Tobacco Control Plan

Alex Cunningham Excerpts

Thursday 19th July 2018 Commons Chamber

[Steve Brine]

I agree with the right hon. Gentleman. Those of us who have secure estates in our constituencies and go in and visit them regularly will be aware of just how much of a challenge this is, given how ingrained smoking is within the cohort. That relates to the point I made about specific groups. I think that the Prison Service deserves great credit. Suffice it to say that it has a lot of pressures on it, and in some ways it probably felt that this was the least of its worries and the last thing it could deal with, but it is actually very important. That is why I say we are working well across the Government, and the Prison Service is really pulling out the stops in its area. I thank him for that intervention.

To finish on the protocol, HMRC will continue to lead on it on behalf of the Government, working with my officials at the Department of Health and Social Care. Through the protocol, we are sharing our expertise as a leading tobacco control nation; this is not just about what we are doing domestically. We are funding the FCTC secretariat with £15 million over the spending review period to support tobacco control in 15 low and middle-income countries. I am very proud of that work, and I am pleased to say that we are already having an impact. Georgia introduced smoke-free legislation and a ban on advertising on 1 May. It seems strange to talk about banning advertising as a new measure, given how long a ban has been in place in our country, but it shows that other parts of the world have a long way to go to catch up. I am very proud that we are using our experience and our evidence-based experience to help countries such as Georgia to do so. I want to place on the record my congratulations to Georgia.

Domestically, Her Majesty’s Treasury continues to maintain high duty rates for tobacco products to make tobacco less affordable, which is absolutely right. Public Health England, for which I am responsible, and NHS England are working on a joint action plan to reduce smoking in pregnancy. A key part of this is helping midwives to identify women who smoke and help them to quit and to support the implementation of National Institute for Health and Care Excellence guidance on reducing smoking during pregnancy and immediately following childbirth.

PHE has been encouraging the use of e-cigarettes to help people quit. As part of this, the most recent Stoptober campaign for the first time highlighted the role of e-cigarettes in quitting. The best evidence suggests that e-cigarettes are helping thousands of people to quit and that they are particularly effective in the context of a smoking cessation clinic. PHE’s data website, “Local tobacco control profiles for England”—another snappy title I dreamed up—is helping local commissioners and service planners to identify where they are succeeding, where they face the greatest challenges and how they compare with their neighbours and the rest of England.

[Alex Cunningham (Stockton North) (Lab)]

I very much welcome the Minister’s comments in The Guardian newspaper this morning about the activities of one tobacco manufacturer that has been contacting or at least trying to ingratiate itself with NHS staff by helping them to quit smoking. Will he write to all trusts and clinical commissioning groups telling them that they should have nothing at all to do with this initiative?

[Steve Brine]

I already have and NHS England already has: we have already done so. We think that Philip Morris International’s move is totally inappropriate and totally contrary to the protocol. I do not think I could have been clearer either in the press or at the Dispatch Box today, and I thank the hon. Gentleman for giving me the chance to say so again.

All our local activity has the overall goal of helping people to quit smoking and stopping others starting in the first place, so how are we doing? Here is the score card. Publications by the Office for National Statistics and NHS Digital earlier this month show that we are making progress. Since 2011, the number of adult smokers has dropped by a fifth to the lowest level since records began, and we are fully on track to achieve our 2022 ambition for adults. Among 15-year-old smokers, there is good progress, and figures published last year showed that the prevalence of smoking has reduced by a further percentage point from 8% to 7% since the publication of the plan. The number of e-cigarette users in that group is also falling. Latest figures from the ONS annual population survey reveal that smoking rates among 18 to 25-year-olds are falling faster than in any other age group. Considering that that age is when most smokers start smoking, I am particularly pleased with that.

We are also making progress on inequality. Although routine and manual workers continue to have higher smoking rates compared with the rest of the population, the gap has narrowed slightly, from 26.5% at the publication of the plan to 25.7% as reported by the ONS earlier this month. Those are achievements to celebrate. Nevertheless, I must be honest with the House and say that progress on tackling smoking in pregnancy is disappointing, and in truth the figures have barely moved in the past year.

What shall we do in year 2 of the plan? First and foremost, I am determined to redouble our efforts to support pregnant smokers to quit. That will be best for them and for their babies, and we need people to understand that. Secondly, we will use the opportunity of the Government’s investment in the NHS, which the Prime Minister announced last month, to embed prevention and cessation more firmly into the culture of the NHS. Last month, the Royal College of Physicians, which has a proud record of groundbreaking reports on tobacco, published “Hiding in Plain Sight: Treating tobacco dependence in the NHS”. That weighty report calculated that the cost of current smokers needing in-patient care is £890 million a year. It points out that smokers are 36% more likely to be admitted to hospital at some point than non-smokers, and it makes the powerful argument that smoking cessation repays the cost from year 1. I welcome that report, and I will be making that case loud and clear as we engage with NHS England on the content of the 10-year plan that the Prime Minister has asked it to produce.

Thirdly, we will continue to engage with local authorities —they are now top-tier public health authorities up and down the land in England—on promoting smoking cessation as the best evidence-based means of quitting smoking. Encouraging the NHS to do more on cessation is emphatically not about removing responsibilities from local authorities. This is about creating a whole-system approach in which addicted smokers can access the support they need to quit. Public Health England will continue to provide local councils up and down the land with facts and advice on tackling smoking—for example, it will work with sustainability and transformation partnerships, which should be leading that whole-system approach in the constituencies of all English Members.

Fourthly, as I have mentioned, we will continue to raise tobacco duty to make tobacco less affordable, while also taking action to tackle the illicit trade in tobacco. Fifthly, we will maintain a careful watch on so-called novel tobacco products. The Government are keen to use the opportunity of newer products, such as e-cigarettes, to help smokers to quit, without undermining the key message that the best thing someone can do for their health is quit completely. As I said in the Science and Technology Committee’s inquiry into this subject, we will continue to keep the harms of products such as heated tobacco products under review and continue to hold the industry to account. We have been explicit that the promotion of tobacco products is unlawful, as my recent letter to Philip Morris International makes abundantly clear—that letter was written before the one I mentioned in response to the hon. Member for Stockton North (Alex Cunningham).

Last but not least, we will continue to make the case for tobacco control internationally, building on our reputation as a leading tobacco control nation with credibility in that space. We have such credibility because our consistent work in this area goes back to the coalition Government, the previous Labour Government and the Conservative Government before them, and such consistency means that we are highly credible around the world. More than 7 million people a year across the globe die from smoking-related disease, and the UK Government can help make a dent in that toll by sharing knowledge and skills.

[Steve Brine]

I think cigarettes cause the most damage, because of the tobacco and the nicotine. The carcinogenic properties of the former are lethal. That link was proven with the lung cancer study that started the ball rolling. I pay tribute to my hon. Friend as the chair of the all-party group for the work he has done in this area. There are a lot of things that we know and there are a lot of things that we still do not know. Some people say that I do not go far enough to promote e-cigarettes and novel products, and some people say that maybe we go too far—I mentioned Stoptober. That generally suggests to me that we are in the right place. What I would say—I think that I said it earlier—is that an awful lot of research is still needed on e-cigarettes. One Member once told me that we should make e-cigarettes free on prescription to all pregnant women. The reason I did not say, “Yes, I think that’s a good idea” is that I still think there are risks to that product. I still think that the best thing people can do is to stop chuffing on anything, whether traditional cigarettes or so-called novel products. I thank him for his intervention, and I look forward to hearing what he has to say during the debate.

[Alex Cunningham]

I thank the Minister for giving way a second time. I join the tributes to both the Minister and the chair of the all-party group. There has been tremendous cross-party work on this issue—that has always been the case. The Minister mentions the role local authorities have to play. We all know the pressure they have been under in recent times. I wonder whether he could see a mechanism that would provide and ring-fence the funds to enable local authorities to fulfil their role. Currently, they are struggling to do so.

[Steve Brine]

I thank the hon. Gentleman for that intervention. On providing support to help smokers quit, as I said, we have moved from the national context of legislative work to local application. The challenge is that adult smoking rates vary considerably across the country—for example, they are 8% in Wokingham and 23% in Kingston upon Hull—so it is right that local councils have the flexibility to spend that money. There is some £16 billion in the ring-fenced public health grant during the spending review period, so there is a lot of money in the system. But am I happy with patchy services in areas where smoking rates are too high? No, I am not. That is why I have said that the Government have not made a decision on full business rate retention. I would be concerned about the impact that that might have. I would want all sorts of reassurances from local councils if I were to make that change. Do I think it right that local authorities can design services for their local area? Yes, I do.

The new Secretary of State and I have already discussed prevention, which is one of the three main pillars he wants to focus on. I have told him that the new investment of £20 billion that we are putting into the NHS is fantastic. Bluntly, we could have the money on the side of the bus three or four times over, but unless we get serious about prevention, in this space as much as any other, the NHS will continue to be under enormous pressure. Local authorities are a key partner for us.

I would also say, not least because the chair of the all-party group on community pharmacy is sitting behind the hon. Gentleman, that community pharmacists and pharmacies have a key role to play. They are an NHS centre on street corners up and down our land. Some of them provide really good work. The healthy living pharmacies I have seen help people to access the services they need. They provide a little bit of mentoring and support, using their experience to say, “Yes, you can beat this,” and signposting them to services, whether through the public sector or the third sector.

There is an awful lot that we can still do. That is why the 10-year plan will have prevention embedded at its heart, as the five year forward view said it would—and it did, but I do not think that it lived up enough to the ambition on that. Perhaps people would expect the Minister responsible for prevention to say that, but I am nothing if not consistent.

Tobacco remains the single biggest avoidable killer in our country today, causing a third of preventable cancers. It contributes to around half of health inequalities between rich and poor in our society and is a potent symbol of the burning injustices that the Prime Minister spoke about, which I think affect the life chances of poorer people up and down our land. The tobacco control plan represents the Government’s continuing commitment to tackling this epidemic. It was never presented as a panacea and it is still not a panacea, but it is a cracking good start.

Over the past year, we have seen some impressive progress, but I am absolutely not complacent. In World cup terms, I would suggest that we have made it through to the knockout stages, but nothing more. I hope to be able to demonstrate further progress in a year’s time, and no doubt we will discuss that again in the House. I look forward to hearing hon. Members’ contributions, and I am happy to introduce this important debate.

--- Later in debate ---

[Alex Cunningham (Stockton North) (Lab)]

I appreciate being called at this stage of the debate. I declare my role as a vice-chair of the all-party group on smoking and health. This was going to be a Backbench Business debate on a motion that I put forward to consider further action necessary to deliver the vision set out in the tobacco control plan for England 2017 of a smoke-free generation by 2022.

I am grateful to colleagues across the party groups for working with me to secure the original debate. I am also grateful to ASH and other organisations for assisting with my preparation today. I will read the original Backbench Business motion into the record so that the Minister can take it on board. It reads:

“That this House welcomes the Government’s Tobacco Control Plan published in July 2017; notes its ambition to create a smokefree generation and to reduce the prevalence of 15 year olds who regularly smoke from 8% to 3% or less; notes the slowing rate of decline in youth smoking prevalence and risk to progress; and calls on the Government to develop new strategies to ensure that it allocates the resources and the funding necessary to deliver on that ambition.”

I very much welcome what the Minister had to say today and the 66 recommendations that are coming forward to move things along. I want to summarise the key points that I had originally hoped to make in much more detail.

This is an important issue for me in relation to my home area, the borough of Stockton-on-Tees. The smoking rate has come down considerably: 15% of the adult population in Stockton are currently smokers. Some 31% of the households that have a smoker are below the poverty line. If they quit, 1,991 households would be lifted out of poverty, and residents of those households include 1,342 dependent children. Smoking costs Stockton-on-Tees approximately £37.4 million, it costs the NHS £8.5 million, and £24.1 million in lost productivity. Some 15.3% of pregnant women in our area smoked at the time of their baby’s delivery.

Furthermore, the analysis of the most recent youth smoking data by Cancer Research UK finds that more than 350 young people started smoking every day. That is the equivalent of 17 secondary school classrooms. At the current rate of decline in smoking cessation, we will fail to achieve the ambition for England that, by 2022, 3% or less of 15 year olds are regular smokers.

Health inequalities are growing: one in four people in routine and manual occupation smokes compared with one in 10 in professional and managerial occupations, and that gap is widening. The key points of the Backbench Business proposal were the need to do more to reduce smoking initiation in young people and to encourage quitting among adults. We must reduce young people’s exposure to smoking in film, television and other media. That issue was raised by the hon. Member for Linlithgow and East Falkirk (Martyn Day) a few minutes ago.

There is substantial peer-reviewed evidence that shows a causal link between exposure to smoking in the media and starting to smoke and that young people are being exposed to smoking on screen in the UK. Government have a role to play in encouraging media regulators to take smoking seriously and to act in this area. The Government need to urge Ofcom and the BBFC to revise their guidelines with respect to smoking on screen in entertainment media viewed by under-18s to discourage any depictions of tobacco use and to require action to mitigate any remaining exposure. We can make it more difficult for young people to obtain cigarettes by increasing the age of sale to 21, introducing retail licensing for the sale of tobacco and properly funding regional activity to support enforcement.

In the UK in 2014, 77% of smokers aged 16 to 24 began smoking before the age of 18. Evidence from the US shows that raising the legal purchase age to 21 reduces the number of young people who start smoking, reduces smoking-caused deaths and immediately improves the health of young people. More than one third of under-age smokers buy their cigarettes from shops without a licence, which can be revoked if they continue selling—so tobacco retailers can continue to sell tobacco to minors or to sell illicit tobacco. A retail licensing scheme covering all levels of the supply chain from manufacturer to retailer would also help to protect the business of legitimate retailers who obey tobacco control legislation.

As others have said, Government need to do much more to support and enhance enforcement where there is illegal activity, but funding cuts have led to significant reductions in the capacity of trading standards departments, which are responsible for seizures of illicit tobacco and prosecutions for tobacco fraud. From personal experience, I know that the capacity simply does not exist. Time and again, I have alerted Her Majesty’s Revenue and Customs to tab houses selling tobacco illegally in Stockton, but those very same tab houses continue to sell. HMRC is the beneficiary of enforcement activity, as it protects tax revenues, so surely it should be required to fund the activity, which could be organised at the regional level, which is the most cost-effective way of doing it.

One of my principal concerns is the much higher incidence of smoking in disadvantaged communities and how we de-normalise it and tackle health inequalities by funding mass media campaigns, which the hon. Member for Harrow East (Bob Blackman) talked about in detail. Some 83% of children who smoke regularly have family members who smoke, and this is magnified in disadvantaged communities, such as the town centre ward in Stockton. Public spending on these campaigns, however, has fallen from a peak of £23.38 million in 2008-09 to only £2 million last year. We need to reverse those cuts, as such campaigns are highly effective and can be targeted at poorer and more disadvantaged groups, which have the highest rates of smoking.

The “polluter pays” levy on tobacco manufacturers, which the all-party group on smoking and health supports, could help to fund mass media campaigns as well as other important tobacco control measures. It is time to consider the greater role for social media to amplify the impact of mass media campaigns. There is now the capability to target individual postcode districts with specific messages using, among other things, the promote tool on Facebook. We could help the 60% of smokers who say they want to quit smoking by funding stop smoking treatment and including inserts in tobacco packets encouraging quit attempts.

In 2017, the budget for stop smoking services was cut in half by local authorities in England. The NHS and local authorities need to collaborate more effectively to ensure that smokers, particularly vulnerable groups who tend to be more addicted and have greater difficulty quitting, have access to the help they need. I think the Minister alluded to that in detail—if one can allude to anything in detail—in his speech. Simon Stevens told the Health Select Committee a couple of weeks ago that local authority stop smoking services were not sufficient and that NHS England needed to do more to treat vulnerable groups of smokers under its care. He said:

“It is pretty clear that we will have to keep pushing harder on smoking, and smoking cessation is part of that. That cannot all be done through local authority commissioned services; we are going to have to look at whether the NHS can embed smoking cessation in more of the routine contacts that we have with vulnerable groups who are still smoking. ASH and the Royal College of Physicians have put out an important set of proposals in the last 10 days, which we will take a very careful look at.”

I very much welcome that, and I hope the Minister does too.

On the subject of pack inserts, research from Stirling University has shown that smokers of a variety of ages, gender and social grade support their use as an aid to encourage them to quit. The Minister said earlier that we did not need more legislation. Well, perhaps we do. We need legislation mandating pack inserts, which would provide an inexpensive and highly targeted means of supplementing on-pack warnings.

People with mental health conditions are being left behind in all this. Approximately 40% of people with a mental health condition smoke. Smoking is the main reason that people with mental health conditions die 10 to 20 years earlier on average than the general population. They tend to smoke more heavily, be more heavily addicted and find it harder to quit. It is not that they do not want to quit, but that they need more help to succeed. The Minister mentioned this in his opening remarks, but I hope that he will say a little more when he winds up the debate. I can help a wee bit—at least the people who are briefing me can.

To reduce smoking among people with a mental health condition, we need to ensure that all mental health trusts treat tobacco dependency alongside implementing smoke-free grounds; to have improved data on smoking rates and service provision for people with a mental health condition who smoke; and to empower and inform people with a mental health condition to take control of their smoking and to include them in the development of services. We need specific national targets for reducing smoking rates in people with mental health conditions, and shared plans between local authorities and the NHS to ensure that smokers get support and help in the community as well as when they are being treated as in-patients. We need to train all mental health staff in smoking cessation and to offer a range of alternative nicotine-containing products, including e-cigarettes, to those struggling to quit. Furthermore, as called for by the Royal College of Physicians and ASH, we need treatment for tobacco dependency to be embedded throughout the NHS, not just in NHS mental health trusts. This would improve treatment outcomes. The Minister knows all this.

Smoking exacerbates as well as causes disease, and helping smokers to quit can reduce NHS treatment costs and improve quality of life for patients. This includes pregnancy, chronic obstructive pulmonary disease and other respiratory diseases, cardiovascular disease, mental health, surgery, diabetes and HIV/AIDS, not to mention 16 different types of cancer. Advice and treatment can increase patients’ chances of quitting up to fourfold. It is about the cheapest and most effective healthcare intervention around, costing hundreds of pounds per successful quitter. But despite these impressive results, only 24% of patients diagnosed with lung cancer are offered advice to quit by their GPs, and only 13% are prescribed stop smoking treatment. The RCP has calculated that if all smokers were provided with help to quit, the NHS could save £60 million annually in hospital readmission costs and A&E attendances alone from year one onwards, once the cost of the treatment is taken into account.

There are many other aspects to this issue. My hon. Friend the Member for Harrow East—I call him my hon. Friend, despite the fact that he sits on the Government Benches—talked about other nationalities living in the UK. We could talk in great detail about people from eastern Europe and the extremely high levels of smoking in those communities, but I want to finish with just two simple questions for the Minister. Will the Government seriously consider all the recommendations that I have outlined in the debate today? Will he commit to asking Simon Stevens, as chief executive of the NHS, to confirm that tobacco dependency treatment for all smokers, as recommended by the RCP and ASH, will be included in the plan for the NHS to be published in November? He knows, as we all do, that lives depend on it.

--- Later in debate ---

[Steve Brine]

With the leave of the House, I will also respond to the debate, Mr Deputy Speaker. I am aware that I am standing in the middle of the A14—almost literally—which is tonight’s Adjournment debate, but I will respond to the points that have been raised in this short and small but perfectly formed debate.

The shadow Minister—my good friend, the hon. Member for Washington and Sunderland West (Mrs Hodgson)—rightly mentioned the issue of pregnant women and smoking, to which I referred in my opening remarks. Public Health England and NHS England are working on a joint strategy at the moment, setting out recommendations for how local areas can work together to achieve our ambition on smoking in pregnancy. In a way, I guess that is given a greater impetus in the light of the flatlining figures—I suppose that is the accurate way of putting it. This work is part of the maternity transformation programme, which started in 2016 and which I know she is aware of. Public Health England will look at how its mass media campaign can more effectively reach young people, especially working-class women of reproductive age and their families and friends. I wanted to put that on the record.

The hon. Lady returned to the subject of smoking services. I repeat what I said during the debate: there are varying rates across the country, so it is right that local councils have the flexibility to respond. I will touch on the point that the right hon. Member for Rother Valley (Sir Kevin Barron) mentioned about this being all the responsibility of local authorities. There is a third way, he will pleased to know, as a Blairite—that has finished his career, I apologise. I put on record again that councils will receive £16 billion of the public health funding until the next spending review, when the spending plans will be announced. We expect them to use it wisely.

My hon. Friend the Member for Harrow East (Bob Blackman) talked about the Back-Bench debate and the general debate. I will leave that matter for the usual channels, but the important thing is that we are having the debate, which is very welcome.

The shadow Minister spoke about smoking cessation training and those services. The success of our plan hinges on all manner of professionals offering help that works, which is why effective training on supporting smokers to quit is central to the tobacco control plan—from doctors and nurses in the NHS to physiotherapists in the community, to pharmacists, who I have mentioned, and to the health professionals who need to equip smokers with the capability, opportunity and motivation to quit for good. It often involves very brief advice and there is a lot of online training out there. Twenty minutes or so of online training can teach a professional how to have a short conversation with somebody with a smoking challenge, with proven results. I wanted to put that on record.

My hon. Friend the Member for Harrow East mentioned Philip Morris International and its kind proposal to help NHS trusts, which has been in the newspapers today. I thought I would place on record for the House that what it talked about in its offer to trusts was “operating a scheme that allows employees who do not quit to trial one of our range of smoke-free alternatives”. We have to give them 10 out of 10 for effort, but it is totally inappropriate and that is why we have written to all trusts to make it clear.

I understand my hon. Friend’s Budget 2018 proposal for the Chancellor of the Exchequer on the need for the money in respect of the polluter pays principle. I know that the Chancellor will have heard that. My hon. Friend talked about the need for hard-hitting campaigns. We do have them, of course, and they are an essential part of tobacco control. In England for several years now, we have sought the balance between hope and harm. Every January, we have the Health Harms campaign and in the autumn, we have our more upbeat Stoptober campaign, and 2018 will be no exception.

The hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP, talked about the illicit tobacco trade protocol, and I thank him for putting on record that we indeed ratified the protocol on 27 June to eliminate the illicit trade in protocols. The first meeting of the members of the protocol will be in Geneva from 8 to 10 October.

The hon. Gentleman talked about track and trace. The tobacco products directive contains a commitment for member states to provide the track and trace system by May 2019 for cigarettes and roll-your-own tobacco. The European Union has published draft recommendations on the track and trace proposals, and we voted in favour of implementing the regulations. I would say that the EU measures go beyond the requirements of the framework convention on tobacco control, but many of its benefits arise from the exchange of information between nations, so it seemed sensible to us for the UK to align with the EU after exit in this respect.

Both the hon. Member for Stockton North (Alex Cunningham) and the hon. Member for Linlithgow and East Falkirk talked about smoking and the media. The Government do not interfere in editorial decisions. I think it right that content makers decide what to include in their programmes, provided that they comply with the broadcasting code, and I ask them to take their responsibility seriously. Obviously, as Members have said, they are regulated by Ofcom. Last month, it published a note to broadcasters reminding them of the rules in this area, and advising them on the depiction of branding and health warnings. The last time Ofcom found a breach of the broadcasting code related to smoking was in 2015, so I think that broadcasters take the code seriously.

Many Members mentioned the British Board of film Classification, which I know well and which is a well-managed organisation. Its guidelines were last updated four years ago, in 2014. Consultation on the new guidelines began late last year, and they are expected to be published early in 2019.

There was a lot of talk about e-cigarettes, which were partly dealt with at the beginning of the debate. Public Health England will update its evidence report on e-cigarettes and other novel nicotine delivery systems annually until the end of the current Parliament in 2022, and we will include that in our “quit smoking” campaign messages about the relative—I underline “relative”, if Hansard can underline—safety of e-cigarettes. I enjoyed the comparison that the right hon. Member for Rother Valley made with Ireland: I thank him for that.

The right hon. Gentleman also said that not everything could be done by local authorities. We have not said that it should. I have made it very clear to Public Health England that where we have more work to do is where they should target their help and support, but there is also a new grant to support the tobacco control plan. The Government have launched a competitive scheme whereby organisations can apply to undertake work to support the plan’s ambitions. The grant is £140,000 a year for three years, from 2018-19: a total of £420,000 is available. Applications are currently being assessed, and we will contact the successful applicants in the autumn. I will find out some more details and send them to the all-party group.

The hon. Member for Strangford (Jim Shannon)—as always!—asked whether we would introduce vaping areas in hospitals. Public Health England advises that the smoking of e-cigarettes should not be routinely treated in the same way as smoking tobacco, but it is true that it is for NHS trusts to make their own policies. Some, including the Maudsley, have designated areas both indoors and outdoors.

[Alex Cunningham]

Will the Minister give way?

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

It is up to the Minister. He said that he wanted to speak for only one minute.

[Steve Brine]

I will give way.

[Alex Cunningham]

The Minister has 12 minutes left.

[Mr Deputy Speaker]

It was the Minister who suggested that he wanted only one minute in which to sum up. The fact that we are late does not matter to me.

[Alex Cunningham]

Let me tease the Minister on three matters. One, what are we going to do about the “tab houses”? Two, what is his position on cigarette pack inserts? Three, what is he doing to do about the fact that mass media campaign funding has been cut by 90% in the last 10 years? We need that funding in order to be effective.

[Steve Brine]

I will write to the hon. Gentleman about his first two points. As for the mass media point, the hard-hitting campaigns that we conduct through the mass media are incredibly powerful. Last year’s campaign showed a gentleman rolling a cigarette with roll-your-own tobacco made of blood and gore. That was very hard-hitting, and it had an incredibly good response mechanism when we tested it and when we rolled it out. In this year’s campaign, “between hope and harm”, I think the hon. Gentleman will see a good balance of that mass media campaign that he talked about.

I realise that that was more than a minute, Mr Deputy Speaker. There is so much to say about this subject! It is so exciting.

Let me end by reaffirming the Government’s commitment. What everyone has said today has been very kind. Yes, I am committed to this subject, but ultimately we will be judged on our record. We are committed to making further sharp reductions in smoking prevalence, not so that we can meet the ambitions of the plan, although that is all very nice, but so that we can make a difference to people’s lives, because as the right hon. Member for Rother Valley said, if our constituents were dying in these numbers in road accidents we would be calling for crossings.

We want to make the smoke-free generation a reality to help people’s lives and to make a difference. Tobacco control is a key priority for us, and it will be a key priority for the 10-year plan that the Secretary of State and I will be working on with NHS England. I was interested to hear the comments of Simon Stevens at the Select Committee, and I agree with Simon, not for the first time.

I thank all Members who have spoken for their contributions—and it is amazing how far a minute can go, Mr Deputy Speaker.

Question put and agreed to.

Resolved,

That this House has considered the Tobacco Control Plan.

Use of Chamber (Women MPs of the World Conference)

Resolved,

That this House welcomes the events organised to celebrate women’s suffrage and to mark the centenary of the Representation of the People Act 1918; recognises that the Women MPs of the World Conference provides a unique opportunity to gather parliamentarians from across the world to engage in discussions about equal representation and bring about social change; and accordingly resolves that parliamentarians who are delegates participating in the Women MPs of the World Conference should be allowed to hold a debate in the Chamber of this House on a day in November other than a day on which this House is sitting or a day on which the UK Youth Parliament is making use of the Chamber.—(Mims Davies.)