Tobacco and Vapes Bill (Fourth sitting)

Jim Dickson Excerpts

Committee stage
Thursday 9th January 2025 Public Bill Committees

[Andrew Gwynne]

The hon. Gentleman is absolutely right. Anyone who heard the evidence on Tuesday cannot but have been shocked at what medical professionals see with their own eyes—not just the procedures they have to use, such as amputations, but the people who are so addicted to that product that they have to light up, even having lost both legs. That was a powerful contribution, and he is right to labour the point that there is no freedom in addiction. We are seeking to free the next generation from ever being in the situation that, as he reminds us, was outlined in detail by professionals in the evidence session.

That leads me to the amendments. Simply raising the age of sale to 25 will only raise the age at which people start smoking; it will not meet this Government’s, or indeed the previous Government’s, ambition to make the United Kingdom smoke-free. We also know—and we heard this from the four chief medical officers of England, Scotland, Wales and Northern Ireland, in unison—that whenever there has been a change in tobacco control legislation, the tobacco industry is clever; it is smart; it sees that one road has been blocked, so it finds another. The industry has been swift to refocus its tactics. For example, when flavoured cigarettes, including menthol, were banned in the UK, the industry used product innovation to exploit loopholes in the ban. It created new products, such as menthol filter tips and cigarette-like menthol cigarillos.

Those examples demonstrate how the tobacco industry will always regroup and refocus its efforts to respond to whatever regulations are in place. If we raised the age of sale to 25, the industry would likely change its business model to target older age groups.

Let us be clear here about what we are seeking to do. We are not criminalising current smokers; people who are legally able to purchase tobacco products and consume them will always be able to do that. However, we are having a cut-off point. We are saying to the tobacco industry, “This is your customer base now. That’s it. Game over. What you have got is all you have got. You can’t kill two thirds of your customer base and expect other people to come along the conveyor belt. We’re stopping the conveyor belt. What you have got is it.” We will do all we can to make that customer base even smaller through smoking cessation services and effective targeting of existing smokers to help them to quit. But this is it—this is the customer base, and it will shrink rapidly over the next few years, so that no child born after 1 January 2009 can ever legally be sold tobacco products.

That means that the examples we have heard from Members in this debate about a 45-year-old being asked to show ID are an irrelevance. They miss the point. The impact assessment that accompanies the Bill says really clearly that in 25 years’ time—in 2050, which is not that far away—we expect smoking prevalence among people aged 30 and below to be near zero. The logical consequence of that is that there will be very few people of middle adult age going into shops to purchase tobacco. The reality is that there probably will not be a market for tobacco products by then. Retailers will have diversified into selling something else, because there will not be a market of sufficient scale for tobacco to be sold.

All the arguments that we have heard—they have actually been pursued by the tobacco industry—as to why these things are not workable are for the birds. They are for the clouds. They are for another world that does not exist, because the measures in the Bill will ensure that we are smoke-free, and I find that really exciting.

[Jim Dickson (Dartford) (Lab)]

The Minister is making an extremely eloquent case. He referred to the impact assessment for the Bill. I wonder whether he has spotted that on page 61, the likely societal benefits of having a smoke-free generation are estimated at something like £73 billion by the end of the century. I wonder whether he believes, as I do, that the amendment that we are considering puts that societal benefit hugely at risk.

[Andrew Gwynne]

It does, for the reasons that I have set out. I thank my hon. Friend for pointing to the impact assessment, because it sets out a very clear reversal of the current situation, in which the costs of tobacco to society, the individual, the economy and our health and care services are massive. In the future, that situation will be reversed—it will become a positive, not a negative—because people will be healthier and living longer. They will not be living with the comorbidities that are a direct consequence of tobacco use. They will be free from addiction. They will actively participate in the economy. That is why we are moving to smoke-free, rather than just shifting the age of sale to a fixed point and continuing to give tobacco companies that conveyor belt. If we did so, people would eventually reach 25 and the tobacco companies would be able to target them again—maybe not in as great a number, but we would have switched the conveyor belt back on.

I want that conveyor belt stopped for the next generation. That is what the last Bill did, to be fair, and it is what this one does. It is about protecting future generations from becoming addicted to nicotine and carrying the horrible burden of disease that is a direct consequence of all tobacco products. Breaking the cycle of addiction and disadvantage and allowing people to live healthier lives—that is true freedom. Let us be clear: there is no freedom in addiction. There is freedom in never being able to be sold tobacco and having a genuinely smoke-free UK. For that reason, I ask the shadow Minister not to press these Liberal Democrat amendments.

Tobacco and Vapes Bill (First sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Mary Kelly Foy (City of Durham) (Lab)]

I cannot hear everything because of that noise, but I am co-chair of the all-party parliamentary group on smoking and health.

[Jim Dickson (Dartford) (Lab)]

I declare an interest as vice chair of the APPG on smoking and health.

Examination of Witnesses

Professor Sir Chris Whitty, Sir Francis Atherton, Professor Sir Michael McBride and Professor Sir Gregor Ian Smith gave evidence.

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[The Chair]

I am sorry, Sir Chris. Just for the purposes of timekeeping, which is my job, we have about 20 minutes left and five people wish to ask questions, so can we keep the questions as tight as possible, and within reason the answers as well?

Professor Sir Chris Whitty: I wanted to give the exact numbers, which I just found in my notes. Some 75,000 GP appointments a month are caused by smoking—just think of that when you phone up the GP—and 448,000 admissions to the NHS: again, think of that when you look at these areas. So the impact of this is really very substantial.

[Jim Dickson]

Q May I ask a question about some of the arguments from tobacco companies for heated products to be excluded from the tobacco regulations and the Bill—and presumably therefore the age of sale regulations. Would you have a view on whether that is a sensible proposal?

Professor Sir Chris Whitty: I have a very strong view. The tobacco industry is extraordinarily adept at pretending that it is on the side of the angels, and that it is trying to help with the problem. This goes along with slimline cigarettes, filters, low-tar cigarettes—many other marketing things, all of which claim to try and help with the health effects. Tobacco is extraordinarily dangerous, as well as being addictive. The heated tobacco products have probably slightly lower levels—they do have lower levels of the multiple chemicals that are toxic: multiple, not just one or two, but they are way away from safe levels. So heated tobacco products, while arguably being slightly lower in terms of the risk if someone had exactly the same amount, are a long way short of anywhere near safe, and they are still addictive. They also have some side-blow areas where they will have some issues for people around them as well. So the idea that this is some kind of solution only makes sense if you have shares in a company. So I would very strongly argue against trying to exclude these and carve these out.

Sir Francis Atherton: Nicotine is addictive however you take it—whether it is in heated tobacco, in cigarettes, in snus, in chewed tobacco or in shisha pipes—so in terms of protecting the next generation, the great value of this Bill is the flexibility to deal with not just the issues that we see in front of us, but the things that may well come down the pipeline in the future. I believe the Bill is flexible enough to allow us to protect the next generation from these terrible problems that flow from addiction.

[The Chair]

Sir Michael, you were nodding. Did you have any comment to make?

Professor Sir Michael McBride: I simply echo Sir Frank’s comments on the flexibility that the Bill affords us, and again confirm my agreement with Sir Chris’s comments. Let us be clear: there is no other product that causes life-limiting addiction, that kills two thirds—kills two thirds—of the people who use it. It is staggering, and this Bill provides us with an opportunity to address a scourge on our society. There is no safe tobacco product —none.

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[Mr Barros-Curtis]

Q Some of the evidence that has been submitted referred to the gateway effect and how there is perhaps not the evidence to suggest that there is a transition from one to the other. Are your organisations still concerned about the increase in vaping among groups who have not previously smoked cigarettes?

Sarah Sleet: That is a tricky one. We know that a lot of people who use vaping to stop smoking end up dual-using for a while. Some then move on to just vaping, and some eventually move completely away from it. We seriously need a comprehensive programme for nicotine cessation and smoking cessation to support people on that journey and make sure that people who go on that journey do not come back in. We heard earlier from ASH Wales about some really good measures that have been put in place, but without that wider context it is hard to cement the behaviour needed to move completely away from it. We need to think broadly about the whole support structure to help people to get off smoking and eventually to move away from nicotine altogether.

Dr Ian Walker: I agree. The real killer in the room, if you like, is cigarettes and tobacco. There is no safe way of consuming tobacco. The alternative of smoking versus vaping is very clear; even though we do not know the long-term health implications of vapes, we know that you are much better off vaping than smoking. Having said that, of course we do not want young people and never-smokers to vape either.

The power of the legislation is its double-pronged approach: preventing people from ever smoking in the first place by raising the age of sale by one year every year, and putting in place a comprehensive package of measures alongside that to control vaping, particularly the access to vaping and the appeal of vaping for young people, to reduce uptake in those communities. All those things together, alongside—you will forgive me for saying this—the investment that will be required for smoking cessation services and to support enforcement by Border Force, HM Revenue and Customs and retailers, will be important components of the Bill’s ability to drive the change that it can make.

[Jim Dickson]

Q Thank you for all your work to advocate for smoke-free legislation. Can I ask you about differential smoking rates across the country? Which parts of the country are likely to benefit most from this legislation as we see a decline in smoking rates and in tobacco use more generally?

Sarah Sleet: Health inequalities relating to lung disease are profound. The three conditions with the biggest gap in health outcomes between rich and poor are lung conditions: asthma, COPD and lung cancer. All three are profoundly affected by smoking, and smoking is concentrated in socially and economically deprived areas. Those in the poorest part of the country are twice as likely to smoke as those in the richest part of the country.

It is even more profound in certain segments. We heard that young mothers are four times more likely to smoke in poorer parts of the country than in richer parts. If we can drive down smoking, particularly among young people, the impact will be greatest in those areas that are most in need of help and support. This is probably one of the biggest things that can be done to tackle health inequalities. For that reason, I think the Bill is probably the most important public health measure being passed through Parliament in a very, very long time.

Dr Ian Walker: Thank you for the question, which I think is a really critical one. At CRUK, we have done a lot of research and work on cancer inequalities, which are part of broader health inequalities and which generally mirror similar trends. We know that people in the most deprived communities have higher incidences of cancer. They typically present at a later stage, they typically engage less with screening, they typically have worse outcomes and they typically do not get optimal treatment —it is a pretty difficult story right along the pipeline. The reasons behind that can be very complex and involve lots of different things.

Despite all that, the one thing we do know is that higher smoking rates, particularly among children and young people in the most deprived communities, are a really significant contributor to health inequalities. It is very clear from the evidence that the most deprived communities across the UK are the ones that suffer most from the impacts of tobacco.

This Bill is clearly not a magic switch—it will not change those things overnight—but it sets us on the pathway to fundamentally reversing some of those inequalities and to reducing some of the cancer inequalities that we see across the UK. Alongside the important measures in the Bill, a really clear, targeted set of actions around health marketing interventions in those communities and the effective funding of cessation services where we need them most will contribute to reducing health inequalities much more quickly and much more effectively. Again, it is a very positive story in terms of the potential impact on health inequalities.

[The Chair]

Thank you very much. As there are no other questions from Members, let me thank the witnesses, Ian Walker from Cancer Research UK and Sarah Sleet from Asthma and Lung UK.

Ordered, That further consideration be now adjourned. —(Taiwo Owatemi.)

Tobacco and Vapes Bill (Second sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Dr Chambers]

Q I am assuming that from a public health point of view, looking at the epidemiology, certain communities and demographics will be more greatly affected by this. Is that something that you are mindful of? How do you see the Bill changing health inequalities?

Alison Challenger: We are very mindful of that. Some of the statistics we give around smoking prevalence are an average smoking prevalence for often quite large geographical areas. For my own area in west Sussex, our local survey suggests there is a variance of 4.3% in our most affluent area compared with 16% in our least affluent area. Those are still averages. We also know that in households in the most deprived part of our area, 40% of children are exposed to cigarette smoking from a parent or carer. That is through our own survey.

The point I am trying to make is that there is very much a health gradient, and in those who are most disadvantaged and living in our most disadvantaged areas, we see both higher rates of smoking and more children exposed to that smoking. Those children are more likely to take up smoking if they have been exposed to it.

[Jim Dickson (Dartford) (Lab)]

Q This is to Councillor Fothergill. Are there any circumstances you can envisage where local enforcement would not be enough and the Secretary of State would need to utilise the powers granted in the Bill under clauses 130 and 131 to intervene?

David Fothergill: We have discussed this outside the room, and I think the area we would be most concerned about is illegal sales online. Our local teams could not get into those, and therefore we might need more national resources to break into how people are bringing illegal substances into the UK.

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[The Chair]

I call Jim Dickson.

[Jim Dickson]

I am fine, Sir Mark.

[The Chair]

If there are no further questions, I thank the witness, Professor Bauld, for her contribution. We will move on to the sixth panel of witnesses.

Examination of Witnesses

Lord Michael Bichard and Wendy Martin gave evidence.

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[The Chair]

One final quick question from Jim Dickson, before we have to go on to the next panel.

[Jim Dickson]

Q Tobacco companies, as we know, collect a pretty rich dataset on their sales. Do you think that requesting, or placing in legislation an obligation on them to publish, that sales data would be a useful tool for trading standards?

Lord Michael Bichard: I cannot see that it would not be useful, but it is not something that has come across my desk.

Wendy Martin: Mine neither, but intelligence-led enforcement means the more that intelligence is available, the better one is able to target. I do not know exactly what tobacco companies collect, but generally any intelligence is useful.

[The Chair]

I thank both panellists for their evidence. We will move on to the next panel.

Examination of Witness

Inga Becker-Hansen gave evidence.

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[Mary Kelly Foy]

Q As we know, we have very high levels of child poverty in this country. Much of that poverty is in the areas where there is high smoking prevalence, as well as many other health issues. How important do you think the Bill is for the health of children as they grow into adulthood, for the impact that it will have on the communities they live in, and for addressing inequality?

Professor Steve Turner: Touching on what I have said before, there are communities, invariably the poorer communities, in something called the tobacco map. If you look at the areas where tobacco use is greatest, it maps totally on top of deprivation. We have an opportunity to break that generational social norm of, “It’s okay to smoke.” The people who come to the greatest harm from cigarette smoking and nicotine addiction are invariably the poorest. What is proposed here will be a good step towards narrowing the divide we see in this country in health outcomes, which is totally determined by poverty.

Professor Sanjay Agrawal: We estimate that around 350 children a day start to smoke. A lot of those will be from the most deprived communities. In addition, smoking in the UK brings around a quarter of a million families into poverty, and those families have children. The Bill will go a long way to not only reducing the health harms to individuals, but reducing poverty and hopefully smoking-related deprivation.

To answer one of the questions earlier about the cost of smoking to the NHS, it is estimated that it costs secondary care about £1 billion a year. With primary care in addition, that is a total cost of £2.6 billion to the NHS, around £20 billion a year to social care, and about £50 billion a year in lost productivity. That is the overall cost of smoking to our society, whether at the level of the individual, poverty, deprivation, social care or workforce productivity, and that is why the Bill is so important.

[Jim Dickson]

Q Some other countries, notably Australia and Canada, have introduced mandatory health warnings for manufacturers to place on individual cigarettes and filters, because quite often, young people in particular are accepting cigarettes away from the packaging. Do you see that as a useful way of increasing the saliency of health warnings?

Professor Sanjay Agrawal: These additional measures warn people away from smoking—those who might be looking at the packaging or the individual cigarette. Remember, an individual cigarette—every time someone takes out a cigarette—is an advertisement for cigarettes. Lots of times, children are sold cigarettes on a per-cigarette basis, and they have never actually seen the packet; they have only seen the cigarettes. Therefore, having on-cigarette warnings is another measure that we can introduce to warn people off the harms of smoking. It would be great to see that.

[The Chair]

I was incorrect; we have until 5 o’clock, rather than 4.50 pm, which is now. Do we have any more questions from Members? No. In that case, I thank Professor Turner and Professor Agrawal for giving evidence, which I am sure will be useful to the Committee in its deliberations. The next panellist happens to be the Minister. Instead of asking questions, he will come under fire from his own Committee.

Examination of Witness

Andrew Gwynne MP gave evidence.

Tobacco and Vapes Bill

Jim Dickson Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

It is a privilege to speak in this debate on a Bill that delivers on our manifesto commitment to finish the job started by the right hon. Member for Richmond and Northallerton (Rishi Sunak) at the back end of the last Parliament. We should be proud that, once the Bill receives Royal Assent, it will be the most advanced legislation of its kind in the world.

I should declare at the outset that I was a smoker, and that experience gives me particular clarity on the need for change. I am also honoured to be vice-chair of the all-party parliamentary group on smoking and health. I will use my six minutes to say a little about why this Bill is so necessary and—I hope the Minister does not mind —to gently set out where I think it could go further.

We often hear that smoking is about choice. The only choices I made were to have my first cigarette at the age of 15 and then, almost 15 years and thousands of cigarettes later, the much more difficult choice to finally give up.

According to the wonderful Action on Smoking and Health, which has been quoted widely in this debate, the majority of smokers wish they had never started, and it takes, on average, 30 attempts to quit. This legislation will ensure that future generations in this country, including in Dartford, will not have their freedom to choose stolen by a deadly addiction.

The latest figures, before their collection was interrupted by the pandemic, show that in Kent, nearly 6,000 people died from smoking between 2017 and 2019, with 10,000 hospital admissions due to smoking during 2019 and 2020 alone. Before being elected to this place, I was, for many years, a local councillor working on public health issues, and I saw at first hand the burden that smoking places on my local community. Now that I have the great honour of representing the wonderful constituency of Dartford, I see smoking taking a similar toll.

No matter where we are in the country, we will hear the same stories of loved ones lost too soon, of people becoming addicted as children and of the most disadvantaged groups bearing the heaviest burden. We cannot, and must not, accept a situation in which more than 74,000 deaths a year are attributable to smoking. We now know, with more clarity than ever, the damage that smoking causes. Smoking can lead to at least 16 different types of cancer, and it cost England £21.8 billion in 2023, mainly in lost economic productivity.

We have a chance to change this. Modelling by the Department of Health and Social Care estimates that raising the age of sale by one year every year will prevent almost 500,000 cases of stroke, heart disease, lung cancer and other lung diseases by the end of the century. It will save tens of thousands of lives and help untold numbers of people to lead healthier and more enjoyable lives.

An issue that often comes up when discussing measures of this nature is how we make them enforceable. The legislation enjoys widespread public support, with 69% of the public in favour of the measures, according to polling undertaken by YouGov for ASH earlier this year, and even a slim majority of smokers in favour, which indicates that many smokers recognise that we do not want the next generation to grow up addicted to smoking. The measures command high levels of public support, and when such policies are done with and not to people, compliance is self-enforcing and high.

Turning to where the Bill might go a little further, I welcome the additional powers to create smokefree outdoor spaces and to designate smokefree places as vape-free. However, I admit slight disappointment that the Government seem to have ruled out hospitality premises from the scope of the regulations, rather than setting out options via a consultation about how we might proceed. I hope the Minister will recognise that there are options other than an outright ban.

As the number of smokers in the UK continues to decline, there are discussions to be had about how we use public spaces and protect individuals from second-hand smoke, particularly children and those with health conditions. From my time in local government, I know that councils can play a vital role in improving the health of their communities. Councils across the country have used the pavement licensing system to create smokefree outdoor spaces. That has proved popular with businesses and customers, particularly families with children. I gently urge the Minister to consider whether the Bill might be amended to allow local authorities to decide which additional spaces, beyond those regulated nationally, they might like to make smokefree in the best interests of communities.

My final point, which reflects those made by other hon. Members, is about the “polluter pays” principle. We all know that public finances are under significant strain. If the funding we desperately need to create a smokefree country cannot be found in our existing budgets, I would urge Ministers to consider the imposition of a “polluter pays” levy on tobacco manufacturers.

National Insurance Contributions: Healthcare

Jim Dickson Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

The right hon. Gentleman tempts me to go into my previous career working with GPs and their employment and contractual status, but I will not do that now, Mr Speaker, as you would rightly curtail me. GPs have a complicated contractual status that has been long in the process. We understand the precariousness of primary care. GPs are crucial to our plans for developing the health service, and we will discuss with them, in the normal process, the allocations for the following year.

[Jim Dickson (Dartford) (Lab)]

Last month’s Budget finally gave my constituents hope that there will be an NHS that works for them. Will my hon. Friend assure me that this Government will avoid the sticking-plaster, piecemeal approach of the last Government, and bring forward a long-term plan to fix the NHS for the future?

Oral Answers to Questions

Jim Dickson Excerpts

Tuesday 15th October 2024 Commons Chamber

[Andrew Gwynne]

I absolutely do, and I pay tribute to Abbi, a beautiful woman whom I was privileged to meet after the Westminster Hall debate last week. Although care after sepsis will vary hugely on a case-by-case basis, we need to make sure that the needs of each individual are met. In this case, it sounds like they have not been met. If the hon. Gentleman wants to meet me to discuss this issue further, I am more than happy to do so.

[Jim Dickson (Dartford) (Lab)]

Given that last month was Sepsis Awareness Month, will the Minister join me in paying tribute to the courage of John Snow and his family in my Dartford constituency? Tragically, he has just experienced a quadruple amputation due to sepsis. He has received amazing support from the Dartford community, who have rallied around to help fund support for his family. Will the Minister use that as a spur to improve treatment for sepsis more generally across the country?

[Andrew Gwynne]

I pay tribute to John Snow and, indeed, my hon. Friend’s constituents, who have rallied around him at his time of need. This matter highlights the need to have better joined-up care to ensure that people who have sepsis receive the best care possible, that those who tragically lose limbs as a consequence of sepsis are able to have good-quality aftercare, and that we continue to raise awareness of sepsis and the risks it poses.