(Leicester South)
(Lab/Co-op)
(Urgent Question): To ask the Secretary of State for Health and
Social Care to make a statement to the House on the Government’s
announcement that e-cigarettes will be available on
prescription.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
I am grateful to the right hon. Gentleman for his question. Covid
has been a stark reminder that our underlying health and
lifestyle determine how resilient we are to new risks and
diseases. Covid did not strike evenly. People who smoked, were
overweight, or struggled with chronic conditions fared worse. We
are determined to level up health for a society that is not just
healthier but fairer.
Smoking rates are down to 13.9%—the lowest on record—but tobacco
continues to account for the biggest share of avoidable premature
death in this country. It contributes half the difference in life
expectancy between richest and poorest. Action against smoking is
therefore at the heart of our mission to level up. Our goal is
for England to be smoke free by 2030. To support this goal, we
have an ambitious tobacco control plan, and will soon publish a
new plan with an even sharper focus on tackling health
disparities. Our new Office for Health Improvement and
Disparities will support this vital mission nationally and
locally.
Ministers from my Department have long been clear, including in
this place, that we support e-cigarettes as part of a gateway
process for stopping smoking. Last week, the Medicines and
Healthcare Products Regulatory Agency updated its guidance on
licensing as medicines e-cigarettes and other inhaled
nicotine-containing products. The updated guidance sets out the
steps needed to license an e-cigarette as a medicinal product, as
well as quality, safety and efficacy standards.
Having e-cigarettes as a licensed product will enable them to be
available on prescription, which I know will give health
professionals greater confidence in their use. I am happy to
update the House further when we are closer to having a licensed
product. We will continue to consider e-cigarettes, and indeed
any other innovative ways of improving the health of our nation,
so that we can end disparities and level up to a healthier and
fairer country.
We welcome the announcement that e-cigarettes will be available
on prescription. It should be a really significant step in
helping 7 million smokers to quit. As the Minister says, smoking
kills; it leads to 90,000 deaths and 500,000 hospital admissions
every year across the UK. I think she will find broad support for
what she has announced, but the House would have preferred to
have heard this first, rather than via a press release issued by
the Secretary of State on Thursday evening.
The Minister says that she will return to the House when she has
more detail. What is the timeframe for that, and when does she
expect the first prescriptions for e-cigarettes to be issued? She
will know that to those who find it hardest to quit, the offer of
e-cigarettes will be important, but it would be much better if it
were backed up with access to specialist support services.
However, smoking cessation services have been cut by over £22
million in the last five years. Indeed, areas with high levels of
heart disease, cancer and stroke are among those hit hardest by
the cuts. For example, Dudley has had a 17% cut. Derbyshire,
which is where her constituency is, has had a 20% cut. Hartlepool
and Wolverhampton have had cuts of 81% to their smoking cessation
services.
To be frank, there will be no levelling up unless health
inequalities are tackled, and unless we prevent cancer, heart
disease, stroke, chronic obstructive pulmonary disease and
diabetes where we can, but that demands fully funded local public
health services, whereas in recent years, the public health grant
has been cut by £1 billion in real terms, and in the Budget last
week, it was just maintained at present levels. As the
Association of Directors of Public Health has warned, this will
mean further
“significant… reductions in public health services and capacity
across the country.”
Will the Minister guarantee no further cuts to smoking cessation
services? She mentioned the tobacco control plan, which is
supposed to be published this year. Can she tell us at what point
in the next two months that will happen?
I welcome the right hon. Gentleman’s support on the issue we are
talking about and on our ambitions to make this country smoke
free by 2030.
On the MHRA, the updated guidance provided further details on the
steps required to license an e-cigarette as a medicinal product.
To achieve a licence, a product would need to meet the standards
of quality, safety and efficacy expected of a medicinal product.
If successful, that would potentially allow safe and effective
products to be made available for prescription for tobacco
smokers who wish to quit. The update provides clarification and
gives more guidance to potential providers on that issue.
The right hon. Gentleman asked about timescales. We anticipate
that if a product was put to the MHRA today, for example, there
could be an 18 to 24-month process for that product to be
licensed. At this stage, we could not say anything further than
that, so we are quite a long way from any e-cigarette being
licensed and provided as a prescription medicine.
The public health grant increased by £135 million in 2020-21 and
by £55 million in 2021-22. With regard specifically to the public
health grant for smoking services, it is up to the local
authority to decide how it spends its allocation of funding, but
in addition, in our long-term plan, we have committed to helping
to drive smoking cessation for a number of different groups. We
want to provide help with cessation plans for in-patients and
pregnant women, and to provide support for those with mental
health and learning disabilities to tackle their smoking
addictions. All in all, a lot of money is being spent both at the
public health level and at the NHS level. We will continue to
make sure that we do whatever we can in our power to make England
smoke free by 2030.
(Scarborough and Whitby)
(Con)
Many people who wish to stop smoking are motivated by the wish to
be healthier, but there is also a financial impact on the family
from somebody smoking, not least because the Chancellor put 88p
on the most expensive cigarettes and even the cheapest are almost
a tenner now. However, many people buy cigarettes under the
counter or from a mate down the pub. Will the Minister engage
with her opposite number in the Home Office to ensure that
combating tobacco smuggling remains a priority for Border
Force?
My right hon. Friend makes a very good point. I promise I will
engage with my opposite number in the Home Office to tackle the
illicit import of cigarettes and other substances.
(Chesterfield) (Lab)
My mother smoked herself to death and died of lung cancer at the
age of 62, so no one needs to tell me how important it is that we
do all we can to support people to give up smoking. I also know
people who have given up smoking through e-cigarettes but now
find that they smoke quite a lot more than they did with
traditional cigarettes. What analysis has been done of the impact
on overall intake of switching from traditional tobacco
cigarettes to e-cigarettes? Do the Government have longer-term
concerns about moving people off e-cigarettes to not smoking
altogether?
The hon. Gentleman is quite right that our goal is to help people
to stop smoking completely. My heart goes out to him regarding
the story about his mother. My father was a smoker and it damaged
his health as well. We all have these personal stories. The
evidence is clear that e-cigarettes are less harmful to health
than smoking tobacco and are an effective way to help people to
stop smoking, but, as the hon. Gentleman said, there is always
more to be done.
(Sleaford and North
Hykeham) (Con)
History has shown us that an absence of evidence of long-term
harm is not the same as evidence of absence of long-term harm.
Indeed, in the 1940s, conventional cigarettes were considered
healthy. With that in mind, how will the Minister ensure that
children are protected from breathing in the vapes of
e-cigarettes, prescribed or otherwise, and that their
prescription by a doctor is not seen as a green light that they
are healthy, encouraging uptake among teenagers?
My hon. Friend is right that e-cigarettes are just a gateway to
stopping smoking completely. That is the ultimate goal. We want
to ensure that people go from smoking to e-cigarettes, and then
to no smoking at all.
(North Tyneside) (Lab)
COP9 is due to start next week and, as yet, the Government have
not announced their delegation. Will the Minister therefore
please tell us who the delegates might be and what their approach
will be to COP9, given that the World Health Organisation is
completely against vaping?
There will be officials at COP9. It is a very important meeting.
The UK’s approach to e-cigarettes has been and always will be
pragmatic and evidence-based. I am sure that will be the message
they put forward at COP9.
(Harrow East) (Con)
I declare an interest as chair of the all-party parliamentary
group on smoking and health. Clearly the best way of ceasing
smoking is to stop altogether. I welcome the fact that this
proposal was originally contained in the last tobacco control
plan in 2017, so I congratulate my hon. Friend on her prompt
action on assuming the job. We will get an opportunity to debate
the tobacco control plan on 16 November in Westminster Hall, and
I trust she will reply to that debate. Will this particular
proposal be targeted at the extreme smokers—the people who are
hardened smokers and smoke a lot—and pregnant women to encourage
them to give up?
I thank my hon. Friend for his question. I am looking forward to
our debate in a couple of weeks’ time. As I mentioned earlier,
the NHS already has measures in place through the long-term plan
to help those who are pregnant to stop smoking. That is
important. Should e-cigarettes be licensed as a medicinal
product, it will be a gateway for those smokers to stop smoking
through that method and hopefully stop smoking completely.
(York Central)
(Lab/Co-op)
What investment will the Government put into research into the
long-term use of e-cigarettes, so that we can understand the
impact that will have? Will the Minister also commit to invest in
health checks, so that we can screen people for public health
issues, such as smoking and other forms of harm, and get the
right interventions at the right time and address these
issues?
This Government are determined to level up, and as part of that
we are levelling up for health, as well as some of the issues
that the hon. Lady mentioned. Our Office for Health Improvement
and Disparities will play a big role in moving forward with this
issue.
(North West Durham)
(Con)
We know that smoking is a key cause of major health inequalities
across the country between different demographics and different
areas. Does my hon. Friend agree that if we want to level up
health outcomes in the country, we will need to target products
to support people by providing effective alternatives to smoking?
As a smoker who wants to quit, I have seen many of my friends
using multiple different products recently, from snus to
heat-not-burn. Will she consider other options, in addition to
e-cigarettes, that can cause less harm and enable people like me
to quit?
My hon. Friend tempts me to say that he is a great role model.
Perhaps he should try e-cigarettes and then probably try stopping
smoking completely. He can put that message out across the
Chamber about why levelling up is so important.
(West Suffolk) (Con)
I welcome not only the Minister’s emphatic support for the
cessation of smoking by 2030 as a target, but the cross-party
support. We have seen in this short discussion today unanimous
support for the use of e-cigarettes as a route out of smoking.
The UK is one of the most advanced countries in the world in the
proper evidence-led approach to the use of e-cigarettes. The
Medicines and Healthcare products Regulatory Agency is perfectly
placed to herald that evidence and make sure the approach is
evidence-based. Can she assure me that we will speed up the
processes as much as possible? We must follow the evidence, but
we must follow it rapidly.
I thank my right hon. Friend for the work he has done on this
important issue. He is right that the MHRA’s expertise is
recognised worldwide, so it is only right that it looks at it,
and it provided clarification last week. As health disparities
are so important, it is fantastic that we have cross-party
support on the issue.
