, “It’s a matter of personal choice. Everyone should be free to smoke if they want”? What would an older person say to that young person?
Paul Farmer: I think a lot of people would say that they wish they had never started. Those are certainly the conversations we have been having with older people in preparation for this session. The reason for that is that, as you enter into your later life, you start to understand the consequences of smoking through your personal experience. The list is frightening.
Dame Andrea Leadsom
Q
Paul Farmer: Very clearly, there is the relationship between smoking and multiple forms of cancer, COPD, pneumonia, heart disease, aortic aneurysm and stroke, vascular diseases, diabetes, rheumatoid arthritis, hip fracture, cataract and macular degeneration—and dementia. In a society where we are increasingly debating dementia’s impact, I think the relationship between smoking and dementia is a really important context.
These are in and of themselves very challenging physical health conditions, but we can also see the correlation with people who experience multiple long-term conditions. I think many older people who experience those multiple long-term conditions—who have to live with the impact of them often because they smoked in their early life—would say this impacts on the individual being able to do the things they want to do in their later life. There is a severe detriment on pursuing their ambitions of later life as a result of having smoked in earlier years.
Dame Andrea Leadsom
Q
Paul Farmer: I think different people will have different opinions about choice, and whether it was as a result of choice. I think what many older people have been telling us is that if they had known about the damaging consequences of smoking, they would not have started in the first place and would certainly have considered it in a greater way.
I want to pay huge tribute to colleagues at British Heart Foundation, who I know you have just heard from, who I think have taken the best way of trying to campaign over a long term on this issue. This is a long-term issue. Sadly today’s generation of older people is seeing the consequences of what has not happened.
Kirsten Oswald
Q
Paul Farmer: We work with people over the age of 50, which may be news to some of you here. One of the reasons why we have recently chosen to drop the age group that we increasingly work with is precisely for prevention and early intervention.
This is not the earliest intervention; you can, of course, argue that many health interventions need to take place among children and younger people. However, from an Age UK point of view, we know that there is potential to intervene in people’s lives and support them to live healthier lives—it is not just about health, but in this context it is mainly about health—which means that your healthy life expectancy can improve and, as I mentioned earlier, you can fulfil some of the ambitions of your later life. The burden on the NHS of unhealthy life expectancy is a big issue.
The bulk of our direct work is with people over pensionable age, if you like. In each of those generations, you see the differences in experiences of smoking. Somebody now in their 80s or 90s almost certainly will not be alive if they are a heavier smoker, because they probably will not have benefited from any of the public health information that has taken place under previous Governments, so that is obviously the major difference.
In terms of the different health conditions, we know that certain health conditions will increase with age. Dementia is the greatest example of that, where we know that the older you are, the more likely you are to develop dementia. In a sense, as our population as a whole has gotten healthier and lived longer, it has become increasingly apparent where those health inequalities are at their most acute.
The Chair
I will attempt one final question from Dr Lisa Cameron. I simply make the point that the briefer the question, the more possibility there is that she will get an answer.
Dr Cameron
Q
Paul Farmer: I think a lot of people made a choice without having the information in front of them. I suppose my parting thought to this Committee is that the consequences of failing to intervene in previous generations are now seen by the older people of today. If this legislation is implemented, the first generation of people will not reach 65 until 2074, but I can tell you that that generation of 65-year-olds will look back and recognise the contribution that the Government have made to changing and impacting on their long-term health in the same way that this generation looks back on the contribution of other Governments in other health initiatives.
The Chair
I thank the witness for his answers to the questions from Members, which were really helpful. They gave us not only the perspective of those who his organisation represents, but the intergenerational nature of their role in the world. That brings us to the end of this morning’s sitting. The Committee will meet again at 2 pm here in the Boothroyd room to continue taking oral evidence.
Ordered, That further consideration be now adjourned. —(Aaron Bell.)
Tobacco and Vapes Bill (Second sitting)
Tuesday 30th April 2024
(1 week, 2 days ago)
Public Bill CommitteesRead Full debate Tobacco and Vapes Bill 2023-24 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 30 April 2024 - (30 Apr 2024)
The Chair
We will now hear from Councillor David Fothergill, deputy chair of the Local Government Association, and Greg Fell, president of the Association of Directors of Public Health. We have until 2.30 pm for this session. I ask the witnesses to introduce themselves for the record—I do not really need opening statements, because we will have plenty of questions for you, but if you want to add a sentence to your introduction, I will not object.
Cllr Fothergill: Thank you for the invite this afternoon to speak on behalf of the Local Government Association, which speaks for all councils across England and Wales. I will present a combined view to you. I am chair of the community wellbeing board, the lead policy board, which is responsible for adult social care and health matters. I am delighted to be here. On the whole, we are supportive of the Bill, and that will be the thrust of the evidence I give.
Greg Fell: I, too, thank the Committee. I am Greg Fell, director of public health in Sheffield and president of the UK Association of Directors of Public Health, thus representing DPH. Similarly, all DPH strongly support the Bill—I have yet to find a public health professional who does not, as I do not think that one exists, particularly on the smoking elements. No other product is as uniquely dangerous as smoking; we strongly support both the smoking and vaping elements of the Bill. I look forward to talking more.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
Q
Cllr Fothergill: Our view is that enforcement is key to the success of the legislation, and enforcement has to be through trading standards. Over the past few years, trading standards has had a number of reductions in its budget and cuts, as well as a restriction on the number of people being trained to come through in this area. We believe that we need clarity from the Government as to what the responsibilities for trading standards will be, and we need clarity about the funding that will be allocated. We also want to see an apprenticeship fund set aside for the training of new trading standards officers to come through. We need a longer-term view of trading standards. It is worth noting that trading standards is responsible for enforcing more than 300 pieces of legislation, so this is just another one, but it will add strain unless we get those clear responsibilities, clearer funding and apprenticeship levy put aside for the future.
Greg Fell: I agree with all those points. There has definitely been a reduction in funding for trading standards over the years. It still exists—many local authorities spend quite heavily on trading standards—and it makes a difference. Enforcement against illegal vapes and tobacco is a clear example. Our trading standards team in Sheffield regularly confiscate very large quantities of illegal tobacco, which we know are linked to organised crime. Trading standards still exists and it does make a difference, but to make the Bill—hopefully Act—as successful as possible, we will need to invest sustainably in trading standards and other enforcement.
Preet Kaur Gill
Q
Cllr Fothergill: We fully support the local penalty notice being issued by the councils. We believe that that is the right way to go and that it will not clog the courts, but there is always the option to refer to the magistrates court if required. Our big concern is the size of the fine, which we believe needs to be reviewed: £100 or, if paid within 14 days, £50 is hardly a penalty. We argue that we need to have greater opportunity to fine those in contravention of the law. Then, we believe, there would be less and less need for the Secretary of State to be involved. The reason he or she would need to be involved is if we cannot contain it—because we cannot issue enough penalty notices to contain it locally.
Greg Fell: A similar issue would be multi-local authority enforcement scenarios. We know that organised crime networks are not linked to an individual area, so it stands to reason that there will be a need for enforcement that cuts across many authority areas, hence there is a need for networked trading standards. That might also include, possibly, the borders—stopping the imports of illegal vapes and tobacco.
Additionally, as Councillor Fothergill said, we are concerned about the size of the fine. Certainly I hear through DPH parochially, who talk to their trading standards and licensing teams, that when there is a much larger fine that may or may not be linked to the removal of an alcohol licence, that will make a retailer really sit up and think.
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
Q
Cllr Fothergill: Certainly. Although we fully support the Bill, we think there could be one or two changes, which I have already referred to—we would like to see amendments—and there is the option of a licensing scheme, which we would support. If it was done on a similar basis to liquor licensing, we would be able to enforce that, because it would be backed by legislation. Of course, we would need to make sure that trading standards were fully funded for that. We would support that, if it was something that the Government brought forward.
Greg Fell: I cannot speak for the LGA’s position; ADPH does not have a formal view on licensing. I would broadly support it, but there is a danger that putting that into the mix delays getting the Bill through Parliament and turned into an Act, and getting the Bill through Parliament is arguably the most important thing.
I would broadly support that, but I come back to the complexity. Vapes are sold in hairdressers and beauty parlours and so on, so we would need to think it through. Arguably, if we are going to get into a licensing scheme, that should be for tobacco and nicotine-containing products, not just vapes; I would personally go to tobacco as well. Critically, the resourcing to make it work properly would need some very careful thought and consideration. All of that would need to be in the mix, but broadly I would support it, with those caveats.
Dame Andrea Leadsom
Q
Cllr Fothergill: Specifically on vaping, we support the move to plain packaging, moving them away from the counter and restricting flavours—we support all those things. I have to say that we recognise the role of vaping in helping people to give up smoking, but where children and younger people are involved, we want to move the vapes away and make them less accessible. Trading standards will enforce that, as long as there are clear definitions of what can be sold, where it can be sold and who it can be sold to. A lot of the work that they do is evidence-led, so they will work on people who are giving them tip-offs or where they are seeing that there is a trend in an area where those products are being sold. As long as we are resourced and we recognise that a lot of that evidence-led work is required, it is entirely achievable.
Greg Fell: I have a fairly similar view. Largely, trading standards do this work now. The easier and simpler we can make it, and the more we make sure that it is resourced appropriately, the better, but they largely do this job now pretty well.
Rachael Maskell (York Central) (Lab/Co-op)
Q
Greg Fell: Hopefully only illegal vapes contain cannabis or Spice, and not legally produced ones—I sincerely hope that is the case. I have mixed views on vaping in public. I think that Prof McNeill will talk later this afternoon. It is worth reading her evidence review for the Office for Health Improvement and Disparities, which has a whole chapter on the passive inhalation of vapes. The ADPH does not have an official position on the passive inhalation of vapes, but my personal view is that in open spaces I am not too worried about it. In enclosed spaces, I might be, particularly for people who have pre-existing respiratory conditions, but I do not think that the evidence supports it being as big an issue as people think. However, that is definitely a question for Prof McNeill, who is the expert on such matters.
Steve Tuckwell (Uxbridge and South Ruislip) (Con)
Q
Cllr Fothergill: I have already said that we believe the amount of the fine needs to be reviewed. We believe it is right to do it by a local penalty notice, which is issued locally and can be enforced. We do not believe that £100, reduced to £50 if it is paid within 14 days, is sufficient. It will not have the effect that it needs to have and it should be reviewed.
We are also keen, as part of the Bill, for a review of whether we should be brought into line with Scotland on age verification. Scotland has very clear guidelines that legally, people have to produce identification that they are of an age to buy, and we think this is an opportunity for us to bring that in as well. There are two things where we would like to see enforcement strengthened: mandatory age verification and an increase to local penalty notices.
Nickie Aiken (Cities of London and Westminster) (Con)
Q
Greg Fell: I would say that we need a licensing scheme for shisha smoking, and probably more education about the fact that it is a potent way to consume large amounts of tobacco really quickly and is quite damaging for people’s lungs. I am not sure what more could be achieved in the Bill, but I would like to see a licensing scheme for shisha bars. We enforce the law to its limits, but there are some limits to it.
Bob Blackman (Harrow East) (Con)
Q
Cllr Fothergill: It is not a topic that we have a policy position on, but my personal view is that it would need to be a separate scheme, because it would have separate enforcement and separate legalities within it. It needs to be very clear for trading standards what they are enforcing against, whereas alcohol is quite different. We should not mix the two just because they both need licensing. I think that they need to be separate.
Bob Blackman
Q
Cllr Fothergill: I could not answer that one, I am afraid, but I would be happy to come back to you with a view on that.
Greg Fell: I have the same view. It is not my area of expertise so I would rather think about that one carefully.
Mary Kelly Foy (City of Durham) (Lab)
Q
Greg Fell: It is the single biggest cause of death. There is no real question about that. It may not be in many years’ time when smoking prevalence has come down, but right here, right now, it is. No other product is available that kills more than half its users when used according to the manufacturer’s instructions. Death is often preceded by a long illness—sometimes a short illness, but often a long one—often in folk of working age. Most people who die from smoking-related illnesses die too early.
Sheffield-wise—I know my numbers locally—it is a bit north of 700 deaths a year out of 5,000 or so, so not insignificant. To give you a reference, covid killed 1,500 people over the period of the pandemic. Smoking kills 700 people every year, year on year, and that is before we get into the illnesses. Aggregated across the country, that is 80,000-odd people—a Wembley stadium-sized group of people, a non-trivial number. It is also very inequitable and led by addiction. People spend enormous amounts of money on smoking, so stopping smoking would free up that money to be spent in other ways. Smoking remains the No. 1 cause of death and it is very inequitable—almost certainly causing the largest gap in healthy life expectancy and life expectancy inequality.
Mary Kelly Foy
David, do you want to add anything?
Cllr Fothergill: I think Greg summed that up perfectly.
Preet Kaur Gill
Q
Greg Fell: Years and years ago, the narrative was about raising the age of sale to 21, but I think the evidence has shifted. I hear from a number of stakeholders and sources that the tobacco industry is targeting its public relations at slightly older young people—the 18 to 25 age group. If you were to stop at 21, the tobacco industry would just change its marketing and you would therefore get a new target group recruited into smoking. Nobody thinks that that is a good idea, so the evidence is shifting.
The ban sets a really important norm. We can all remember walking out of a pub smelling of cigarettes. We cannot imagine that now, so continually shifting the norm changes population behaviour just by norm shifting, which is important and often underplayed. I would support the lifting lid—I think that is the right phrase.
Cllr Fothergill: I think Greg is absolutely right. At the LGA, we support the progressive lifting of the age as opposed to raising it to 21. We think that is the right way to go. It will then move through the population over a number of years rather than just being static at a single point.
Kirsten Oswald (East Renfrewshire) (SNP)
Q
Greg Fell: Yes, in part, in terms of the measures in the Bill. I would treat vapes like I would treat cigarettes in terms of colours and marketing, with plain packs out of sight behind the counter and strongly enforced. I would take care, though: we use and want to continue to use vapes as a route out of smoking cigarettes, so getting the balance right remains important, but I would be quite aggressive about the regulation and the deterrent.
Education in schools by itself will not be sufficient. It might or might not be effective, but it will not be sufficient. Action on Smoking and Health has co-produced with a number of local authorities a range of resource packs for parents, teachers and others, which are fairly widely used, but they are not sufficient by themselves to stop the rise in young people vaping, so we need strong regulation with the enforcement of that to boot.
Cllr Fothergill: It is not part of this Bill, but it is part of LGA policy that we would like to see a ban on disposable vapes. There are 5 million sold every week, with the vast majority sold to younger people. The vast majority are thrown away. Those that are thrown away responsibly finish up in one of our recycling lorries where the lithium batteries cause major problems with fires. It is not part of this legislation, but we think that that needs to be tackled separately; I think it will be.
Greg Fell: One point that I just remembered on the resource pack that has been widely circulated to headteachers and schools: a line was taken in that to tell the truth—not to over-egg the pudding but to tell the truth and say what we do and do not know, because in my experience scaring kids usually switches them on to something rather than turning them off something. In the pack, we have also told the truth about the methods and tactics that the tobacco industry has used to get kids hooked on vapes, and that as a rule makes kids pretty angry. It certainly makes parents pretty angry when they realise what has happened.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Q
Greg Fell: Agreed.
Dr Johnson
Q
Greg Fell: Possibly. I would need to go back to the science and have a really careful look at it. There is the danger of unintended consequences and turning people away from vaping as a route out of smoking. Outdoors it is not a thing; indoors—for me, it is a carefully balanced thing and I would want to go back to read the science. It is a while since I have read it, to be fair.
Dr Johnson
Q
Greg Fell: I am thinking of my logic now, and would agree. What I would not want is for somebody to not switch from smoking tobacco to vaping because they fear they would not be able to vape in a pub. That would be the unintended consequence I would try to avoid.
Rachael Maskell
Q
Greg Fell: I do not know that there is a lot of evidence on the gateway effect of switching from vaping to smoking. Again, there are proper experts, some of whom are sitting behind me. It might be something that you want to test them on later, but I do not know that there is lots of evidence of that. Nobody thinks it would be a good thing to do. I think it is fair to say that there is widespread misunderstanding, and occasionally misinformation, about the dangers of vaping in much of the popular press. When we read a study about immensely high doses of vape in the lungs of mice, that leads to awfully lurid headlines, and that causes people to have misunderstandings and misinformation about the relative risks and benefits of vaping compared with smoking. Sadly, I cannot stop that, but it is a problem and I do not think there is an easy solution, because the media like to publish good headlines. I get that; I understand it, but it often skews us away from what the science is actually telling us.
Bob Blackman
Q
Greg Fell: I do not have a view, Bob.
Bob Blackman
You do not? I am surprised.
Greg Fell: I do not think it is a terribly sensible thing to do. I do not think it would be possible to get it into this Bill. How one would regulate it I do not know. I shall give some consideration to that and get back to the Committee.
Bob Blackman
That would be helpful.
Cllr Fothergill: Again, from our perspective, it is not an area that we have looked at in terms of policy. We do have a policy on shisha, but we have not gone as far as the product you have just mentioned. But we will, I am sure.
Dame Andrea Leadsom
Q
Cllr Fothergill: We have to be very careful that we do not spook ourselves out of doing something that is absolutely right. If people get to the age of 40 and have to show that they are 40 to be able to buy cigarettes, that is what they should do. I am sorry to say that I am 67. I have to show a bus pass every time I get on a bus to show that I am old enough to travel for free.
The Chair
You don’t look it.
Cllr Fothergill: Thank you very much—I’ll take that.
At every stage in life, you are asked for verification, and this is just another time. It should not stop us from doing the right thing and moving the age up so that we eventually achieve a smoke-free population.
Greg Fell: It is a long time since I have been asked my age. It may throw up some tricky moments, but as Councillor Fothergill said, let’s not stop ourselves doing the right thing here. I think most people agree that it is broadly the right thing. The Bill itself is massively important for norm-setting. Even if the norm-setting achieves half of the goal, thousands of lives will still be saved.
The Chair
Greg, before I bring Andrea in again, you do not look 67 either. I want to get that on the record.
Greg Fell: Not a day over 25, Chair.
Dame Andrea Leadsom
Q
The additional things—heated tobacco, shisha and so on—that come under this legislation include cigarette papers. We all know that they can be used for rolling joints and other purposes, and that cigarette papers contain carcinogens. However, some have quite a strong desire to exclude them—I do not know why. What is the view of the LGA and ADPH on that point?
Cllr Fothergill: We believe that the scope of the Bill as it is currently written is right, and that is what we would support. We would not want to see anything excluded. Every time there is a change to smoking legislation, we hear the argument that it will increase the amount of illicit trade coming into the country. That is not a reason not to do it. It is our responsibility as trading standards to enforce, and although people always use that argument, we have to do the right thing and enforce by properly funding trading standards.
Greg Fell: If I had £1 for every time I have heard the illicit trade argument, neither of us would be here. The heat-not-burn—the clue is in the title—is a tobacco product, and I would treat it like a tobacco product. It may be safer than burned tobacco—we do not know. I would like to see some independent research. However, I would not delay the Bill until I see independent research. I would personally argue to not allow exclusions. It may seem much harder to enforce, but there will already be some tricky points in enforcement; we already know that we need to resource that properly. I would keep the simplicity and not allow exclusions.
The Chair
We have two minutes left. Is anyone burning to ask the last question? We have had very clear evidence and it has been an excellent session, but is anyone sitting on a question they have not yet asked?
Angela Richardson (Guildford) (Con)
Q
Greg Fell: Again, without wanting to take the fifth amendment, that is a question for some of the experts behind me, who will give you a full view based on the science. We are 20 years into vaping now—we would probably have started to see significant amounts of vaping-related harm. Cases can always be found of somebody who has terrible lung damage as a result of vaping, but they are usually the exception rather than the rule. The comparator is always tobacco smoke: is it safer than tobacco smoke on the basis of all the science that we know, 20-odd years in? Yes, unequivocally. Is it safer than fresh air? No—hence we do not recommend that people who do not smoke start vaping. As the chief medical officer has said repeatedly, the tobacco industry marketing vapes to kids is completely unacceptable. I am happy—hand on heart, I can say that ADPH pretty much follows the line that it is a route out of tobacco smoking, as we know that smoking kills half of its customers or more. Should the science change in another 10 years, then we would change our view, but on the basis of the evidence we have now, I am happy that we have got the right position.
The Chair
Thank you very much, David and Greg, for an excellent session with some very clear evidence.
Examination of Witness
Ailsa Rutter gave evidence.
The Chair
We now move on to our next witness, Ailsa Rutter, who is the director of Fresh and Balance North East. I am looking forward to find out what that is. We have 20 minutes for this session. Ailsa, could you kindly introduce yourself for the record? By all means, add some more if you wish to, but the Committee will have plenty of questions for you.
Ailsa Rutter: Thank you so much. I am absolutely privileged to be here with you this afternoon, speaking on behalf of the north-east and the many partners in the region who will give you their overwhelming support for this absolutely crucial, complete once-in-a-lifetime opportunity to have the single biggest impact in addressing the biggest cause of cancer. For those of you who might not know what Fresh and Balance is, we are a regional tobacco and alcohol programme based in the north-east of England. We have been going for 20 years, we are funded by our local authorities and our NHS trusts, and we are doing a lot of work to drive down the harms on both tobacco and alcohol.
Preet Kaur Gill
Q
Ailsa Rutter: Tobacco is devastating. It is devastating to every individual who dies way too young, and to the family who lose their loved one. In my region alone, just since the turn of the millennium, 120,000 of our loved ones have died from smoking. It is not an adult choice, but a childhood addiction. The vast majority of those smokers reach a point where they deeply regret having got hooked in childhood, not thinking that first puff on a cigarette would be so addictive. It is really important that we remember the 6.4 million remaining smokers in the UK and the fact that 350 18 to 24-year-olds will get hooked on lethal tobacco smoking today.
I would like the Committee to imagine that cigarettes did not exist. It is 2024, and here we are discussing a product that is designed to hook, kill, maim, and be completely addictive. This discussion today needs to be about the future world we want to strive for. We can talk a lot about how we will enforce it, which is very important, but for me this is about imagining that in 20 years’ time we have created an entire new generation protected from this uniquely lethal product. That is why in the north-east, all 12 local authorities, all 10 NHS trusts, our integrated care board—the biggest in the country—and our Association of Directors of Public Health have given whole-hearted, unanimous support to the “stopping the start” proposal on the age of sale of tobacco.
We absolutely recognise that smoking is much more harmful than vaping, but vaping is not risk-free. Vaping is playing a pivotal role in our region—with our higher levels of deprivation and addiction—to get people off lethal smoking, but that is not to say that we do not absolutely agree that much more needs to be done to reduce the appeal of vaping to young people. We wholeheartedly believe that we must address the inappropriate packaging that is too youth-friendly. Some of the in-store promotions are completely inappropriate, where children are really noticing it. We must ensure that we recognise that children are growing up within a family context; children do not live in isolation. There is also the importance in our region of sending clear, evidenced-based messaging. We can also see the positive impact on children’s health if we can get the parents and carers off lethal tobacco smoking and if we can reduce second-hand smoke harm. Really important as well is more money in people’s pockets, because cigarette smoking has such a negative effect on your income.
Dame Andrea Leadsom
Q
As you will know, rates of smoking during pregnancy in the north-east are some of the highest in the country. Do you think this legislation will help to reduce those very high numbers? The rate is somewhere in the region of 14% in the north-east.
Ailsa Rutter: We have made really good progress in the north-east in reducing maternal smoking; that has come through very good collaboration between our local maternity services and our local authorities, as well as the fantastic leadership from key people in the local maternity and neonatal system, the LMNS, and the direction from directors of public health.
As with anything, there is not one magic solution; it is about taking comprehensive measures. The tobacco age of sale increase will undoubtedly have a really positive impact on reducing maternal smoking. It needs to be coupled with important things that we must continue to do as well, so we also welcome the increased investment for stop-smoking services.
We hugely welcome—thank you—the reinvestment in the evidence-based health harms campaigns. We are thrilled that nationally you are using our fantastic “smoking survivors” TV advert featuring Sue Mountain. The role of financial incentives is also really important; we know that they have a very strong evidence base. This will have a positive impact on maternal smoking.
Nickie Aiken
Q
Ailsa Rutter: Gosh! There are already some fantastic elements in the Bill. The key thing for me is to make sure that we can get the Bill through—particularly the focus on tobacco. It is really good to think that there is going to be subsequent consultation on the important elements around vaping. Factoring in what colleagues said previously, we need a simple mandatory age verification scheme. That is already in place in Scotland, and I would certainly welcome its introduction in England.
Trudy Harrison (Copeland) (Con)
Q
Ailsa Rutter: I think we are doing some really good work in the north-east but I absolutely think that this Bill is required. I go back to the uniquely lethal nature of tobacco smoking; that is the one key argument that we need to think about. This is guaranteed to kill. For me, this is about a societal shift.
I am really pleased with the huge shift in the north-east on the social norms of smoking. We talk to people who smoke every single day, and you have their backing because they desperately do not want their own children to fall into the same trap. As I mentioned before, this is about aspiring into the future. We are all conscious of the pressure and strain on our NHS. Think about the impact—one in four beds in the north-east and elsewhere with somebody suffering from a smoking-related condition. I think our NHS colleagues in particular really welcome this.
There is another important aspect when it comes to the economic costs. We all get the healthcare costs and we also really understand the strain on social care, but actually it is business that bears the brunt of this. That can surprise people. It is about the lost productivity and people having to retire early and dying early. I would like to think about who these people are. I have mentioned the pivotal role of Sue Mountain and the showing of her TV advert, but so many other people have come forward who sadly were diagnosed in their late 40s—women in the north-east who are desperate to tell their stories. Cathy Hunt, diagnosed with lung cancer at 49; Claire Oldfield, diagnosed with lung cancer at 49. Their real appeal to you today is to think about taking this seismic leap forward and about the leadership the UK can show globally by recognising that smoking had a beginning and a middle, and it is down to us to say that it can have an end.
Mary Kelly Foy
Q
Ailsa Rutter: I think we are really fortunate in the UK. The UK has shown great leadership by commissioning evidence-based reviews that are completely independent of Government; we have had eight of those now since 2014. That has been incredibly important. Fresh is not complacent. We have been monitoring the evidence around the rise in vaping and how this is positioned in terms of public health for the last 20 years—since we were set up. I would strongly recommend that many of the really useful questions we have had today could be answered by looking at those systematic reviews from the Office for Health Improvement and Disparities. In particular, when people say, “We don’t know what’s in vaping,” there is a significant chapter on the constituent chemicals and so on in vaping, and the magnitude of potential harm.
I have forgotten the second bit of your question, Mary.
Mary Kelly Foy
It was about the use of vapes by heavily dependent smokers.
Ailsa Rutter: Yes. In the north-east, vapes have been a “game changer” for some of our heavily addicted smokers. I have permission to share with you the fantastic role that vapes have played in our biggest mental health trust, Cumbria, Northumberland, Tyne and Wear. We are talking about people who have been smoking 40 or 50 cigarettes a day, often for decades, who have really struggled to imagine that they could ever get off lethal smoking. Being able to give them something that still gives them their nicotine, but in a much purer, safer and cleaner form, has been a game changer.
Vapes are being used successfully in our drug and alcohol treatment services—on the point about alcohol, the two often go hand in hand. If we are really intent on ending smoking, we must do more on alcohol. Wearing my Balance hat—Balance is the alcohol bit—it is really important that we do not think of risk-taking behaviour in youth as just vaping. Last week, the World Health Organisation published a report that shows that across 44 countries, the UK sadly has the highest use of alcohol among 11-year-olds. I hope nobody thinks that the amount of alcohol promotion, advertising, marketing and so on is okay. I think it is quite important that we look at risk-taking behaviours in the round.
Bob Blackman
Q
Ailsa Rutter: That is a really good point. I think it goes back to not wanting to delay the progress of the Bill. It is not necessarily for legislation, but it is important that we have a very clear communications strategy. Reflecting on previous legislation, much of the high levels of compliance we have seen in this country have come from very proactive communications in advance. We need to be really careful that the narrative does not get overly confused. It worries me enormously that too many people are staying on smoking because they are scared of even trying to switch over to a significantly less harmful product. I worry enormously about scaring people. It is absolutely right that we have evidence-based messaging to children and young people, but they are messengers who go back to their parents, and we know that it is very important that they are sending clear messages back. So, I will defer on your question about additional amendment—sorry.
Bob Blackman
Q
Ailsa Rutter: I absolutely would. Fresh has been advocating a tobacco licensing scheme for many years. I do not know whether it is in the parameters of the Bill, but it is wrong that anybody can set up their car boot and sell a lethal consumer product. I would also strongly recommend that previous consultations on things such as pack inserts are looked at again: there is a strong rationale for that. Canada is leading the way with a clear message on the cigarette stick itself. Those are called dissuasive cigarettes. There are certainly other things within that realm. I would also be really willing in the future to discuss the role of a “polluter pays” levy; that is something worth considering.
The Chair
Thank you. There are four minutes left and three people have already caught my eye, so short questions and short answers please, colleagues.
Mary Glindon (North Tyneside) (Lab)
Q
Ailsa Rutter: We have a really good track record over the last two decades of collaboration and cross-party working, with fantastic support from civil society, the NHS and local authorities. The previous legislation has gone through really well, overall, because we have worked together to build up public awareness and support. It is really important that we have adequate resourcing for our important professional groups, such as trading standards.
For me, it is about the communication, the vision and the narrative that we can set. Undoubtedly, if we can get this through, it will not just stop a whole new generation starting; we also know that it will trigger many people to think, “You know what? I am going to give it another go. I am going to try to quit.” We know that it can take people many attempts to quit for good. That is why it is really good that this is being backed up by additional investment in the important stop-smoking support systems and in our NHS trusts.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)
Q
Ailsa Rutter: I note the aspects of the Bill that deal with flavours. We absolutely think that more should be done on the descriptors. We wholeheartedly agree that some of the description is completely inappropriate. However, flavours play a really important role. For example, in our mental health trust, it is the fruit flavours that have got addicted smokers to stop. I genuinely have not heard that come up in the north-east—parents thinking that it is somehow healthy for a young person if it has a fruit flavour. What is wrong, though, is when it is in a packet called “Unicorn bubbly shake” or whatever, with a cartoon image on it. Those are things that we should look at addressing.
On vaping by young people in the north east, I want to make the point that we need to be careful about the data. Sometimes people say that all young people are vaping, but the evidence does not stack up. All of our local authorities do health behaviour questionnaires and, across the board, around 10% occasionally vape. I am not at all saying that we should be happy with that, but the risk of a public narrative that all young people are vaping is that we inadvertently promote it as a norm. Schools North East—
The Chair
Order. I am sorry, but we have hit 2.50 pm. Caroline, I am sorry to you, too. We are not allowed to go over the time limit. Ailsa, thank you so much for your evidence; it has been absolutely first-class. We wish you well with all the important work.
Examination of Witness
Adrian Simpson gave evidence.
The Chair
We now turn to our next witness, Adrian Simpson, a policy adviser at the British Retail Consortium. Colleagues, we have until 3.10 pm for this session, which is 20 minutes—it flies by when the witnesses are so good. Caroline, you can have the first question after Preet if that would help you. Witness, would you please introduce yourself and say an additional sentence, and then we will throw lots of questions at you?
Adrian Simpson: Good afternoon. My name is Adrian Simpson. I am from the British Retail Consortium. We are the trade association for large retailers throughout the UK.
Preet Kaur Gill
Q
Adrian Simpson: Yes, the large retail sector, which we represent, is broadly in favour of the Bill. We recognise that these products do require regulation. Putting forward this Bill at this time certainly feels like the right thing to do. Our members take their responsibilities around safe, responsible retailing very seriously indeed, but we feel that, for all this to be successful, there needs to be strong and robust enforcement behind it all.
Preet Kaur Gill
Q
Adrian Simpson: I am not sure I can comment on whether the amount is right, but one thing we would like to caution on around fines is the need to make sure that businesses are adequately notified of those fines. Some of the big retailers might not always be aware that a fine has been issued at the store level. For this to be effective, we think that trading standards officers will need to work with, for example, head offices as well. Something to be aware of is that some of these fines will have substantial personal effects on the shop workers who are given them. We need to think about how that is communicated to the shop workers themselves, but also to the head offices of these large retailers.
Preet Kaur Gill
Q
Adrian Simpson: In the large retail sector, we have worked on things such as Challenge 25 for many years, so we are used to challenging consumers buying products. One thing that we would like to make clear is that this can be a very controversial issue. We know that challenging consumers for proof of age leads to violence and aggression against shop workers. We think it would be beneficial if a long period were given for these regulations to come into effect, to give retailers the chance to educate their staff on these issues and to educate consumers.
Dr Johnson
Q
Adrian Simpson: It is not an issue that we have discussed at any length in the British Retail Consortium. We are aware, of course, that there are parts of the UK where licensing is required for certain tobacco products. We are well used to the alcohol licensing that has been going on for many years. Unfortunately, I cannot comment on whether the whole sector would be in support of that. We would perhaps need to see how a potential licensing system would operate before we gave our full support to it.
Dame Andrea Leadsom
Q
May I press you a bit further on the point that Preet made about whether the fines are sufficient? You have said that it is a bit complicated and will require some lead-in time—which is obviously provided, with the 2027 date—to give appropriate training to shop staff. The quantum of the fine was intended to enable on-the-spot fines, rather than having lengthy litigation because the person who incurs the fine does not have the cash and needs to go away, may or may not pay it, may or may not have to be pursued, may or may not have to go to court, and so on. Understanding that there are different views on all sides, is the balance just about right or, if you could have put your own wish list together, are there things that you would have done differently?
Adrian Simpson: We would have liked to see more education provided to retailers who might have broken the rules. A fine can be life-changing for someone who is given one, so we like to see whether there might be a way around that; perhaps the shop worker could be educated first, rather than going straight to a fine, if at all possible. We would like to see that balance of education before strict enforcement, if possible. That would be our wish.
Steve Tuckwell
Q
Adrian Simpson: The first challenge is education of all the shop staff. Our members are the very large, household-name retailers, and it will take a long time to get that education out to the hundreds of thousands—in some cases—of shop workers throughout the UK. We also think that there will be issues to do with changing our point of sale systems, things like where we are going to store some of these products if we need to, and even things like the size and nature of the tobacco notices. Retail operates in many different ways—we think of the large supermarkets, but there are very small stores as well—so a lot of thought needs to be given to the technical parts of the legislation, which of course we always work with you on.
Preet Kaur Gill
Q
Adrian Simpson: Certainly. Ever since the point at which a potential vape ban and the rolling age restriction on tobacco were announced, we have been working very closely with the Chartered Trading Standards Institute, which represents local authority trading standards officials. Ever since the beginning, we have been in close conversation with them, talking about our concerns on the points I made about education and enforcement. Many of our members are closely linked to trading standards already, through the primary authority scheme. I am pleased to say that many of our BRC members have long-standing primary authority relationships, so they already work very closely with trading standards. Certainly at the BRC, I have been working closely with colleagues in the Chartered Trading Standards Institute.
Dame Andrea Leadsom
Q
Adrian Simpson: I think you made a wise point earlier, Minister, about the difference between a 40 and a 41-year-old. That is absolutely our concern: how will we do that? We hear a lot of things about artificial intelligence and new technology for age verification, but a lot of it is still down to human interaction—whether a human can tell the difference between 40 and 41, which can be difficult. That is certainly one of our biggest concerns. Again, we are keen to avoid situations where there could be a touchpoint for violence against shop workers.
Dame Andrea Leadsom
Q
Adrian Simpson: There certainly needs to be a bit more research into what the best methods are to keep this age restriction going. It is a new challenge in the retail sector. We have never had anything like this before, and the UK is a leader in this area. I think that, at the beginning, it will be about us all working together to try to get the age restriction going and to make sure that it is enforced, because—this is one point that I would like to make—our members are obviously very compliant and want to do the right thing. These household names are very protective of their reputations; they want to be good and to do the right thing for society. However, I certainly think that, with this new system that might come in, there could be some teething problems. We hope not, but that can naturally happen with all new systems.
Dame Andrea Leadsom
Q
Adrian Simpson: It was definitely a point that came up quite a lot when we were debating this with members themselves. I would say that we are cautiously welcoming it, just because it will then bring about a level playing field for all retailers—because we know that these measures are not necessarily directed at our members, who are, as I say, in the legitimate, responsible retail sector. It will bring about a level playing field but, as I say, we might still need to see how it would operate in practice, I suppose, before we give it our wholehearted support.
Mary Glindon
Q
Adrian Simpson: Exactly. Our membership is predominantly the household-name retailers—the large retailers; the ones that certainly would not be selling illicit vapes. We have comprehensive supply chains, and our members put a lot of effort into making sure that their supply chains are operating with integrity, so that illicit products cannot enter them. I have not seen that report, but my feeling would be that the sellers mentioned in it are highly unlikely to be members of a reputable trade organisation. They might be ones that would not be looking for the same standards that our members would operate to.
Dr Cameron
Q
Adrian Simpson: A lot of the training done by our members has been put together with the help of trading standards’ services, so there is a lot in there about the law, but also about what perhaps is termed the soft skills—how to deal with the aggression, and with violence as well. Of course, this is a high-profile issue, and it is one of the top priorities at the British Retail Consortium as well.
We know that, with new rules, new regulations and new opportunities to challenge consumers, there will always be some resistance from consumers. We will certainly make sure that all our colleagues working in our members’ stores are given all the support they need to deal with any potential aggression or any bother, and our members will comply with whatever the law says. They will not let someone who should not buy a product buy it just because they are worried, or something like that. They will follow whatever the in-store procedures are and the training from the work with trading standards.
Dr Cameron
Q
Adrian Simpson: I agree—that is difficult. It takes me back to discussions around Challenge 25, which we have mentioned. It started out as Challenge 21, and the age was raised because it was very difficult to tell the difference between a 21-year-old and an 18-year-old. Technology is evolving in this area. There are new things. We know that members are using new forms of technology to help with that. They rely on things like Government-issued ID. There are various ways of challenging someone. It comes down to things like the training and how the consumer is around the till. Are they acting nervous or like they are up to something? It is then down to the retailer to use the training that they have been given to check the ID and use their own in-store procedures, as well to try to operate responsibly.
Kirsten Oswald
Q
Adrian Simpson: Yes, we do work closely with trading standards, who are very good at doing the education side. It is not just about educating our members, but educating the public and bringing about a cultural change where it is almost expected that you will be asked for ID. If you have been in any large retailer recently, you have probably seen the badges they wear that say, “It’s our job to ask for your age”, for example. Certainly, among our member businesses, it very much is the culture to go for the Challenge 25. Although these regulations with the rolling age will have challenges, I am sure our members are well placed to overcome them.
The Chair
Adrian, thank you so much for your evidence this afternoon. It has been clear and concise.
Adrian Simpson: Thank you, Sir Gary, and thank you, everyone.
The Chair
We will now move on to our next session—I am speaking slowly to allow John and Kate to find their way to their places.
To colleagues and anyone else tuning in, we are likely to have votes in the Chamber from about 3.30 pm or 3.45 pm—we are not quite sure; it is always fluid. That might do two things. It could curtail this session and prevent us from having the later sessions. Colleagues, in this session, in which we will hear extremely important evidence from the Chartered Trading Standards Institute, we might want to be concise for the first 20 minutes in case that dreadful bell goes and we all have to scarper. We will be voting four or five times and therefore not coming back. Let us get what we can from our two excellent witnesses.
Examination of Witnesses
John Herriman and Kate Pike gave evidence.
The Chair
John Herriman and Kate Pike, will you introduce yourselves, please?
John Herriman: I am John Herriman, chief executive at the Chartered Trading Standards Institute. We welcome the Bill, as I hope has been clear from the stuff that we provided before. It provides important clarity for businesses and enforcement agencies, as well as the public. We have also welcomed the early engagement in the development of the Bill.
Kate Pike: I am Kate Pike, lead officer for tobacco and vaping at the Chartered Trading Standards Institute. I have been involved for many years on the regulatory side. I was a member of the Department of Health tobacco expert group for many years, and I am now a member of the vaping expert panel as well, so hopefully I can answer your questions—fingers crossed.
Preet Kaur Gill
Q
Kate Pike: I will separate out illicit tobacco and illegal vapes, if that is okay. Illicit tobacco is the day job, which we have been doing for years. You are probably aware that HMRC came up with the first strategy on tackling illicit tobacco around the turn of the century, and since that time the amounts of illegal tobacco consumed in this country have come down hugely. Seventeen billion illegal cigarettes were consumed in 2000 and we are now down at 2.5 billion to 3 billion— I always say that as though it is a small number, but I know it is still huge. We have the latest strategy from HMRC to tackle that. Trading standards undertakes a really important role locally on illicit tobacco—your colleagues in Birmingham will be doing that work locally—but we work closely with HMRC and Border Force overseas, at the borders and inland, so we are on that.
With vapes, however, it is a different story. Obviously, the illegal vape market is much newer. Trading standards is responsible at ports and borders, and inland. The rise of illegal vapes probably took us by surprise, but we are now getting all our ducks in a row and starting to seize the products that are illegal. We work incredibly closely with our colleagues at HMRC. The notification system is helpful—it could be better, so we welcome the Bill clarifying that it can be extended and strengthened. We are getting on to the case now. There is a huge illegal market for vapes at the moment, but we can learn from what we have done on illegal tobacco and apply it to vapes, to ensure that we tackle those as well.
Preet Kaur Gill
Q
Kate Pike: The Bill gives enabling regulations to ensure that vape products can be reduced in attractiveness to children. There will be restrictions on the flavours, on the packaging and on the display to reduce the attractiveness of vapes to children. That is really important, because no problem has ever been solved by enforcement alone, whatever industry says. The approach has to be holistic: demand reduction as well as supply disruption. No problem has ever been solved like that, so the enabling powers, on sale and supply, will be brilliant.
Other bits of legislation are going through, such as the statutory instrument to ban single-use disposables. Potentially, that is an opportunity to look at an import ban on such products. Obviously, we will never get an import ban on something that we make here and sell overseas, because that is just not allowed under international trade law, but we talk all the time about how the ports and borders are such a pinch point.
The Chair
John, did you want to say anything?
John Herriman: I want to pick up on Kate’s point about the ports and borders. One of the challenges is that stuff coming in through the ports and borders is not being detected. Something will be flagged—we produced a manifesto in the past couple of months to highlight the importance of ensuring the right level of enforcement and activity at the ports and borders. If we think about it in the context of vapes—or any other illicit product, to be honest—the reason they get on to the high street is that they come through the ports and borders. At the end of the day, we are an island, so if we have the right level of activity there, in co-ordination with other agencies, hopefully we will stop it getting through to the high street, and that reduces the burden of activity on trading standards.
Preet Kaur Gill
Q
Kate Pike: We really welcome the addition of a fixed penalty notice to our enforcement toolkit, but we absolutely want to have our own range of sanctions, which includes the opportunity to go to prosecution for persistent or egregious offenders. The fixed penalty notice can be a really quick solution, potentially against an individual salesperson, depending on the setting and the nature of the offending. I think that £100 can be quite a lot; £200 would be more. I think that is enough, given the opportunity in the Bill to increase it at a later stage if it is not working or having the impact that we want.
John Herriman: It is all relative at the end of the day. It needs to be tested first. To some illegitimate businesses, that will be seen just as a business cost. Whatever the amount is, we need to ensure that it is not seen as a business cost that can just be absorbed. It has to be a tangible deterrent: that is the key.
Dame Andrea Leadsom
Q
We have sought to get the right balance, with a £100 fine that can be reduced to £50 if it is paid on the spot. For any of us, a day when we have to dish out £50 because we have done something wrong is a significant bad day. On the other hand, there is an escalation process to criminal prosecution. I am really keen that we get the balance right up front, notwithstanding that there will be powers to change it. Can I press you a bit further: is this or is this not the right place to start?
John Herriman: Can I make a broader point, and then maybe Kate can come in on the specifics? This is all about the market surveillance activity that allows you to understand what is happening on your local high streets and your ability to take enforcement action where necessary, whether that is a £100 fine or a prosecution. Fundamentally, that is the challenge at the moment. It is about the ability to have the right level of market surveillance and the right level of enforcement activity. I am sure it is a question that will come up. It is a challenge for trading standards at the moment, because over the past decade or so it has had significant cuts, in the region of 50%.
There are two halves to this question. First, is this the right legislation and are the amounts right? Secondly, legislation is only as good as the ability to enforce it. It feels as though the legislation is right—I will let Kate comment further on that—but the ability to enforce it is critical.
Kate Pike: Absolutely. Whenever we look at a new piece of regulation—as I think somebody mentioned earlier, we enforce more than 300 pieces of legislation across the spectrum—we ask, “Do we have the powers to enforce?” In the Tobacco and Vapes Bill, yes, we do. “Are there criminal penalties in there?” Yes, there are. The key things from our point of view—the building blocks—are there.
Across the spectrum, how many businesses sell tobacco? The impact assessment for the Bill says that there are something like 60,000 or 70,000 across the United Kingdom. On that spectrum, there are big businesses that know what they are doing and do not need a lot of support from us. There is a big chunk in the middle that might need a bit of support and guidance—they may make a mistake, but we can support them, help them and train them. Then there are a small amount at the other end that are the dodgy ones. We need to focus our enforcement efforts on them, because we will never be able to put one trading standards officer outside every business to be watching all the time.
Dame Andrea Leadsom
Q
Kate Pike: The Bill will have enabling regulations on vapes, with powers and criminal sanctions. That is good, but the specifics around where the vapes are positioned in store will be down to the next stage. We get calls all the time from people saying, “There’s a shop in my area called Toys and Vapes—do something about it!” There is actually no legislation that we can use to tackle that.
If you do not want the vapes next to the sweets, legislate for it. We will enforce what it says in the legislation, but we cannot make it up. People are always saying, “That’s not right,” but we cannot enforce morals. We can only enforce the law, so get it in there. If you do not want the vapes there, for very good reasons, give us legislation and we can enforce it.
Rachael Maskell
Q
Kate Pike: Illegal drugs are not a trading standards issue. If drugs are consumed via vape or by injection or rolled up in a roll-up, that is not our issue; that is a police issue. We can only enforce the law around the products where the enforcement is given to trading standards. We have no role whatsoever in illegal drugs in vapes. But there is a huge amount of enforcement around illegal drugs in this country, with the police, and the public health approach, about ensuring that people do not use illegal drugs. However they consume them, it is really important that they are on board—
Rachael Maskell
Q
Kate Pike: If you have intelligence around a vape seller selling an illegal drug in a vape, or in any other sort of format, that should be reported to the police. The police will take action against illegal drug sales, or Border Force at the ports and borders. There is a huge enforcement body around illegal drugs.
John Herriman: It is the market surveillance point again. If you have the right level of market surveillance, which is down to capacity, you will have trading standards officers, as well as those from other agencies, out and about who will detect the stuff. Then you can take the appropriate enforcement activity by whichever agency is appropriate at that particular point.
I take the point that was made earlier. I was walking down Hackney high street with trading standards just a couple of weeks ago. About every third or fourth shop, regardless of whatever the main thing it sold was, was also selling vapes on visible display. It is about making sure that we are aware of the level of vapes being sold, and that we therefore take the appropriate action, which is what the Bill should enable us to do.
The Chair
Colleagues, we might be voting fairly soon, so short questions, please, and concise answers.
Dr Johnson
Q
Secondly, someone showed me on packets of cigarettes recently that there is a scannable code, and trading standards have a special scanner that they can scan that with. Would that sort of thing help on so-called legitimate vapes?
Kate Pike: Potentially. The track-and-trace legislation on tobacco that enables us to scan a packet of tobacco and find out if it is where it should be—it is tracked all the way through the system—could potentially work on vapes. It would be very complicated to bring in—well, not complicated; it would be a big exercise to bring in track and trace for vapes, but it is potentially something. As you know, there is a consultation out at the moment for vapes to become an excise product, so it could possibly be that we introduce track and trace alongside that for vapes.
If you look at a vape and you look at the packaging, there are lots of red flags that tell us if it is illegal. We can usually tell by the packaging alone. We are doing some market surveillance work at the moment for vapes that look as if they should be compliant; they are notified to the MHRA, to check the ingredients. So far, touch wood, we are not finding too many issues in those nominally compliant vapes. But there are so many illegal vapes out there. It is actually quite easy to see that they are illegal, when you see them. We do know how to identify them at the moment, but obviously it could become more difficult. We will just have to make sure that the new regulations are still enforceable when they come in. For example, if there is a ban on types of flavour, we would want that to be really clear. We do not want to have to go round sniffing or tasting. It needs to be clear by the description, rather than just some sort of guess along the lines of, “Is that strawberry bakewell-flavoured?” It would be very difficult for us to manage that.
Kirsten Oswald
Q
Kate Pike: I think the Bill is really good at closing some of those loopholes. It will include an age restriction on 0% nicotine vapes, for example. There are other nicotine products, such as the little nicotine pouches. The popular term is, I think, snus, but we know that snus is already banned in this country. The enabling regulations to put a regulatory framework around products like that will be really helpful. These industries are very innovative, so we just need to make sure that we are keeping up with our regulation. I think that the enabling regulation powers will enable us to keep up with new products, but it is continually little steps, and regulation chasing after innovation. We would like it to be the other way round, really.
Trudy Harrison
Q
John Herriman: I think this is all about strategic resourcing. As I have already articulated, the profession has had a significant cut in resources over the last decade or so. Actually, we now have to go into a phase where we are rebuilding the capacity. We can do this; we know that we can enforce regulations, because we have seen that we can do it successfully within the world of tobacco. It is now about what we are doing as a profession to start building back that capacity. We are taking some new steps: for example, there are now apprenticeship schemes running in England, both at level 6 and level 4, and we are supporting the level 4 apprenticeships in Scotland and Wales.
One of the things that I think is really good about the Bill, and the work that DHSC and other Departments have been doing, is the taking of a strategic view. We have to build this capacity gradually—fairly swiftly, actually—into trading standards, but we also have to be clear on expectations with businesses, so that they know what is coming and we can therefore make sure that we are moving at the same sort of pace. By taking that strategic approach, it allows us to build the capacity at the right level and make sure we have trading standards officers who are qualified—it can sometimes take two to three years to train somebody as a fully-qualified trading standards officer. That way, we have a sustainable platform to make sure that the legislation can be enforced. Essentially, that is what we are seeing here. We have not seen this level of strategic approach to resourcing and tackling a problem in many other areas, so it is quite welcome.
Preet Kaur Gill
Q
John Herriman: The Bill itself is helpful in that it has enabling regulations within it. It is about a phased approach. We cannot turn a switch overnight: we have to build it up gradually. We will need to do a lot of training—and not just training, but recruitment of new apprentices, students and trainees into local authorities, as well as doing the business education part, alongside that—and move in a very structured way. The worst thing that could happen is that we have the regulations, we have the law in place, but cannot enforce it. That would mean that it became ineffective. It is about having a phased approach, and the Bill does that quite nicely. It fits within where trading standards is as a profession. We need to build back that capacity over time. We are still waiting to hear the outcome of the discussions on funding, which are happening at the moment.
Bob Blackman
Q
Kate Pike: We pushed for tobacco licensing for many years. Since the last time we did that we have had tobacco track-and-trace sanctions come in and the regulation around track and trace, which ensures that every single business selling tobacco in the UK has to have an economic operator identifier, so that, using our scanner, we can see whether a particular product is legal for sale, or whether a business is legally able to sell. Although that is not a licensing system, it does give us many of the advantages of a licensing system that we would look for. Although there are potential benefits in thinking about a licensing system for nicotine products, I am not sure that it is a silver bullet to some of the answers. We have said before that the issues are not just around tackling supply, which licensing does; they are also about tackling demand. We just need to get to grips with a holistic approach to vapes in order to do that. In terms of licensing on the tobacco side, we are probably okay now, as long as we can make use of the track-and-trace sanctions. We might be able to use those for vapes as well, further down the line, given the vape excise duty.
Bob Blackman
Q
Kate Pike: We do enforce around products. Any tobacco product has to be notified to OHID—it was PHE when it first started. So, there is responsibility for enforcement around products that are legally allowed to be sold in the UK. If they are tobacco products, if they are not notified they cannot be sold. So, there is a role there, although it is more difficult—it is not a day job. Certain local authorities will have more of an issue than others. It is probably not going to be everywhere, but for some local authorities it is a big issue. Perhaps we need to do more enforcement around what we can already do, and see where the gaps are.
John Herriman: To go back to the first point, there is a layered approach, which I think Kate has just articulated. There is a lot in the Bill that should work, so we need to look at that and see how we can enforce it and whether it works. There is a subtlety to this whole issue, particularly with regard to vapes, given that although there are under-age sales and illicit vapes, there is also a positive public health benefit for those that are smokers. So, we do not want to withdraw that access. Trading standards sits right in the middle of that. We can do a really good job when the regulations are clear; so we would like to have that clarity at the outset, which the Bill will give us. We can see whether that works; and there are always opportunities to come back if it does not. We have proved, though, that we can make it work in other areas.
Dr Cameron
Q
John Herriman: I will let Kate answer on this one as well. There was a really good, comprehensive answer earlier from one of the people giving evidence: if this is the right thing to do, the right idea, it is something we will have to get used to doing. I think that is probably the principle that we would apply within the world of trading standards as well. We just have to get used to the new legislation and what it asks us to do, and then make sure that sellers are following that legislation. Probably the problem will be more at the business end rather than at our end, and this is where there is a really important role for business education and the likes of the British Retail Consortium, the Association of Convenience Stores and other organisations.
We must get the balance right: this is about the enforcement activity and the right level of legislation, but we also have to make sure there is an onus of responsibility and accountability on businesses themselves to solve part of the problem. I do not think it is right to put all of the problem on enforcement, for example. Therefore I would definitely be looking towards businesses to make sure that they are embracing this and making sure that they are doing the right business education and training along the way. Have you anything else to say on that, Kate?
Kate Pike: Absolutely. The other point, obviously, is about resources, which John has already highlighted. We are in discussions, but we do need to make it clear that trading standards needs more resources to enable it to deliver the enforcement in this Bill.
The Chair
I think we have received that message very loud and very clear.
Kate Pike: Good.
John Herriman: Did I mention that? [Laughter.]
Steve Tuckwell
Q
Kate Pike: We think that the tobacco age of sale should definitely apply to all tobacco products, and that the enabling regulations for vapes also allow the opportunity to add other nicotine products. The definition of nicotine is really helpful. The closing of the loopholes is really helpful. Loopholes are not helpful to enforcement, but closing the loopholes is really important to enforcement, so we are happy with that.
Preet Kaur Gill
Q
Kate Pike: Yes. As I say, we are already in the consultation that HMRC has running now about a vape excise tax. One of the questions is, “Would you want to see these products subject to track and trace?”, and the CTSI will go back and say, “Yes, but let’s get the vape excise tax in now,” because of what that is going to give us. A number of you have said your worry is illegal vapes. HMRC being involved in this enforcement picture will be a real game changer, because there will be extra boots on the ground in addition to ours, and that will really help in tackling illegal vapes.
The Chair
Q
Examination of Witness
Laura Young gave evidence.
The Chair
Colleagues, we have at least 10 minutes left—perhaps 10 or 15 minutes. We are now, by the science and wonder of technology, zooming up to Dundee, I think. We welcome Laura Young from the Centre for Water Law, Policy and Science at the University of Dundee, via Zoom. I am going to ask you to introduce yourself in a moment, Laura, and I will just say that when Division bells start ringing in about 10 or 15 minutes, we will all be dashing off. It will be nothing you have done wrong or something you have said that we don’t like; it is nothing at all like that. Laura, over to you, please.
Laura Young: Well, I am Scottish, so I will try to speak as fast as we are known for. Hello, I am Laura. I am a PhD researcher in environmental science and a campaigner, and I have worked extensively, looking specifically at disposable vapes but also looking at vaping in general over the past 18 months. I very much welcome this Bill and support a lot of what has been said, but I also think there is room for taking more action and I am happy to be giving evidence today.
The Chair
Thank you very much. You will hear first from your own Member of Parliament, Kirsten Oswald, who will ask the first question.
Kirsten Oswald
Q
Laura Young: The environmental impact cannot be overstated. Vapes are a huge issue, especially for waste, and we have seen the numbers growing and growing. Material Focus, an environmental electronics charity, did some research specifically looking at disposable vapes in 2022 and 2023 and the number quadrupled. In 2023 we were looking at about 5 million a week. Jam-packed inside each and every vape are lots of precious materials, which of course are going to waste after one single use. We know they are not being recycled, so those materials are just being wasted. We are not getting them back.
We also know that vapes pose a huge risk to our waste workers. They have lithium batteries inside them and we have seen some devastating fires already because of them. That represents what we have been hearing today. Walking down any high street you will see the prevalence of these being sold in almost every type of shop everywhere. We see them sold everywhere, wasted everywhere, and having a huge impact on the environment and the health of people and children who get their hands on them.
Preet Kaur Gill
Q
Laura Young: Of course, one of the obvious things is litter. Every single street has cigarette butts on it and that is very harmful. We do not want any litter, if possible. Disposable vapes have become an increasing site of litter as well. They are not just litter; they are electronic devices and are very damaging with lots of chemicals inside them. We have even had garage owners talking about people popping tyres with these shards of metal as they get squashed and run over, so they are very damaging.
All the way through the process of particularly vapes we see a lot of material resource—lithium, copper and cobalt, things that have to be mined around the world—put together for these devices to be used just once before they run out and are thrown away. The disposability speaks to a lot of the other problems. These are made as disposable. They are throwaway and cheap, and that leads to the fact that so many young people buy them because they are cheap, accessible and throwaway. Something that is absolutely an environmental issue with waste and litter is also a big problem in terms of accessibility for young people.
Preet Kaur Gill
Q
Laura Young: I think the regulations and how those are designed will be crucial. I know there will be follow-up legislation mopping up other parts of the issues, with disposable vapes hopefully being banned, but it is important that we look at the design. How we get the most circular economy version of vapes is crucial: limiting as much as possible single-use plastic, looking at how we can make them modular, making sure we do not just shove a charging port at the bottom and hope for the best, but actually looking at how they can be circular by design.
On design, it is also important that we are beginning to see vapes that are legal—there are the illegal ones, which are to one side—that I believe are getting around existing legislation in terms of capacity. You now see ones that have different cartridges, so it is almost like the pens that you had where you could switch between the inks. You can now do that with vapes that are being sold legally. They are getting over the limits because they are saying, “This isn’t one big cartridge. This is four small ones.” We are already seeing the industry innovating in a negative way to get around the legislation, so we need to make sure that that does not happen when we bring in environmental topics as well as all the other ones for public health.
Trudy Harrison
Q
Laura Young: This may be something that has gone under the radar: the No. 1 item littered is cigarette butts, particularly when you look by number. They have a huge environmental impact, particularly because plastic is inside the filters, and the filter is the butt that is let behind. Although there has been a lot of campaigning around the environmental impact of vapes, there have been amazing efforts to raise awareness of the environmental issues around tobacco by organisations like ASH Scotland and the Marine Conservation Society, one of which I know has already given evidence.
Globally, we also need to look at this as a huge industry. Of course, kind of like any other industry, they need to be looking at their footprint and their sustainability measures. We know of course that air pollution is absolutely key to the conversation, and that has an impact as well on wildlife and biodiversity. Neither tobacco or nicotine products, such as vaping, are good for the environment; they are very harmful to the environment. We are just beginning to see those harms with disposable vapes in particular, but we know that cigarette butts have had a longstanding impact on the environment. They are also just a nightmare to collect. They are so small and so problematic. On beaches, you will see them as much as you see sand. We definitely need a lot more action across both those sectors.
Mary Glindon
Q
Laura Young: Absolutely. The first thing to remember is that vaping is not good for you. It is slightly better than smoking, but let us definitely not push the message that it is good for you.
On disposables, that is something I got to see first hand just last week. Only one place in Scotland has the capacity to recycle disposable vapes or any vapes at all. From watching that process, it takes an individual staff member with personal protective equipment under a ventilation hood—if you remember chemistry from when you were at school—pulling them apart manually with pliers. They separate the parts of the vape out and put lots of it to the side because it cannot be recycled, and they take away things like the battery, covering it in this special type of tape to ensure that it does not combust and burn, because of course lithium is very explosive. The whole process of recycling one vape takes over a minute for one member of staff. It is a huge cost, and it is not an economically viable piece of WEEE—waste electronical and electronic equipment—to recycle.
We know that only a tiny number of vapes are actually being recycled. If all five million a week that are currently being thrown away in the UK were sent to recycling centres, it would be a huge cost to local authorities, which often are the ones collecting them, and it would take a lot of infrastructure and people hours to process them.
I will just say that nobody wants to ban things—I certainly do not want to ban things. Nobody started by saying, “Here, these seem like a bit of an issue. Should we ban them?” We actually went through the process of asking all the questions that you and many others have asked. What are the solutions? What can we do? How can we raise awareness?
Unfortunately, with an item that is just so damaging and dangerous and is the complete opposite of a circular economy, which is what we are trying to achieve, they just cannot exist. Disposable electronic devices should not exist, and that is really important. It is our job—the rest of us—to ensure that the public health messaging comes across clearly, which is, “One of the main reasons we are banning these is the environmental impact and youth access, but we still want to help adult smokers quit smoking and move to really just breathing fresh air. We want to move them completely away from tobacco and nicotine products.”
Mary Glindon
I would just like to say that vaping is 95% safer than smoking.
Dr Johnson
Q
I have two questions. First, how do we ensure that the regulations are flexible enough for us to be able to stay ahead of such measures? Secondly, could you say a bit about the effect on wildlife? My hon. Friend the Member for Penrith and The Border (Dr Hudson) has talked about puppies picking these things up in their mouths and the danger they can pose if the puppies bite into them. Could you talk a bit more about the danger that they pose to wildlife when they are thrown away?
Laura Young: Of course. On the regulations, I think that we have to think creatively and innovatively about some of the workarounds that might be being used. We are already seeing charging ports just being popped on the bottom. Of course, that might mean that the battery can be recharged a few extra times, but if it cannot be refilled with the solution, it is still, in practice, a single-use item and will have to be thrown away eventually.
The issue is about ensuring that we look at the builds and make sure that they are modular and that the circular-economy principles that we want to achieve are set in stone. I think that that means working as best as possible with the retailers and the manufacturers—although that will be really difficult—and looking to other initiatives, whether that is single-use plastics bans or treaties on plastic, one of which has just come to an end globally, to see what we can do.
I will tell you a story about the wildlife. A wildlife photographer, a birdwatcher, was taking some images of a marine bird doing a very normal activity, which was picking up a shellfish—what looked like a razorfish—and dropping it from a height to smash it open to get some delicious dinner. But after this young gull had failed multiple times, this photographer realised that, unfortunately, what it was actually picking up and dropping was a disposable vape. We are seeing not only domestic animals, such as cats and dogs and things that we love as pets, getting hold of disposable vapes and potentially breaking them open, but actual wildlife being impacted—picking them up, thinking they are shells on the beach, and trying to eat what is inside them.
That is just from the very short time that we have been paying attention and looking out for this, and from keen birdwatchers capturing it, so we know that there will be extensive wildlife impacts. We are only now scrambling around to try to find more evidence, but we know that it is already happening, and that that is just one example. The photographs are on Twitter, if anyone did want to go and find them. It is sad, but it is definitely the reality of what we are seeing.
Mary Kelly Foy
Q
The Chair
It is a fair question; it is not within scope of the Bill, but it is a fair question.
Laura Young: Yes, absolutely. Just last week, I and other leading scientists from across the UK published a piece in Science, the science magazine: a letter about disposable technology, using vapes as an example—the first in a wave of disposable, cheap tech that is having an impact—and about the need for a global effort to tackle this. That is absolutely a hot topic right now; if we do not get a grapple on it now and use vapes as an example of how to tackle it, we will just continue to see disposable electronics, which are all jam-packed full of things that we need for other devices for a green economy.
The Chair
Laura, thank you so much for your evidence this afternoon. There are no more questions—we are about to zoom off and vote right now—but you have brought the subject to life with your very colourful descriptions. Thank you so much for that.
Aaron Bell (Newcastle-under-Lyme) (Con)
We apologise to the remaining witnesses, who we will try to squeeze in tomorrow.
Ordered, That further consideration be now adjourned.—(Aaron Bell.)
Tobacco and Vapes Bill (Third sitting)
Wednesday 1st May 2024
(1 week, 1 day ago)
Public Bill CommitteesRead Full debate Tobacco and Vapes Bill 2023-24 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 1 May 2024 - (1 May 2024)
The Chair
Good morning everybody. I call the Government Whip to move an amendment to the programme order. “Wednesday 1 May Until no later than 4.55 pm Professor Robert West, Professor Emeritus of Health Psychology, University College Long; Professor Ann McNeill, Professor of Tobacco Addiction, King’s College London”
Ordered,
That the Programme Order of the Committee of 30 April be varied by the insertion of the following words at the end of the table in paragraph 2—
—(Aaron Bell.)
Examination of Witnesses
Professor Sir Chris Whitty, Sir Francis Atherton, Professor Sir Michael McBride and Professor Sir Gregor Ian Smith gave evidence.
The Chair
Q
Professor Sir Chris Whitty: I think you have introduced us, Dame Siobhain—unless you would like us to make just three comments on previous witness statements, just to help the Committee.
The Chair
That would be great.
Professor Sir Chris Whitty: I think I speak on behalf of all the chief medical officers when I say we enormously welcome the Bill, which I think the overwhelming majority of doctors, nurses and other healthcare workers fully support. It is an extraordinarily important public health measure.
There are three points we thought it would be useful to make, the first of which is about the harms of tobacco overall. You have heard already from witnesses how extraordinarily impactful tobacco is in multiple domains of health, right from stillbirth in children through to dementia in old age, and it is important to stress that that is true of all tobacco products. We have had questions about chewing tobacco, and I know there have been debates about heat-not-burn tobacco. Tobacco is an extraordinarily dangerous product that is highly addictive and causes cancer, heart disease and many other problems in all its forms. It is important to stress that. The cigarette industry is extremely adept at trying to claim that this kind or that kind of tobacco is safer, and therefore safe, and asking why we do not just let it go. The industry did it with filters and many other things. But I think we should be really clear that all tobacco is dangerous.
The second point is to re-stress that the whole basis of the cigarette industry, and indeed the vaping industry, is to addict people and to remove their choice. The tobacco industry has been highly successful at framing the debate as if this legislation is about removing choice, when actually it is selling products whose whole point is to addict people who then regret that choice for the rest of their life, many of whom will die as a result. All of us as doctors have seen so many people in all stages of life—from pregnancy all the way on—who wish they could stop but cannot because their choice has been removed. If you are pro-choice, you should be firmly in favour of this Bill; it is a very pro-choice Bill.
Alongside that are the suggestions that the arguments somehow change at particular ages, such as 21. Tobacco remains equally addictive all the way through the life course, and all the way through the life course, people who start are likely to regret that choice but be unable to come back from it, because they have had their choice removed. We therefore cannot see a logical reason why, if Parliament is going to take this bold public health step, which is extraordinarily widely supported across the country, as well as in the health professions, it would not wish to finish the job and go all the way through. There is not really a logical point to that.
The final point came up in evidence yesterday, and I want to be clear, because I think there is actually a high consensus on this. We are strongly supportive of Ministers in all four nations having the power to regulate flavours as well as colours, packaging and other areas. There is a debate about the best way to do that, which will be dealt with; because it is in secondary legislation, this can be dealt with as we go through. But we would be very supportive of them having those powers. We know that otherwise the vape industry will use this to essentially drive a coach and horses through the aims of the Bill, which is to make products less attractive to children and, to a lesser extent, to non-smoking adults. That would be a big mistake. We also do not know the long-term effects that some of these flavours may have when smoked. We want to clarify that we are strongly in favour of this component of the Bill as well as others.
The Chair
Q
Sir Francis Atherton: I will briefly say hello. I am Sir Frank Atherton—rather than Francis, if I may, Chair. To echo what Sir Chris has said, it is rare to achieve such a high degree of consensus across the medical community as there is around this Bill. It really matters for people of the UK, and it really matters for the people of Wales.
Professor Sir Gregor Ian Smith: I would reiterate every word that Sir Frank has just said. The consensus across the medical profession, as far as I can see, is absolute. Chris has spoken very clearly and represents the views of all the CMOs and our deputies. From conversations we have had with past CMOs, we know that they are supportive for the same reasons. We have the weight of professional opinion behind us, certainly from the medical profession.
Professor Sir Michael McBride: I am chief medical officer in Northern Ireland. I would echo all that has been said. To add to Sir Gregor’s point about the weight of professional opinion, in Northern Ireland we also have the weight of a huge majority of the public. They are hugely supportive of the smoke-free generation and of measures on displays, point of sale and flavours of vapes.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
Q
Sir Francis Atherton: To echo what Sir Chris said earlier, nicotine is uniquely addictive, and it is addictive across all ages. Simply raising the age to 21 may have a limited effect and may well not have a long-term effect. The tobacco industry is incredibly adept at adapting its tactics to target smokers, whatever their age. It would seem likely to us that people could quite reasonably become addicted beyond the age of 21, but the legislation would prevent that from happening because of the rising age across the course of life.
Preet Kaur Gill
Q
Sir Francis Atherton: Age verification is a relatively simple matter if there is to be a cut-off at 2009. It is much clearer to retailers that that would be the age at which people would not be eligible to buy tobacco products.
Preet Kaur Gill
Q
Professor Sir Chris Whitty: Shall I have a first go? One of the first groups to be enormously positively affected by the Bill will be pregnant women and their unborn children. I know you will be hearing from the chief midwife, but briefly, stillbirth, premature birth, “small for dates” babies and birth deformities are all things that happen as a result of smoking. It is extraordinarily dangerous. All mothers want the best for their children; but, to reiterate, smoking is so addictive that people’s choices have been removed. They wish to get rid of the smoking in pregnancy, and they cannot because their choice has been removed.
What is clear is that the age band at which the greatest amount of smoking in pregnancy occurs is the youngest women. People who have babies in their late teens or early 20s have by far the highest rate of smoking. Those, therefore, will be the ones who would be positively affected by this Bill the most quickly, because then they would not be going into a pregnancy already addicted to smoking, with all the consequent harms for their baby and subsequent child, which may be lifelong. I do not know whether any of my colleagues want to add to that.
Professor Sir Michael McBride: One of the most concerning aspects of smoking tobacco is the health inequalities that it accentuates. In Northern Ireland, rates of smoking in the most deprived areas are over three times the rate in the least deprived. As a consequence, lung cancer rates are two and a half times higher in the most deprived areas.
If we look at pregnancy, pregnant women in Northern Ireland in the most socioeconomically deprived areas are five times more likely to smoke than those in the less socioeconomically deprived areas. The consequences for their health, and for the health of their children and unborn child, are very significant. They are addicted to a habit that is causing them harm and their unborn child harm.
Professor Sir Gregor Ian Smith: To add to Sir Michael’s data, in Scotland in 2023, there were just over 50,000 pregnancies; 11% of those pregnancies—that is 5,500 pregnancies—were booked where the mother was recorded as still being a smoker. A further 6,000 were booked where the mother was a former smoker. These are still really significant numbers. Of course, as Sir Michael has just said, this not only has implications for the mother and the health of the pregnancy; it has longer-term implications for the baby as it develops and grows. We know that anything that we can do to reduce the number of women in these age groups who are coming to pregnancy as smokers will have a beneficial effect not only on them and the health of their pregnancy, but on the health of future generations.
Preet Kaur Gill
Q
Sir Francis Atherton: It is certainly true that we are not going as fast in Wales as we would like to see. Smoking prevalence has dropped, from about 22% in 2020 down to 13% at present, but our target is to reach 5% by 2030, and we are not currently predicting that we will meet that target unless we go further and faster. We believe that this Bill will enable us to do that.
You asked for the reasons. One of the reasons is that we have deep-seated sociodemographic problems in Wales, which you have been referring to. Given the inequity that we see, meeting the needs of current smokers from those really deprived socioeconomic groups is really quite a challenge. We are doing everything we can in Wales to try to address that through “Help Me Quit” and smoking cessation support, but we really need to prevent the next generation from coming on board with smoking.
Professor Sir Michael McBride: Just following on from Sir Frank’s comments, you are absolutely correct that, while population prevalence of smoking sits at around 14% at the moment—behind the 12% in England and the 13% in Wales—we are doing slightly better than Scotland at the moment, which is sitting at about 15%. The figures for the Republic of Ireland are somewhere in the region of 18%. There is absolutely no doubt that we have the same socioeconomic drivers, in terms of social deprivation and health inequalities, that are fuelling this. Should the Bill succeed and pass into legislation, I see this as a once-in-a-generation opportunity to make a significant change to protect future generations and their children from all the harmful consequences of smoking tobacco and other forms of tobacco use.
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
Q
At the other end of the age range, elderly people who have smoked all their lives end up with decades of ill health brought on by a lifetime of smoking. I would be grateful, too, if you talked about some of the health outcomes for those who have smoked all their lives—some of the horrors of that. Sir Chris, you told me an anecdote of when you were a young vascular surgeon. For the record, it is important to talk about some of the heartbreak for those who wish they could stop smoking.
Professor Sir Chris Whitty: I completely agree with all the points you made. Starting off with the beginning of life, there are clear and significant increases in stillbirths, premature births, birth abnormalities and long-term effects from smoking just in the pre-birth period. Then, of course, if parents are smoking around babies and small children, that affects lung development and, if children have asthma, that will trigger asthma effects. Young children are significantly affected by passive smoking from their parents. The parents, of course, want the best for their children, but the problem is that they are now addicted to a product that has taken their choice away. We get those problems right from the very beginning, and we have talked about some of the issues in young pregnancies and where that leads.
Moving to the other end of the age spectrum that you were talking about, the full horrors of smoking for most people start to take effect from middle age onwards. At this point, people get a range of things. Everyone knows about lung cancer, I think, and most people know about heart disease, but there are effects on stroke or increases in dementia, which are significant—one of the best ways to delay dementia is not to smoke or to stop smoking at an early stage. That is a huge problem for all of us. Smoking also exacerbates any problems people have with diabetes—it makes that much worse—and people have multiple cardiac events leading to heart failure. In heavy smokers, we see extraordinary effects, like people having to lose their limbs. As you and I discussed, it is a tragedy to be on a ward with people with chronic obstructive airways disease, or on a vascular ward as a vascular surgeon with someone who has just had an amputation, weeping as they light up another cigarette, because they cannot stop, because their choice has been removed. I cannot hammer that point home firmly enough: this is an industry built on removing choice from people and then killing them in a horrible way.
Sir Francis Atherton: Minister, you also pointed out the cost to the NHS. In Wales, we estimate that we have about 5,500 deaths every year from smoking-related diseases. If we look at admissions to hospital, about 28,000 in the over-35 group is about 5% of overall hospital admissions. That is an enormous burden to the NHS. On a more personal basis, in a former life I was a GP, and I remember sitting with an elderly gentleman who at the end of his life was suffering with chronic obstructive pulmonary disease. There is no worse death than not being able to breathe when just sitting there. I remember sitting with him as he was trying to talk to me and trying to express that same level of regret that Sir Chris talked about. If you talk to any smokers towards the end of their life, who are facing such terrible ends to their life, the sense of regret that you hear as a doctor is quite overpowering.
Professor Sir Michael McBride: It is estimated that in Northern Ireland there are more than 2,000 deaths each year directly attributable to smoking cigarettes; over the past five years, smoking makes up 12% of all deaths in Northern Ireland. Sir Frank and Sir Chris have clearly described the horrors of the impact that it has at an individual level, and as doctors we have all experienced that. We have all had those conversations with individuals who look back on a lifetime of regret.
On a more personal level, I also think at this moment about the impact that premature death, and the morbidity and mortality associated with smoking, has on families and children. My own father died at 46 years of age, when I was 16, from acute myocardial infarction as a consequence of a lifetime addiction to smoking cigarettes. So, we need to bear in mind the very human costs, family costs and wider societal costs as well. It is not just the cost to the health service, but the societal cost, the family cost and the cost to the wider economy.
Professor Sir Gregor Ian Smith: We should never forget the societal cost that Sir Michael just spoke about. I am the child of two smokers who died in their mid-60s from smoking-related disease. We see it all too often in Scotland. In fact, in Scotland we still have 9,000 deaths a year attributed to tobacco addiction and smoking. That is one death every 61 minutes that families suffer across Scotland as a consequence of addiction to smoking.
As a clinician, one of the diseases that I had become quite specialised in treating and led a lot of work on is chronic obstructive pulmonary disease. That is a smoking-related disease that people develop, often at too young an age, and begins to really impair their ability to participate fully in life—not only in employment, but in the pastimes that they love. Gradually, over time, it becomes worse.
Sir Frank touched on the sense of regret that people have that they ever started smoking in the first place and find themselves in this position. Beyond that, there is an even sadder element: many of the people who experience these chronic life-limiting illnesses have not only regret that they ever started, but guilt about the burden that they place on the health service and their family because of the illness and disability that they develop. That guilt sometimes reaches to the extent that they do not seek full care. Many people’s attitude is, “I deserve this. I started smoking; I need to pay the consequences.” That is a terrible psychological position for any person to find themselves in. Removing the starting point for that addiction, so that people will not experience that through their life, is the aim of the Bill.
Let me make one last point. We talk about the health impacts of all this. The Scottish burden of disease study projects that over the next 20 years, up until 2043, we will see a 21% increase in the general burden of disease across our population in Scotland, despite having a falling population during that time. Much of that projected burden of disease is smoking related; it relates to cancers, cardiovascular disease and neurological conditions such as dementia, which are all influenced by smoking. It is absolutely necessary for us to address this in a preventive way, and I believe that the Bill is a very good way of doing that.
Professor Sir Chris Whitty: I want to reinforce the point that Sir Gregor just made, with which I am sure the Committee fully agrees, that individual smokers should never be blamed for the situation they are in. An incredibly wealthy, very sophisticated marketing industry deliberately addicted them to something, at the earliest age it could get away with it, and they have had their choice removed. It is important that people do not feel guilt and come forward for care, and that no one blames them for a situation that was deliberately put on them by industry marketing.
Kirsten Oswald (East Renfrewshire) (SNP)
Q
As a follow-on from that, I am concerned about the advertising of vape companies on sports kits, which is profoundly unhelpful. When we look at sporting figures who young people can admire, that has absolutely no place. I wonder what your views are on that.
Professor Sir Gregor Ian Smith: My views are very clear on vaping in young people and on sales to the youth categories. This is an activity that we are still learning much about but that the evidence, as it emerges, appears to suggest is very harmful to them. In my conversations with my paediatricians and with the Royal College of Paediatrics and Child Health, they are very concerned about the impacts on health of young people from beginning vaping. Any attempt to make products such as single-use vapes or flavoured vapes, or the packaging used or the marketing around vapes, more attractive to that age group is something that we need to counter and resist.
I would say that the aims of the Bill will allow us the means by which we can properly consult on the way that we attempt to reduce overall vaping use in this age group. I am very clear in my views on this: while I understand that vaping may be an assistance to people who are already addicted to tobacco and nicotine products as a consequence of use of many years—I see that there may be an argument that it allows them to reduce the level of harm they are exposed to—I am not convinced or led by any of the arguments that starting vaping in a younger age group is a safe activity at all. I do not believe that that is the case; I believe that it is harmful to those groups. We must try to counter that, and to counter the marketing machine that Sir Chris has spoken about, by reducing the flavours and packaging that are attractive to younger people.
Kirsten Oswald
Q
Professor Sir Gregor Ian Smith: I am very much in favour of the sports industry in general promoting health-promoting behaviours in any way. Where I become very uncomfortable, and I am not supportive, is where the massive attraction of sports companies is used in a way that promotes behaviours that are known to be unsafe or unhealthy. Given the evidence base that we have for this, I would certainly favour breaking the connection between the marketing of these products by any organisation—I do not limit this to sports companies—and anything that is attractive to this demographic and age group.
Professor Sir Chris Whitty: I completely agree with all the points that Professor Sir Gregor has made; I know all the CMOs would agree with that. What all the witnesses that you have heard so far have said, which I think reflects the debate, is that we want to retain vapes as one of the tools to help some smokers to quit. That is a sensible thing to do. We are reasonably confident that they are safer than smoking, but saying that something is safer than smoking is setting an unbelievably low bar, because of all the harms that it does.
So yes, moving from smoking to vaping is a step in the right direction—we want to be clear about that—but we absolutely do not want this to be marketed to anybody who is not a smoker, and above all to children, which is utterly unacceptable. We should be very clear about this. Many people in the vape industry will say, “No, no, no: we don’t market to children.” You walk into a vape shop and think, “Who are you kidding?” It is very clear what is happening.
We should be really clear that the only thing that is being supported here is to help people who currently smoke to move over to not smoking and eventually to quitting. A step towards that can be vaping; all other uses of vapes we would absolutely not want to do anything to support. The balance in the Bill is to allow enough elements to make it more attractive to vape than to smoke, because we do want to do that, but to make it in no way more attractive than that, because we absolutely do not want anyone else to do it.
Kirsten Oswald
Q
Professor Sir Chris Whitty: I think we are all very keen for the Bill to get through in the time that remains in this Parliament, so none of us would want to complicate this, but as Sir Gregor says, what we really want is for sports to be very firmly in the area of things that promote health. This is one of the areas that I do not think any of us would suggest is promoting health, so in broad terms we would agree, while not wanting in any way to complicate the Bill that is before Parliament at the moment.
Rachael Maskell (York Central) (Lab/Co-op)
Q
Professor Sir Chris Whitty: I wonder whether Sir Michael might want to go first, and then Sir Frank.
Professor Sir Michael McBride: We have to start somewhere. What we actively want to do, at this point in time, is encourage those individuals who smoke to quit smoking. We recognise that there are nicotine replacement products other than vapes that are very effective and that individuals successfully use, but for some individuals, as has been stated already and as is outlined in the relevant NICE guidance, vapes can be effective and are safer than smoking. It is about finding the sweet spot—hence the powers to consult.
We need to get a balance to ensure that we are absolutely not creating circumstances in which vaping is attractive to young children, starts a lifetime of addiction to nicotine and is potentially a gateway to smoking tobacco, as I think your question is suggesting. But at this point in time, this is an important step to ensure that the next generation are protected from smoking tobacco. We need to support those individuals who currently smoke or are currently addicted to nicotine to gradually move away from that addiction. That includes supporting smokers who currently smoke to quit, but we are increasingly seeing individuals who wish to quit vaping and are finding it difficult.
We are at the start of a journey. As Sir Chris has said, we do not want to delay this Bill and this important step change, in terms of making very significant progress. Sir Frank, do you want to add to that?
Sir Francis Atherton: Very briefly. The principle of alignment is a positive one. Keeping it simple for the public is in the interest of messaging, as a general point. In Wales, we did try—in 2016, I think it was—to align smoke-free and vape-free public places. Personally, I think that there is merit in that, but we have to be careful, because some of the arguments are different. The arguments around smoke-free public places are based on passive smoking, but we do not have a lot of data on passive vaping; many people see it as a nuisance, but that is a very different argument. We need to be a little bit cautious about that, even though I would personally be in favour.
The important thing is to remember that we really need to keep vapes as the quit tool. Your point about moving towards a nicotine-free next generation is absolutely right; that is really what we want to do. If we can make it less acceptable and less prevalent that children take up vaping, we should move towards that. The reality is that over the last three years we have seen a tripling of vaping among our children and young people. That is just unacceptable. The measures in the Bill will help deal with that and lead us, we hope, towards the nicotine-free generation that you talk about.
Nickie Aiken (Cities of London and Westminster) (Con)
Q
Professor Sir Gregor Ian Smith: My view on the Bill as it stands is that it is a starting point for how we take this work forward. It is adequate in that sense because this is a really important area. For me, the absolute priority has to be to remove young people’s ability to access vapes and so begin the journey to nicotine addiction.
I am not in favour of criminalising the possession of these products, but I am certainly in favour of banning their sale to younger people. If we can achieve that at this stage, and, as Sir Michael said in his previous answer, if we can begin to shift the culture so that people do not start to use vapes and begin to become addicted—potentially also by using other nicotine and tobacco products—for me that will be a good job done.
If we do things that way, it will allow us to protect the useful use of vapes: where people with a lifelong addiction to tobacco can use them as way to help them stop. That is the only justification that I can see now for the way we have set this up and for continuing to use vapes in society: as a useful tool for those with a pre-existing addiction to tobacco, so that they can reduce the harm and gradually stop using tobacco—through formal cessation services, as well.
Professor Sir Chris Whitty: I agree with Sir Gregor. To reiterate, the Minister wanted to get a balance and most people would agree that criminalising people for individual possession is a step further than anyone would want and is needed. I do not think there is a clamour for that from anybody, and I think it would not help the Bill.
On prescription vapes, I would like to see those available for use at the moment. So far—I will go into the reasons for this on another occasion—no products are available that we can prescribe. We would all very much like those products to be there so that people can prescribe them. That is different from saying that they should be only on prescription; at this point, we do not even have any products to prescribe at all. If we did, that would be a very firm step in the right direction, but it depends on the industry coming forward with products.
Speaking directly to the industry, I should say that I do think there is a very important niche for prescription vapes. They would be very useful for some people, particularly those on low incomes who, for other health reasons, have free prescriptions. I encourage anyone from the industry who is listening to think seriously about bringing forward a prescription vaping product appropriate for aiding people to quit.
Bob Blackman (Harrow East) (Con)
Q
Professor Sir Chris Whitty: I have had the privilege of being more heavily involved in this Bill than the other CMOs, so I am going to ask them to answer it. My short answer is that this is a fantastic Bill. What I do not want is for the Bill to be delayed and therefore to not get through in the parliamentary time available. There is always a danger with these things, particularly when we are up against the clock, of the best being the enemy of the good. This is more than good; this is an outstanding Bill, to be clear, in terms of the Prime Minister’s bravery in putting it forward and, I think, the huge support from the general public and massive support from those working in healthcare. Really, what we want to do is get this through. I fully accept the points you are making, but that is my real concern about proposing any additions. Maybe you can start with Sir Michael, then Sir Gregor and then Sir Frank.
Professor Sir Michael McBride: I think this is a situation where perfection risks snatching victory from us. The most important thing, having looked at the Bill closely, is that this is an excellent Bill. I think we have all indicated that this is a once-in-a-generation opportunity, as your question suggests. We need to seize this opportunity. I and my colleagues fully support this Bill. I think this is a point that we will look back on five or 10 years from now and we will say that we were on the right side of history in supporting the Bill. This will make a fundamental difference to the next generation and generations to follow. Again, it is entirely consistent with the commitment in the Northern Ireland Executive to gradually phase out tobacco smoking. I fully support the Bill as it stands.
Professor Sir Gregor Ian Smith: I have nothing much more to add. In my view, this is a momentous point in time when we have the ability to really safeguard the future health of generations of people who will not be exposed to the regretful, harmful addiction to tobacco that they might have encountered. I am very satisfied with the content of the Bill as it is just now. The point Sir Michael makes about perfection being the enemy of good is a really important one. This is an opportunity that, to be honest, I really did not anticipate seeing in my career, yet here we are discussing a potential piece of legislation that will allow us to improve the health of people in our country for years and generations to come. This is an opportunity that we cannot afford to miss.
Sir Francis Atherton: There are no changes to the primary legislation that I would recommend at the moment. One thing I would say is that in Wales, we were very impressed with the Khan review, which gave us a really good steer. Many of the Khan review recommendations will be dealt with through the Bill, while a couple will not. I think the Bill as it stands has enough flexibility, particularly around vaping, to allow secondary legislation to keep up with the industry as it adapts and as it tries to find ways around the barriers to getting young people addicted to nicotine.
If I had a wish from the Khan review, it would be around the industry making a contribution to those costs I was talking earlier—the cost to the NHS—so sort of a levy on the industry to correct the damage, or a polluter pays thing, as is being introduced for the gambling industry. However, I do not think that would fit at all with the current Bill.
Bob Blackman
Q
Professor Sir Chris Whitty: I reiterate at the beginning that we think it is safer to vape than smoke—I always have to say that first. All of us, including the other CMOs—what I am about to say is a pretty central view in the medical profession—would say that there are many things in vapes that we know cause harm, but we do not know the extent of the harm because they are relatively new products, or we would say we do not know whether they cause harm, but they might well do. We know from work on air pollution that there are large numbers of chemicals that if you breathe them in in reasonable concentrations are highly damaging not just to lungs but to brains, the liver and many other things, but are not damaging if you eat them.
The fact that something is non-toxic—a food additive, say—does not necessarily mean that it is non-toxic if you inhale it. So all of us are very cautious about the long-term effects of vaping and very concerned that we do not see a large expansion of vaping in people who were not smokers. That is particularly true for children. Within that, there are things available in legal vapes—multiple things—and every time a new flavour is brought in, new chemicals are introduced for which we often do not have a good evidence base. In my view, the onus should be on the industry to prove it is safe when inhaled, and not on us to prove 20 years later that it was dangerous. There is a very serious concern about that. Additionally, there is a significant additional risk from illegal vapes, of which there are many, which contain really very dangerous chemicals—heavy metals of various sorts.
None of us would want you to go away with the idea that we think vapes are safe and that we would encourage their use, except in the narrow context of someone who was a smoker, where we definitely think they are safer. But that, as I said earlier, is setting the bar very low.
The Chair
I inform Committee members that we have 14 minutes to go and three people who have not yet spoken and would like to. I want to bring in the Minister and the shadow Minister at the end. I notice that there is huge unanimity among our panel members. Could I also ask you to be brief and perhaps get one of your number to answer a question so that we get everybody in? Bambos Charalambous is next.
Bambos Charalambous (Enfield, Southgate) (Lab)
Q
Professor Sir Chris Whitty: In the interests of brevity—the medical director of the NHS is one of your next witnesses—there would be an immediate effect on the NHS because things like asthma attacks in children would be affected almost immediately. Over time there will be a growing positive impact on the NHS as people do not prematurely become unwell with chronic diseases that are extremely difficult to treat and consume enormous resources, in addition to the much more important thing of the extraordinary impact on individuals and their families, their social life, their work life and so on. So there will be a positive and growing impact. If you look forward 30, 40, 50 years, the impact of the Bill on the NHS will be substantial, but we will start to see the effects rapidly, particularly at the paediatric end of the spectrum.
Trudy Harrison (Copeland) (Con)
Q
Professor Sir Chris Whitty: I will reiterate my point and then hand over to Sir Frank for a longer answer. Cigarettes are a product designed to take choice away. That is the whole basis of the industry. If you are pro-choice you are anti-cigarette—absolutely, straightforwardly, no question.
Sir Francis Atherton: As I have said, nicotine is an incredibly addictive substance and it does not take long to become addicted, so it is not really a stage; it is almost instantaneous. People smoke a few cigarettes and the nicotine addiction kicks in. Obviously, it varies from person to person, but by and large it is highly addictive to young people. The younger you start, the more addictive it is, but it is addictive across the whole of the lifecycle, so nobody is immune to that addiction. Breaking that cycle of addiction and getting out of it gets you into psychological dependencies and repeated attempts to quit—the things that many smokers have been through, which cost them so much time, energy and effort, in terms of money and their personal effort and wellbeing. That is all I can say about the status of addiction. Was there anything more specific that you wanted to know?
Trudy Harrison
Q
Sir Francis Atherton: As with any addictive substance, when you are deprived of it you suffer cravings and withdrawal symptoms of a sort, and that leads you to want the next hit—the next cigarette. That cycle of dependency and addiction is well known and well understood, but you would have to talk to a behavioural psychologist or a physiologist to get a more detailed answer.
Professor Sir Chris Whitty: To add to that, most smokers who are determined to quit make multiple attempts—even those who finally succeed, and many people do not succeed. As I was saying, so many people want to succeed and cannot because the addiction has a hold on their brain, essentially.
Mary Kelly Foy (City of Durham) (Lab)
Q
Professor Sir Chris Whitty: There is a surprising degree of consensus on this issue, which is sometimes difficult to pick up. We know it is useful to have in the armamentarium the ability to have some flavours to help smokers to quit, but we also know that the cigarette industry is extraordinarily good at adapting its marketing techniques to whatever leeway it is given. If Ministers do not have the power to chase down the industry’s ability to market to children using flavours, that is what it will do: it will go for multiple flavours as a way to get to children and non-smokers. That is what it has always done, so that is what it will do. This Bill gives powers to Ministers in the four nations to make sure they can restrict these products to the extent that you can make them not attractive, but attractive enough to smokers to move on. It allows the slider to be moved left or right to balance attractiveness to smokers against not making it attractive to non-smokers.
Mary Kelly Foy
Q
Professor Sir Chris Whitty: Possibly, but this Bill gives powers that allow us to vary it depending on what the industry does. That is really the point.
Angela Richardson (Guildford) (Con)
Q
Professor Sir Chris Whitty: I wonder whether I can turn to Sir Gregor first, and then maybe Sir Michael.
Professor Sir Gregor Ian Smith: I am not aware of the NHS ever engaging any of these influencers, in terms of how we approach the subject of vaping. There is certainly a real danger that social media is sometimes used by younger people, and they see things that become really attractive to them in terms of lifestyle. The misinformation and disinformation that exists across those platforms can lead them to participate in activities that are potentially harmful.
Directly to your question, my very strong answer to any young person thinking about using one of these products as an appetite suppressant is: please don’t. Please safeguard your health. Do not begin the potentially addictive journey of using these products. Do not do it for any reason.
Going back to the point we made earlier on, I would love to see a society where our sports organisations promote much more healthy behaviours, where we have a much better understanding of the huge variation in body image we have across our society, and where we promote the very positive and broad representation of who we are as the general public, because there is no “one size fits all” answer to who we are. We are beautiful in our diversity. Anything we can do to have a more positive representation of society across these platforms would be very beneficial.
Professor Sir Michael McBride: Believe it or not, I was a teenager once too, and I remember what it was like. Teenagers tend to push boundaries and experiment. It is all about finding yourself and your place and space in life. It is not cool to vape. It is not cool to succumb to peer pressure. Be yourself. Make sensible choices about what it is right for you. That is the message I would add to Sir Gregor’s point. We have an unfortunate situation where teenagers like to experiment and push boundaries and we have an industry that is only too willing to exploit that and market products at them with, as we heard, cartoon figures on the front, attractive colours and flavours that taste and smell nice. They are extensively marketed by opinion leaders. So don’t follow the crowd. Be yourself.
Preet Kaur Gill
Q
There is a growing illicit vape market, but how would parents know what is illicit or what the Medicines and Healthcare products Regulatory Agency has notified as being compliant? Where is the public health messaging to support schools? We heard really good evidence yesterday from the union. This is my concern: where can people access support and information? We already have a generation of kids addicted to vapes that are marketed as having 0% nicotine, but we know that there is nicotine contained in them. What would you say to that?
Sir Francis Atherton: There is some messaging going on through the various Governments. In Wales we have a “No Ifs. No Butts.” programme, which tries to work at an individual level, to alert people to the dangers that we have been discussing, and with wider society, about the dangers and links between illicit tobacco and illicit vaping and organised crime. Bringing that awareness to the population is really important for those two reasons.
We work with trading standards to try to tackle the issue of illicit tobacco and vapes. It is important that we continue that. My understanding is that wherever we have been successful in reducing demand, which the Bill intends to do, the illicit supply also decreases. We would expect that to be a consequence of the Bill.
Professor Sir Chris Whitty: One of the many talking points of the cigarette industry is, “Well, any kind of downward pressure on cigarettes would lead to an increase in the illicit market.” All the evidence shows that the reverse happens. When you bring in reduced demand, the illicit market decreases.
Dame Andrea Leadsom
Q
Professor Sir Chris Whitty: That would be very damaging, because we know that this is one of the most innovative marketing industries in the world. That is how they have managed to sell to people something that will addict them and then kill them. If we give them room for manoeuvre by nailing things down, they will find a way around it, because they always have found a way around regulations. I am absolutely supportive of the comment you have just made.
The Chair
I am afraid this brings us to the end of the time allotted for the Committee to ask questions. I thank all the witnesses, because you answered a huge number of questions and provided great information.
Examination of Witnesses
Professor Sir Stephen Powis and Kate Brintworth gave evidence.
The Chair
Q
Professor Sir Stephen Powis: My name is Professor Sir Stephen Powis and I am the national medical director of NHS England.
Kate Brintworth: Good morning, everyone. My name is Kate Brintworth and I am the chief midwifery officer for NHS England.
Preet Kaur Gill
Q
Professor Sir Stephen Powis: Yes, I do. As you have heard from the chief medical officers, vaping has a role in tobacco cessation and supporting those who want to quit smoking. That is the guidance from the National Institute for Health and Care Excellence, which we follow and support in the NHS. Evidence is increasing that starting vaping and the use of nicotine-based alternatives to smoking is likely not to be safe. As far as the NHS is concerned, we would support the limited use within smoking cessation, but we have real concerns around the impact that vaping might have over time. At present, we see a relatively small number of admissions into hospital as a result of vaping, but that is growing; it has grown over the last few years. Clearly, as you discussed earlier, the evidence base that these products are not safe is growing.
Preet Kaur Gill
Q
Kate Brintworth: Our position on vapes is that they are a tool for those who are already addicted to smoking. As Chris outlined earlier, this is a way of supporting people to move away from cigarettes. We would then expect that to be part of their journey to becoming a nicotine and smoke-free household.
Preet Kaur Gill
Q
Professor Sir Stephen Powis: Yes, we have. If you look at admissions recorded in our statistics related to vaping, you will see that they are in the hundreds. They are relatively low, and of course much lower than smoking, but as I think you have heard from the chief medical officers’ evidence, these are not safe products. We are at the early stages of the evidence-base building around their impact. I think we should be nipping this in the bud. We should not be waiting for those admissions to increase and for those effects to be seen. This is an opportunity to reverse that direction, and I applaud parliamentarians for taking it.
Preet Kaur Gill
Q
Professor Sir Stephen Powis: I will make a few broad comments on smoking, if I can. Seventy-eight years ago, Parliament passed the National Health Service Act 1946, which led to the formation of the NHS on 5 July 1948. In my view, the legislation that you are considering here today is one of the most important—possibly the most important—pieces of legislation since the passage of that Act. Why? Smoking has an extraordinary impact upon the health of the nation, and of course directly upon the NHS.
To put that into a bit more context—you have heard some of this already, but maybe I will provide some more detail—smoking is associated with, or causes, over 100 individual conditions that are managed and treated within the NHS. It impacts the NHS at all levels: almost every minute of every day there is a hospital admission related to smoking; there are over 100 GP appointments every hour for smoking-related disease; and 400,000 admissions a year are related to or associated with smoking. You have heard the chief medical officers briefly talk about the impact on specific diseases. Lung cancer is the one that everyone knows about, and 80% of lung cancers are caused by smoking. This Bill has the opportunity to transform lung cancer from a common disease into a relatively rare disease, and one that clinicians of the future will not see in any way as commonly as clinicians of my generation.
It is not about just lung cancer; you have heard about the impact on cardiovascular disease, and clearly, chronic obstructive pulmonary disease would again become a rare disease for the clinicians and the patients of the future. This Bill can also have an early impact on diseases that affect young people. Asthma is a disease not caused by smoking but a condition exacerbated by it. We see such admissions particularly over the months when asthma is worse and when there are respiratory infections, which are no doubt exacerbated by smoking.
In mental health, smoking doubles the risk of developing depression. More than one in two people with severe mental health conditions smoke, and the life expectancy of those with mental health conditions is reduced because of smoking. Mental health issues in our young people and children are well-known and well-described, and smoking simply exacerbates them. There is great potential, even in the early years, in the passage of this Bill for an impact on conditions that we see and manage in the NHS. Over the long term, that potential impact is extraordinary on those conditions, which number over 100.
You may know that I am a kidney doctor, but you may not know that smoking can impact on kidney disease. The kidney, like any organ, is supplied by blood vessels. When smoking impacts on the health of blood vessels and causes vascular disease, that can reduce the bloody supply to the kidney, which can cause kidney failure and lead to dialysis and transplantation. There is a large range of conditions that are impacted by smoking, and it will be extraordinary for those clinicians of the future not to have to do what we have done—tell patients and their families that people are going to die prematurely. That is an extraordinarily difficult thing for clinicians to do. Those are preventable diseases, and this Bill will prevent them.
Dame Andrea Leadsom
Q
Kate Brintworth: It is important to start with the fact that we know that smoking is the single biggest modifiable risk factor for pregnancy, and we know that every women who gets pregnant wants the best for her baby. As a midwife, I have never sat in front of a woman who does not want the absolute best for her baby. It is important to build on what Chris Whitty said around the removal of choice. Women will go to extraordinary lengths to protect their bodies and babies to ensure that their children have the best start in life, and yet the quit rates that we see in pregnant women are between 30% and 40%, showing how difficult it is for women to extricate themselves from the situation in which they find themselves.
The effects are devastating: stillbirths are increased by 47%; you are twice as likely to have a baby that has not grown properly; and you are 27% more likely to have a baby that is born pre-term. You are more likely to have complications of pregnancy, such as bleeding, the placenta not forming properly or the waters that surround the baby breaking earlier with the risk of infection, so there are immediate effects that we can see. If a baby is small, it goes into labour more vulnerable to the stresses of labour, so we can have more complications there. If a caesarean section is needed, the mother is more vulnerable to recovery and it can be a much harder road to recovery for her, with the risk of infection and blood clots, but also for the baby. If the baby is born early, obviously the risk then is that the baby and mother are separated and you have this unnecessary trauma to a family of a baby having to go into a neonatal unit. The risks that come from prematurity are well-documented for children, for educational attainment and for their lung and health development, but when the children go home, they are more at risk of sudden infant death syndrome—up to three times more—in a smoking household.
There are then the long-term effects. We have already heard about asthma, chest infections and obesity. All those are heightened in children born into smoking households. You have a situation where children are at risk and women are at their most vulnerable when they are pregnant, and it really feels like it is our duty to support this Bill to protect the most vulnerable in our society, because there are the effects of having a child born with possible behavioural problems and malformations, which have been described. Those are really shocking events. I was talking to service users yesterday who have had children in the neonatal unit, and it is incredibly shocking when your pregnancy ends early and you are separated from your baby. There is a mental health impact on the family. There is also the point that this affects those coming from the most socioeconomically deprived backgrounds, for whom having any kind of health challenge makes it a much higher bar to fight.
Dame Andrea Leadsom
Q
Kate Brintworth: The birth of a child is so happily anticipated by every person who gets pregnant. From the moment that you see a thin blue line, you are having a baby. You have hopes and dreams for the expansion of your family, but not just for that individual family: a baby is born, and it is a niece, a nephew, a grandchild, a cousin. It really ripples out across the entire family. When there is then a 35% risk of miscarriage and a higher risk of ectopic pregnancy and, as you said, the absolutely awful, tragic and devastating news that your baby has died when it reaches term, that is something that no parent should ever have to face unnecessarily. It just feels like the worst thing you ever have to do as a clinician to tell someone that their baby has died. Every time I have ever had to do that, it has been the worst point in my career. It is difficult to explain how destroying it can be for families, and we see the long-term sequelae in terms of mental health, to the point where we have put in extra perinatal mental health support for families that have suffered that kind of trauma.
Professor Sir Stephen Powis: Can I pick up on the health inequalities aspect, because I think that is really important and I have the figures in front of me? In 2021-22, 21% of pregnant women in the most deprived areas smoked at the time of delivery, compared with 5.6% in the least deprived areas. That is a really stark difference. Smoking is widely accepted as the most significant driver of health inequalities in the UK. Detailed analysis has concluded that 85% of the observed inequalities between socioeconomic groups could be attributed to smoking. We spend a lot of time in the NHS quite rightly targeting our interventions and support to deprived areas to address health inequalities. At a stroke, this Bill would have the greatest impact that we could possibly see.
Steve Tuckwell (Uxbridge and South Ruislip) (Con)
Q
Professor Sir Steven Powis: I have already highlighted some of the short-term impacts, and there will undoubtedly be short-term impacts. Some conditions are exacerbated by smoking, with asthma in children being an obvious one. I have talked about mental health conditions and the way that smoking exacerbates conditions such as depression and chronic mental health illness.
We will start to see immediate effects, but those effects will grow over time. I have given you some of the conditions that are impacted on by smoking—there are well over 100 of them—but I can give some more stats. By stopping children from ever starting to smoke, we estimate that we will prevent about 30,000 new cases of smoking-related lung cancer every year. More than 1.4 million people suffer from chronic obstructive pulmonary disease, which is a chronic disease of the lungs caused by smoking—it causes nine out of every 10 cases. As I said, that is a disease that clinicians commonly see. A common cause of admissions to emergency departments, through the winter particularly, is other respiratory infections on top of COPD—these are diseases that future clinicians will see rarely. They will not see them in the way that clinicians of my generation have had to manage them. The impact will begin immediately, but over time that impact will get greater.
Rachael Maskell
Q
Professor Sir Stephen Powis: As I outlined earlier, the impact on the NHS of vaping at the moment is relatively small compared with the impact of smoking. Nevertheless, there is an impact, and we are seeing growing numbers. I have highlighted the number of admissions per year, but they have doubled over the past few years, so that impact is becoming apparent. For example, yellow card reporting to the MHRA is a mechanism for reporting harm, and again the number of incidents related to vaping is increasing, although still in relatively low numbers.
As I said earlier, however, what is important here is that the evidence base, although emerging, is growing. This is an opportunity for us not to get into a position where, in years to come, we regret that we did not take the steps early on to change the trajectory. Instead of seeing rising impact on the NHS—small at the moment, but with the potential to be greater—that trajectory should be changed. This is a golden opportunity for parliamentarians to step in early and to prevent further pressure building over time on the NHS, while recognising that the evidence is still emerging.
I agree with the chief medical officers you heard earlier: I do not believe that vaping is safe. It is undoubtedly safer than smoking, which is why we support its use as a means of smoking cessation, but beyond that the evidence is building that it is not safe. Unquestionably, it will have a building impact on the NHS.
Angela Richardson
Q
How much do we know about the difference between the impacts of smoking and vaping? Thinking of the impact of vaping on babies, is vaping still an okay thing for pregnant women to be doing? Do we need to specifically address the impacts of vaping and smoking on pregnant people in the Bill?
Kate Brintworth: If we start with the evidence, as we have heard this morning there is a limited evidence base around vaping, but that does not mean we should be complacent. We know there is evidence around the transfer of chemicals and the reduction in lung capacity, which we see. As Chris said, while that is an improvement against the very, very low bar of smoking, we would see it as one step on a journey—an interim measure to being nicotine and tobacco free. On that basis, I do not think I would frame it as being okay to vape. We would see it as a tool—a means to an end—to reach the position of being nicotine and smoke free.
We will absolutely support research monitoring the impact of vaping. We cannot be complacent that it is going to be all right. However, at the moment, vaping is absolutely better than smoking, with the very well documented impacts that I have described on not just the mother but the baby and the future health of the family; we know that children born into households where smoking occurs are likely to start smoking themselves.
Angela Richardson
Q
Kate Brintworth: It is all of it—all the elements. In some babies born to smokers, the children can almost suffer withdrawal symptoms and be jittery and restless in the neonatal period because they themselves are having to go through that withdrawal that is so difficult to enact. We also know of the numerous chemicals—arsenic, carbon monoxide—all of which are toxic to infants, so in no way would you want to distinguish out. It is a whole package of things, all of which we would like pregnant women and babies not to be exposed to.
Mary Glindon (North Tyneside) (Lab)
Q
Professor Sir Stephen Powis: Over time, this Bill will lead to the eradication of an addictive condition that causes the immense harm that we have described. But of course, that will occur over time, so it is also important that we continue with a range of other measures to encourage those not immediately impacted by the raising of the age of sale of tobacco products to cease smoking.
We have a number of smoking cessation programmes within the NHS, which was part of our ambition in the long-term plan for the NHS five years ago. We have been rolling out and supporting those services within hospital settings, and we should continue doing that. Of course, local authorities should also continue their work in supporting smoking cessation. Much of that is also targeted at women who are pregnant.
Part of that work is also supporting staff. Smoking rates across the 1.3 million or 1.4 million people employed within the NHS are lower than across the general public, but we nevertheless continue to see NHS staff who smoke. It tends to be in the lower pay grades within the NHS, but of course for all sorts of reasons we would like that rate to come down. Obviously there is the health benefit, but also, as you all know, smoking causes illness, illness causes absenteeism and absenteeism is a cost to the NHS. Although, as I said, we strongly support the Bill, it is important for us within NHS England and the wider NHS to continue to take other measures and put in place other programmes that will assist the public and our own staff to quit cigarettes.
Trudy Harrison
Q
I would like to understand the power of addiction to be able to make the point that this is a pro-choice Bill. It will give women more choice against that addiction that they are enduring at the most important point of their lives, when they are unable to make that choice for themselves.
Kate Brintworth: I absolutely agree with you. As I have said, pregnant women go to extraordinary lengths to protect themselves and their babies. They change what they eat and drink and how they behave in myriad ways to ensure that they are doing the right thing, yet it has proven very difficult to shift the figures you describe—I think nationally it is a little over 7% of women who are still smoking. That is a poignant demonstrator of just how difficult it is and how addictive nicotine is, when all women want to do is the right thing for their children. That is why all the chief nursing and midwifery officers across the four countries are united in support of the Bill, as our medical colleagues are, because we see the damage wrought across families and generations. We are 100% behind it.
Professor Sir Stephen Powis: It is important to re-emphasise the point made repeatedly by the chief medical officer for England: smoking and nicotine addiction takes away choice. When you are addicted, you do not have the choice to simply stop doing something. It is an addiction. It is a set of products that removes choice, and in removing that choice, people are killed.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Q
Kate Brintworth: The information that we have so far suggests, as it does across all areas of healthcare, that vaping is safer than smoking. What we do not have is the long-term data that we have on smoking to give us the confidence to describe the harms clearly. That is something that we need to keep observing and understanding so that we can give people the best-quality information.
Professor Sir Stephen Powis: NHS England is not a primary funder of research but we are an evidence-based organisation, as I described earlier, particularly on the use of vaping for smoking cessation. We are very keen that the evidence base, particularly on vaping, is expanded. We would support research in terms of calling for it to be undertaken but also in terms of supporting the NHS as a delivery mechanism for the context in which that research is done.
We very much want to support further research because, as you know as a paediatrician, this is an area where the evidence base is emerging but there is more to do. It is not as complete as the evidence base for smoking. It is really important, even with the passage of this Bill, that that evidence base grows and that we in the NHS support the generation of further evidence where we can.
The Chair
Thank you. That is a good point at which to say that this session has ended and to thank our witnesses for all the information they have provided.
Examination of Witnesses
Professor Kamila Hawthorne and Professor Steve Turner gave evidence.
The Chair
Q
Professor Hawthorne: I am Kamila Hawthorne. I am a GP in south Wales. I work in a post-industrial, very deprived town up in the Welsh valleys. I am chair of council and have been for the past 18 months.
Professor Turner: Good morning, everybody. Thanks for having me. I am Steve Turner, president of the College of Paediatrics and Child Health. My other job is as a paediatrician in Aberdeen. I have 20 years’ experience as a consultant looking after children with asthma and other breathing problems, and I have done 20 years’ research into the harm of tobacco exposure to children before and after they are born. I am an advocate for our 20,000 members in the UK, including one here, and our 4,000 members overseas. I am also an unapologetic advocate for children and young people. Finally, we believe this Bill is splendid. We would be happy for the version that we have seen to be approved unamended.
Dr Johnson
As a declaration of interest, I am an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health.
Preet Kaur Gill
Q
Professor Hawthorne: Smoking-related illnesses cost the NHS about £2.5 billion a year. Everybody knows that lung cancer goes with smoking, but what I am really seeing is awful chronic obstructive airways disease. I work in a deprived area. Many of my patients have smoked ever since they were teenagers and find it very difficult to stop. Every winter, they come to see me repeatedly with severe chest infections that require courses of steroids and antibiotics and sometimes hospital admissions. It is really difficult.
I had a patient who sadly has passed away now with end-stage lung disease caused by smoking. The difficulty we had keeping her as well as we could at home was that she could not have home oxygen because she continued to smoke. It was a massive difficulty for her to stop smoking, even though it was causing her to virtually strangle herself. That just shows what a difficult thing this is.
Professor Turner: To follow on briefly, you might think that children do not demonstrate some of the impacts that Kamila has just described, but that is not the case. Following on from the conversation before, nicotine is not good for you. If you are a foetus inside of your mam, it will cause uterine arteries to spasm and effectively strangle you—reduce the oxygen to you.
We know that vaping contains nicotine. Nicotine makes you small and, if you are born small, you are already on a trajectory for all the non-communicable diseases that Kamila and her colleagues will see in primary care: cancer, heart disease, stroke and hypertension. From the paediatric perspective, there are issues. Children do not concentrate so well when they are addicted to something, so their attention in school is changed. That will affect their learning outcomes and their future economic productivity. The devices sometimes set on fire, so if you have one in your mouth, it can create burns. Fortunately, there are few serious life-threatening complications, but you might have heard of popcorn lung, which is fortunately rare but is very serious. With popcorn lung, when you look at the lungs on a scanner, it looks like they are full of holes.
Preet Kaur Gill
Q
Professor Turner: Yes, absolutely. The tobacco industry knows that, at the age of 15, we as a species are at the sweet spot for becoming addicted to nicotine for life. The proposed Bill will effectively stop that. Protecting our children from becoming addicted to something that will shorten their lifespan by 10 to 15 years has to be a good thing for us as a responsible society to do.
Preet Kaur Gill
Q
Professor Hawthorne: We know that vaping can cause people to start smoking; it can lead to smoking. We do not have much evidence—I think you have been told this already this morning—as to what the long-term effects of vaping are. We have known about smoking damage since the work of Sir Richard Doll in the 1960s, so this is relatively new. We know there are chemicals in what people are inhaling—that is what causes the popcorn lung—but it is actually only one particular chemical that has been linked, and there are lots. Since 2016, vapes have not been allowed to actually have that chemical any more, but there are other chemicals, and we still do not know what long-term effects they might have.
Preet Kaur Gill
Q
Professor Hawthorne: There is probably very little research on either.
Professor Turner: If I could just bring a bit of clarity, it is well known that nicotine is bad for us. Sir Walter Raleigh brought it back with some potatoes, and we have known for hundreds of years that nicotine is an addictive drug. As I said previously, it will shorten your life expectancy by between 10 and 15 years. Because we know nicotine is in all nicotine-containing vapes, whether licit or illicit, it is harmful regardless of what the other components might be. It is likely that those other components add to the harm, but there is substantial and well-described harm from nicotine addiction to us as human beings.
Dame Andrea Leadsom
Q
Professor Turner: There is not a lot of research on that. Certainly, we know that if you are in utero and your mother is smoking, you will get the harmful effects of nicotine. That is a very good question—I honestly do not know what the effects on the unborn child would be. Certainly, we know that children born to parents who are addicted to morphine or cocaine have learning difficulties. I have to be honest and say that I might have to get back to you on that one, but I can assure you that it is not good to be in utero and exposed to nicotine.
Dame Andrea Leadsom
Q
Professor Hawthorne: We have known for a long time that passive smoking increases the risk of not just asthma, but upper respiratory tract infections and ear infections. It is very much part of a GP’s role when they are consulting with such patients coming in with these infections to ask about parental smoking. It is interesting that the responses are nearly always the same. If the parent smokes, they will always say, “But I only ever smoke outside.” Of course, one has to take that as it is, but I suspect that they are probably not always smoking outside. It is definitely a well-recognised link, but I am seeing it a bit less than I used to.
Everybody knows about the dangers of smoking. A lot of my patients, when I talk to them about needing to stop smoking, already know what I am saying. Quite often, I will say to them, “Well, you know what I am going to say next, don’t you?”, and they will say, “Yeah, I know. I need to stop smoking.” The conversation then proceeds from there.
We also have evidence that, in general practice consultations, a short intervention can be very effective. We know that people are very pressed for time, and there is only so much we can cover in a 10-minute appointment, especially if the patient is coming with three different problems. But there is good evidence that with even a very short intervention—I think in about 10% of cases—patients will actually stop smoking. It is always worth talking about, and if I get the time, I have a much longer spiel, because you need to think about the behavioural and addictive aspects of smoking. We go through, “When are you most likely to want to smoke? Is it after a meal, when you are on the phone or when you first get up in the morning?” We talk about what else they can do instead. I had one patient who went and dug the garden whenever she wanted to smoke. It is that kind of conversation.
Dame Andrea Leadsom
Q
Professor Hawthorne: For adults, it is having that heart attack that maybe you could have avoided if you had stopped smoking before. Again, that is part of the conversation I have with patients. I say, “You are a heavy smoker, and you are at risk. Wouldn’t it be better if you stopped smoking before you have the heart attack, rather than after?” There are things like that, for sure.
We also operate a cycle of change psychological model—the Prochaska and DiClemente model. Essentially, it is a bit like having a clock face. We work out where the patient is on the clock face, and we are trying to get them round the clock to 12. If they are at somewhere like 2 o’clock, that is them saying, “Yeah, I know it is bad for me, but really no way am I going to do anything.” By 4 or 6 o’clock, they are saying, “Yeah, I know it is bad for me. I have tried a few times but it is just hopeless.” By quarter to, they are saying, “I’ve really got to do something”, and by five to, they are coming in and saying, “Doctor, you have to help me stop now.”
Dame Andrea Leadsom
Q
Professor Hawthorne: Not necessarily. It is about pushing people psychologically around that clock face. I try to work out where they are on the clock face and see if I can nudge them a bit further round, until one day they come and say, “I’ve got to stop now. What can you do to help me?”
Dame Andrea Leadsom
Thank you.
Professor Turner: As Kamila says, there are myriad drivers—teachable moments. Sometimes, when your child is admitted to hospital with an asthma attack, that might be the thing that makes both parents say, “That’s it.” It might be that the grandmother says to her daughter, “You’ve got to stop for your child.” Legislation might also be one of those teachable moments that make people reflect on their 29 past unsuccessful attempts and think, “I’m going to do it again.” There is no one thing, but there are clearly teachable moments, as we all have when we change our behaviour. As I suggested, I think this legislation will be one of those.
Dame Andrea Leadsom
Thank you very much. One last question: do you think the financial incentives for pregnant women and their partners would help?
Professor Turner: I think this is extremely contentious, but the evidence is that it does—sorry, you did ask me about pregnancy before. Pregnancy itself can be one of those opportunities to quit. Those parents who continue smoking—12% in Cumbria—feel terribly guilty. Anything we can do for that person, who has been addicted since she was 15 or 16, can help them to quit. There is no doubt—in Dundee, the trials have shown that, if you give mums incentives, in terms of vouchers rather than money, it helps them to quit, particularly if they are from deprived communities.
Rachael Maskell
Q
Professor Hawthorne: I am not a nicotine expert, but my understanding is that there is a risk from vaping, but it is about 5% of the risk from smoking. That is the best I can do in comparing the two. When I talk to patients about stopping smoking, vaping is one of the things we talk about as an alternative, with a view to eventually stopping vaping as well. Of course, there are all the other products: we use patches and chewing gum—all the usual things. It is difficult to quantify exactly how much less dangerous vaping is than smoking.
Professor Turner: Just to supplement that, as a user—if that is the right word—or a customer buying a vape, you can select the dose you want. There are doses that are equivalent to cigarettes and doses that you can wean yourself down on.
You asked whether we would be missing an opportunity if we do not introduce a smoke-free generation. I think we would absolutely be missing an opportunity. If we look back, the legislation on smoke-free public spaces across the UK was landmark. We all remember the days when you went on a plane and there was a smoking bit up front and a non-smoking bit at the back. If we were to go back and say there would be no smoking areas, we would think, “Wow, that would be transformational.” We have come on a journey, and the legislation has been part of it. I see a smoke-free generation as the logical next step, and I really think we have to take it.
Rachael Maskell
Q
Professor Turner: To me, smoking and nicotine are two sides of the same coin. Nicotine addiction is smoking.
The Chair
I just want to advise the panel that we have about 13 or 14 minutes to go, and four Members want to ask questions, so be kind to your colleagues.
Steve Tuckwell
Q
Professor Turner: That is a fair question. We recognise that there is a thriving illicit vape market, and the vaping industry is aware of that. As to whether the legislation will exaggerate that should it be passed, that is difficult to tell because, by definition, we do not know how much illegal activity there is. It is a reasonable consideration, and probably a lot of illicit vapes are already being sold. It is one of those things that you might consider when you vote, but I do not think the problem is sufficient to mean that the Bill should not go through.
Mary Kelly Foy
Q
Professor Hawthorne: It is much more prevalent. There is a theory called future discounting. If you have few choices—if you do not have much money and much choice in what you eat, what you do and where you work—you do not think about your health in 20 years’ time; you think about today. Many people feel that smoking helps them get through the day, and that is what they do. It is a really difficult thing to talk to people about because some people will say to me, “I’ve just got to. I can’t get through my day otherwise.” I can say, “There are alternatives. There are other ways that we can help you get you through your day,” but you have to get them round the clock face that I was talking about, until the point comes when they say, “I’ve got to do it now.”
Nickie Aiken
Q
Professor Hawthorne: Do you mean as part of a smoking cessation programme?
Nickie Aiken
Yes, rather than having them sold as they are at the moment.
Professor Hawthorne: That is an interesting question. I prescribe nicotine patches; why should I not prescribe vapes? That would be my thought.
The Chair
I call Dr Caroline Johnson—you have all been so kind to one another, we are now ahead of time.
Dr Johnson
Q
Do children breathe in second-hand chemicals when they are proximal to adults vaping, or in an enclosed environment? If they do, what effect does that have on children’s lungs? Would you, or the royal college, support a ban on vaping in public places in a similar way that we currently ban smoking?
Professor Turner: I think that vaping in schools and school toilets is a big problem. First, it means that fire engines come out and that disrupts school. As you say, there are some children whose asthma will get set off by exposure to vapes, for example. So I think that it is a big problem, and you have already heard from schools. We are still not sure what components of the exhaled second-hand vape, if you will, are causing symptoms, but, as you described, that happens.
On your third question about banning vaping in public spaces, I would not have an opinion on that. If they are being used by people who are nicotine-addicted to help to come off their nicotine addictions, I would not be unhappy with that. Most of the second-hand vape is water vapour, but if you walk behind somebody who is vaping, you can tell what the taste is, so there are chemicals in there. I think that banning them in public spaces, at this point in time, is something that I would not have a strong opinion on.
Professor Hawthorne: I think we are on a journey, over the years, towards stopping smoking as a nation, so this Bill looks like a great step forward. I think that it is a landmark suggestion, and now that New Zealand has backtracked, I think we will be ahead of the game.
Professor Turner: And we have a proud record of doing this, from a legislative point of view.
Professor Hawthorne: Also, to some extent, sometimes, when you make a big step—which this is—you then might want to stop and wait, consolidate, check and gather more data before you make the next step.
The Chair
If there are no further questions, I thank the witnesses for their evidence. That brings the morning’s session to an end. The Committee will meet again at 2 pm this afternoon, here in the Boothroyd Room, to continue taking oral evidence.
Ordered, That further consideration be now adjourned.—(Aaron Bell.)