Tobacco and Vapes Bill

Debate between Baroness Merron and Lord Crisp

Monday 3rd November 2025 Grand Committee

[Baroness Merron (Lab)]

My Lords, I am most grateful for all of the contributions on this much debated set of amendments. I understand the concerns that have been raised.

I begin with Amendment 33 in the name of the noble Baroness, Lady Bennett of Manor Castle, and Amendment 34 in the name of the noble Earl, Lord Russell. Let me turn first to the health arguments that have been put forward. We know that cigarette filters have historically been marketed incorrectly as making smoking safer, and that smokers perceive cigarettes with a filter as being more enjoyable and of lower risk. These points were mentioned by a number of noble Lords, including the noble Baroness, Lady Bennett, and the noble Lords, Lord Rennard, Lord Patel, Lord Bourne and Lord Crisp. However, as with all regulations—I know that noble Lords will understand this—it is important that any measures are based on evidence, are fully considered and do not create unintended consequences. Obviously, that will be a theme throughout the Bill, particularly as we discuss these groups of amendments.

We acknowledge that there is some limited evidence on the health harms of filters, but we are not currently aware of any clear evidence—that is what is not in place—to show that a ban on filters would lead to a reduction in smoking rates; of course, that is the focus of this Bill. When it comes to encouraging existing smokers to quit—the noble Baroness, Lady Bennett, rightly highlighted this area—we are prioritising investing in local stop smoking services, delivering smoking cessation campaigns, delivering access to nicotine replacement therapy and introducing positive, quit-themed pack inserts. I was glad to hear support for such measures from the noble Lord, Lord Rennard, and the noble Baroness, Lady Walmsley. On that point, I want to refer to effectiveness, particularly as the noble Baroness, Lady Walmsley, made the point that such inserts might simply be discarded. The modelling suggests that, in terms of increased effectiveness because of themed pack inserts, there would be 150,000 additional attempts at quitting. Over two years, this would result in 30,000 successful quitting scenarios, which would reduce the incidence of smoking—exactly what we are focusing on.

The noble Lord, Lord Young, raised the concern that filters allow for flavoured crushballs to be added. I hope that it is helpful for me to say to your Lordships’ Committee that this Bill gives the Government the power to regulate flavoured tobacco products, herbal smoking products and cigarette papers, as well as any product that is intended to be used to impart flavour; this could include flavoured accessories, such as filters.

I turn now to the environmental concerns raised by a number of noble Lords, including the noble Earl, Lord Russell, and the noble Baronesses, Lady Bennett and Lady Walmsley. It is the case that cigarette butts are the most littered item in the UK. They are a blight on our streets and our communities. They take a long time to degrade, and they leach toxic compounds into the environment. The noble Baroness, Lady Grey-Thompson, raised the role of local authorities and the pressure on them because of this littering; again, I certainly take her point. Local authorities have a range of powers to tackle littering, including fixed-penalty notices for some £500. I also see the challenge that the littering of cigarette butts presents to local authorities.

However, ultimately, the most effective thing we can do to tackle tobacco litter as well as protect people’s health is, clearly, to reduce the prevalence of smoking. It is worth referring to the powers available to Defra, which would enable the Government to limit the damage to the environment caused by filters. Although we do not plan to take action in the short term, I assure noble Lords that we will certainly continue to monitor the evidence and keep this under review.

On Amendment 34, we do not believe there is sufficient evidence at present that banning plastic filters will lead to better environmental outcomes, although I absolutely understand the wish for this. Evidence suggests that filters labelled as biodegradable or plastic-free, as the noble Baroness, Lady Walmsley, mentioned, can still take a very long time to degrade in the natural environment and leach harmful chemicals. Studies have also shown that people who believe that cigarette butts are biodegradable are more likely to litter them. We are therefore concerned that a ban on plastic filters could have unintended consequences and undermine attempts to reduce littering, if people incorrectly believe that plastic-free filters somehow do not damage the environment.

[Lord Crisp (CB)]

Before the Minister moves on, can I ask a question that I asked earlier? If she recognises that 75% of smokers think that filters reduce the risk—indeed, they may increase it—does she not think the Government should be doing something to counter that belief, perhaps more actively than they are doing at the moment?

[Earl Russell (LD)]

Before the Minister rises, I welcome the response to this amendment, but the point is that most people still litter their fag butts in any case and believe that they are already biodegradable, so I press the Government to take further action in this area.

Anti-depressants: Cost, Risks and Ramifications

Debate between Baroness Merron and Lord Crisp

Wednesday 11th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I am not specifically aware, but I will be glad to look into this.

[Lord Crisp (CB)]

My Lords, I want to raise the issue of dependency on anti-depressants. As the Minister will know, a lot of people have great difficulty coming off these anti-depressants. It is striking that for those using drugs illegally or with substance abuse, there are many services, but there are no services in the NHS for those seeking to withdraw from anti-depressants. This is a major problem. With that in mind, I ask two questions. First, will the Government consider the delivery of a helpline, which has been called for in a number of reviews, so that people can have some access to help? Secondly, will they support an NHS project designed to introduce withdrawal services within the NHS?

[Baroness Merron (Lab)]

The noble Lord makes an important point about the effects of withdrawal from any medication. I am not sure that this is an exact answer but there is the 111 helpline, which has been expanded to refer to mental health services, so people can ring and ask those questions. However, I take his point about withdrawal. We may wish to consider this as we go towards the 10-year plan.

NHS Continuing Healthcare

Debate between Baroness Merron and Lord Crisp

Monday 2nd September 2024 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

NHS continuing healthcare fulfils a unique function within the health and social care system, providing support for people with the highest levels of need by fully funding their health and social care. To monitor its effectiveness, the department works closely with NHS England, the wider sector, such as the Parliamentary and Health Service Ombudsman, and voluntary organisations which represent people with lived experience. This includes assurance work and projects to promote consistency in implementing this care.

[Lord Crisp (CB)]

My Lords, I thank the Minister for her very positive response. As she says, NHS continuing healthcare is vital. However, there are problems. Some of those are about finance, but I want to ask her specifically about the criteria for eligibility both nationally and locally, which are obscure and difficult. First, at the national level, can the Minister define precisely the level of nursing or other health services that a local authority can legally provide and which therefore do not have to be provided by the NHS? Secondly, almost 85% of applications other than fast track are refused, yet people have been encouraged to apply by health and care workers locally. Does the Minister agree that more needs to be done to ensure there is a clear understanding of who may or may not be eligible, rather than wasting so much of patients’, relatives’ and professionals’ time on unsuccessful applications?

[Baroness Merron (Lab)]

I do understand the concerns raised by the noble Lord and agree that we need to take a close look at all these areas. I have already raised that with officials and with Minister Kinnock, who is the responsible Minister in this area. On the second question, there is indeed a relatively low conversion rate, and I understand that the decision was originally made to ensure that everyone who might be eligible is actually assessed. The assessment acts as a gateway to other NHS-funded care but, having looked at it, this could perhaps be made somewhat clearer. On the first question, the noble Lord will understand that I cannot give a definitive answer, and he will be aware that legislation does not limit the number of hours or the cost of nursing care that a local authority may provide. However, the Care Act 2014 sets out that local authorities can provide nursing care only in very limited circumstances—for example, where it is a minor part of overall care, such as basic wound care.

Health and Care Bill

Debate between Baroness Merron and Lord Crisp

Committee stage
Friday 4th February 2022 Lords Chamber

[Lord Crisp (CB)]

My Lords, I imagine that your Lordships’ House and Parliament generally very often have a choice in terms of the rightful tensions between, on one level, supporting freedom of action and speech and, on the other, balancing that against harms to individuals and society as a whole from smoking. I know that I am on the latter side of the argument in this case.

It is also worth noting that this is not about just the risk that comes from smoking—risk comes from many sources—but rather the scale of the risk and the impact that it has across the whole of the health system. Despite everything else that has been said about public health, it is worth remembering that this is the biggest risk and that half of the difference in life expectancy between people in poorer neighbourhoods and those in richer ones is due to smoking. That scale is the issue that we are talking about.

I was pleased to add my name to the four polluter pays amendments led by the noble Lord, Lord Young. On the notion that a payment or levy based on income—not a tax—will be used for reducing smoking, providing smoking cessation clinics and improving public health, I believe that this is a different arrangement from that consulted on by the Government in 2015.

I will make several other quick points that very much fit in with what has been said. First, this is about what the Government need to do if they are going to level up under the ambitious plans that were set out only yesterday for delivering improvements in life expectancy and the differences in life expectancy around the country—that is really important, and something will need to be done about smoking if those plans are going to be achieved.

Secondly, this is also about poverty: the average smoker spends £2,000 a year on smoking, and some new research suggests that this leads something like half a million households around the country into poverty. I have not studied that, so I only say “suggests”, but it seems to me to be an important point.

Thirdly, perhaps at one level, this started off for people as a lifestyle choice, but it is actually an addiction. I speak as a former smoker who made an enormous effort to give up. The average number of attempts before you give up is around 30, but I think that I probably exceeded that, and I can tell you the day on which I finally succeeded. It is an addiction, and this whole business runs on addiction—not on the occasional cigarette or the cigar at Christmas—and we should never forget that.

Fourthly, I ask whether the polluter paying is right in principle or just pragmatic. In a sense, it does not really matter: it is pragmatic. Over the last five years, NHS smoking cessation treatment services have been cut: about £23 million a year was spent on such campaigns, but now it is less than £2 million. There is not a lot of money around at the moment, obviously, and this seems a very pragmatic solution for finding money to support smoking cessation services—in addition to the fact that I would see it as being right in principle.

Finally, there is real evidence that those smoking cessation services work. Therefore, it would be money well invested in the future health of our nation.

[Baroness Merron (Lab)]

My Lords, this has been an interesting debate, and we have heard various views. I thank my noble friend Lord Faulkner for leading on this group of amendments, and I thank noble Lords for putting forward their amendments and views so that we can explore how we respond to the challenge of smoking.

My first point leads on very neatly from the comments of the noble Lord, Lord Crisp. Smoking remains the leading preventable cause of premature death. As the noble Lord observed, it is a matter where we should consider the scale of the effect and the fact that this is about addiction. It is not about free choice but is something that we must assist people to overcome. While rates are indeed at record low levels, there are still more than 6 million smokers in England, and the need to reduce this number is particularly important now, as smokers are more at risk of serious illness from Covid.

The economic and health benefits of a smoke-free 2030 would be felt most keenly among the most disadvantaged. However, as we heard from the noble Lord, Lord Young, at current rates we will miss this target by seven years on average, and by at least double that amount for the poorest groups in our society. So it is vital that we motivate more smokers to quit while reducing the number of children and young people who start to smoke.

Within this group of amendments, noble Lords have suggested a broad raft of anti-smoking measures, including information inserts and warnings printed on rolling papers, a consultation on raising the age of sale to 21 and a “polluter pays” approach which argues that tobacco companies should pay for smoker treatment programmes. All these measures can be underpinned by broad cross-party support and public support. Certainly, the All-Party Group on Smoking and Health is very supportive of this group of amendments.

The pandemic has posed new challenges to us, and there is a new group of people who started smoking but who otherwise would not have done so. We have been promised a new tobacco control plan, and I hope that the Minister tells your Lordships’ House when we can expect it. The labelling and information interventions contained within this group of amendments have a strong evidence base from other countries, as well as from research in the UK. I hope that the Minister will be amenable to them.

Picking up on a few of the points raised within this group, it is very shocking to note that more than 200,000 11 to 17 year-olds who have never smoked previously have tried vaping this year. It is a very strange situation that e-cigarettes and similar products can be given free to somebody under 18 but they cannot be sold to them. We do not want to see a situation where young people are brought to smoking by smoking substitutes.

In reference to the amendment that proposes a United States-style “polluter pays” model to fund all these interventions, including the restoration of lost smoking-cessation services, the noble Lord, Lord Young, described practical ways in which this could come about. Certainly, the Minister in the other place did not close the door to this idea in Committee. I hope that we will hear from the Minister some agreement towards this.

Amendment 270 promotes a consultation on raising the age of sale, because we know that the older a person gets, the less likely they are to start smoking. If this is to happen, it requires proper consultation with relevant stakeholders, not least young people themselves, including those who are underage. It must be rigorous in checking what will work. Attitudes to the incidence of smoking have changed over the years, but the direction now is firmly one way, and that is to prevent ill health and premature death. This group of amendments contains proposals to keep us moving in this direction, to assist those who smoke and to prevent those who seek to smoke, particularly those at the younger end of the scale. I hope that this group of amendments will find favour with the Minister.