Bob Blackman (Harrow East) (Con) I beg to move, That this House has
considered the delivery of a new Tobacco Control Plan. It is a
pleasure to serve under your chairmanship, Mr Bone—I believe for
the first time in this place. I speak as, and declare an interest
as, the chairman of the all-party parliamentary group on smoking
and health. We welcomed the Government’s announcement of the new
tobacco control plan, and we welcomed that it would be published
this year,...Request free trial
(Harrow East) (Con)
I beg to move,
That this House has considered the delivery of a new Tobacco
Control Plan.
It is a pleasure to serve under your chairmanship, Mr Bone—I
believe for the first time in this place. I speak as, and declare
an interest as, the chairman of the all-party parliamentary group
on smoking and health. We welcomed the Government’s announcement
of the new tobacco control plan, and we welcomed that it would be
published this year, to deliver the Government’s smoke-free by
2030 ambition. I do not want to put any pressure on my hon.
Friend the Minister, but she does not have long to achieve the
first ambition. The Government’s ambition to reduce smoking rates
to 5% or below, making smoking obsolete, is one that all of us in
the all-party parliamentary group share. I believe that will be
endorsed on an all-party basis this morning, because it is
clearly a great way to ensure the health of the nation.
For me, this is deeply personal. Both of my parents died of
cancer caused by smoking. My late mother was only 47 when she
died of lung and throat cancer, as she was a very heavy smoker
for most of her life. I do not want to see families go through
what my family had to go through during those terrible days. For
me, it is a lifetime ambition to ensure that people understand
the risks of smoking, the damage to their health and the damage
to their families.
The all-party parliamentary group is keen to support the delivery
of the ambition of a smoke-free Britain, which is why, in June
this year, we published a report setting out our recommendations
for the tobacco control plan for England. Those recommendations
were endorsed by more than 50 organisations, including the Royal
College of Physicians, Cancer Research UK and the British Heart
Foundation. On behalf of the APPG, I am pleased to welcome my
hon. Friend the Public Health Minister to her new post, and
indeed to welcome her opposite number; to put our recommendations
on the record; and to give the Minister the chance to respond to
those views.
The APPG has a long-term track record of acting as a critical
friend to the Government on the tobacco control agenda. I am
confident that this collaborative and constructive relationship
will continue. Although smoking rates in my constituency are
lower than the English average, there is no room for complacency.
In Harrow, more than one in 10 people still smoke and smoking
kills around 250 people a year. That is obviously far too many.
In 2018-19, there were 1,566 smoking-attributable hospital
admissions and 370 emergency admissions for chronic respiratory
disease, which is caused almost entirely by smoking. That is in
one constituency, so imagine what smoking does to the national
health service up and down the country.
Research presented to the all-party parliamentary group shows
that, on average, smokers are likely to need social care a decade
earlier than non-smokers, and particularly never-smokers.
Smoking-related disease and disability make it hard to carry out
normal daily activities such as getting dressed, walking across a
room and making a meal. Most of us take these things for granted,
but we should not.
The importance of the smoke-free 2030 ambition is clear. As the
Minister herself stated recently,
“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.”—[Official Report, 1 November 2021; Vol. 702, c.
621.]
More than 70,000 people died from smoking last year in England
alone. For every person killed by smoking, at least another 30
are living with serious smoking-related illnesses.
(South West Wiltshire)
(Con)
I warmly congratulate my hon. Friend on bringing forward this
debate. On the point about the 70,000 deaths, is it not important
to understand that that is year after year after year? Would he
set that in contrast with the awful toll we have had from covid
and the terrible restrictions that we have necessarily placed
upon the population of this country, and agree with me that
getting rid of this horrible substance would be far less of an
intrusion on people’s liberties than the sort of things we have
seen over the past 18 months? Over time, that would have a far
greater impact on health, wellbeing and people’s ability to go
about their daily lives. It would reduce the burden on the
national health service very substantially indeed, and address
the health inequalities that sadly mean the life expectancy of
the richest and poorest in this country are currently separated
by upwards of 10 years.
I could not have put it better myself. My right hon. Friend quite
clearly makes the comparison between covid-19 and smoking. People
cannot help catching covid, but when they smoke they make the
choice as to whether they inflict life-changing circumstances on
themselves.
(Broxbourne) (Con)
Like my hon. Friend, I had a parent who died in their 40s from
throat cancer. As we try to migrate 7 million people away from
burnt tobacco, the challenge is to move them to less harmful
forms of nicotine. Their addiction is to the nicotine; they crave
nicotine, not the burning of tobacco. If we can make these
transitions, we can reduce harm at a much quicker rate.
My hon. Friend is quite right. Nicotine is one of the most
addictive drugs on the market, if not the most addictive, and
perfectly legal to consume. The issue is whether someone, once
addicted to nicotine, can quit. The damage is done not necessary
by the nicotine, but by the delivery mechanism by which someone
gets the nicotine.
Anything that reduces the risk of cancer or other related
diseases has got to be good news. We can migrate people and
encourage them to quit. Ideally, they give up completely.
However, because it is so addictive they may need help and
assistance to do that. Vaping and non-heated tobacco are ways of
migrating people to safer means of delivering the nicotine they
desire.
Taking up the point made by my right hon. Friend the Member for
South West Wiltshire (Dr Murrison), ending smoking is essential
if we are to level up the nation’s health after the pandemic. We
need to reduce health inequalities between rich and poor, and
increase healthy life expectancy by five years by 2035, in line
with the Government’s manifesto commitments.
As well as being necessary, tobacco control measures are popular
with voters for every main party, including the Conservative
party, which both my hon. Friend the Minister and I represent.
Results from the annual YouGov survey of over 10,000 adults in
England, funded by Action on Smoking and Health, show that more
than three quarters of the public support the Government’s
smoke-free 2030 ambition, and eight out of 10 members of the
public support Government intervention to limit smoking.
The Government have the full support of the APPG in delivering
the smoke-free 2030 ambition. However, as the Government stated
in the 2019 prevention Green Paper, achieving that ambition will
require “bold action.” Inequalities in smoking rates have grown
in recent years, not shrunk. In order to be smoke-free by 2030,
we need to reduce smoking by two thirds in just a decade—we have
only nine years left to achieve that—and by three quarters for
smokers in routine and manual occupations. At current rates of
decline, Cancer Research UK has estimated we will miss the target
by seven years, and double that for the poorest in society.
There are still nearly 6 million smokers in England. We will only
achieve a smoke-free 2030 by motivating more smokers to make quit
attempts, using the most effective quitting aids, while also
reducing the number of children and young adults who start
smoking each year. With 1,500 people dying from smoking-related
diseases every week and less than a decade to achieve a
smoke-free 2030, there is no time to waste.
Disappointingly, with the end of the year in sight, there is
still no sign of the tobacco control plan that was promised this
year. My first question to my hon. Friend the Minister,
therefore, is whether she can she set out a timeline for the
publication of the next tobacco control plan. But the tobacco
control plan is only as strong as the measures it includes. That
is why the APPG was disappointed that the Government rejected the
amendments to the Health and Care Bill tabled by my friend the
hon. Member for City of Durham (), and supported by myself
and other officers of the APPG, in Committee.
Those amendments would have closed the loopholes in the
regulations that expose children to the insidious marketing
tactics of the tobacco industry, provided funding for tobacco
control and strengthened the regulation of tobacco. As it stands,
the Bill fails to include a single mention of smoking or tobacco
and represents a major missed opportunity to introduce key
policies for achieving a smoke-free 2030. That is why we have
retabled the amendments on Report. I hope the Government will
look at them sympathetically, because the Bill is the ideal
opportunity for them to deliver their 2019 commitment to finish
the job and introduce the legislation that is needed if we are to
achieve a smoke-free 2030. My second question is whether the
Minister will commit to considering the adoption of tobacco
amendments to the Health and Care Bill on Report.
My next area is the “polluter pays” levy. The bold action that
the Government acknowledge is needed cannot be taken without
investment. The Health Foundation estimates that a minimum £1
billion is needed to restore public health funding to its 2015
levels, with more needed to level up public health across the
country. While there was some positive news on tobacco taxation
in the recent spending review, which we welcomed, unfortunately
the Government opted not to increase the public health grant to
local authorities. As a consequence, we need to establish new
sources of funding.
The Government promised to consider a US-style “polluter pays”
levy on tobacco manufacturers in the 2019 prevention Green Paper.
This scheme would mirror the approach taken in the United States,
where user fee legislation raises $711 million annually from the
tobacco manufacturers, with the funds then used to cover the cost
of stop smoking campaigns, tobacco control policy development,
implementation and enforcement.
(North Antrim) (DUP)
I must say that I am opposed to punitive taxation policies,
because I do not think they work. Does the hon. Member accept
that tobacco companies already pay the Government £13 billion? An
additional levy could lead—and most likely would lead, as the
evidence shows—to a significant increase in criminality, because
instead of paying for taxable product, people will buy smuggled
product. Is that not a huge worry that he has about introducing a
levy?
I will come to some of these issues in a few moments, if the hon.
Gentleman will be patient and let me build the case. Obviously,
it has been estimated by ASH that the funding needed for a
comprehensive tobacco control plan to deliver a smoke-free 2030
would cost around £266 million for England and £315 million in
total for the UK. A levy could raise around £700 million from the
tobacco manufacturers, to be spent on tobacco control and other
public health initiatives. The devolved Governments would also
have the ability to opt into the scheme, should they so wish.
Such a scheme is more than justified in response to market
failure that allows an industry, whose products kill consumers
when used as intended, to make exorbitant profits. While net
operating profits for most consumer staples, such as food,
beverages and household goods, stands at 12% to 20%, Imperial
Brands in the UK enjoyed net operating profits of 71% in 2019.
That is £71 in profit for every £100 in sales. In 2018, it is
estimated that tobacco manufacturers made over £900 million in
profits in the UK alone.
The hon. Member for North Antrim () makes an interesting point about taxation. Would it
be possible for politicians, with all their imagination, to use
the taxation system to encourage cigarette and tobacco companies
to transition their products away from combustible tobacco to
less dangerous nicotine-delivery mechanisms?
My hon. Friend makes a good point; clearly, research could be
undertaken to establish how we could use the taxation system to
transition people in that way. I personally welcome the
escalators that have been put on tobacco products and continued
by the Chancellor.
Despite the enormous profitability for those companies, major
tobacco manufacturers pay very little profit tax in the UK. That
probably reflects their global engagement in diverse and
elaborate tax avoidance strategies, which allowed Imperial Brands
to lower its UK corporate tax bill by an estimated £1.8 billion
over the past 10 years, and British American Tobacco to reduce
its bill by an estimated £760 million over the same period.
Public support is strong for such a measure, with 77% of the
public supporting making tobacco manufacturers pay a levy or
licence fee to the Government for measures to help smokers quit
and to prevent young people from taking up smoking, and just 6%
opposing it.
The covid-19 pandemic has put huge pressure on public finances,
and there is a desperate need for bold, properly funded policies
to level up public health after the pandemic. Our recommendations
on the “polluter pays” approach are backed up by a much more
detailed policy paper on how this would work, which we commend to
the Minister and her officials. Will the Minister commit that the
recommendations for a “polluter pays” mechanism will be included
in any consideration of how the tobacco control plan should be
funded?
My last major point is about raising the age of sale. If England
is to be smoke-free by 2030, we need to prevent people from
starting smoking at the most susceptible ages—when they are
adolescents and young adults. Two thirds of those who try smoking
go on to become regular smokers, only a third of whom succeed in
quitting during their lifetime. Experimentation is rare after the
age of 21. Therefore, the more we can do to prevent exposure and
access to tobacco before that age, the more young people we can
stop from becoming hooked into this deadly addiction.
Raising the age of sale from 16 to 18 was associated with a 30%
reduction in smokers aged 16 and 17 in England, as was increasing
the age of sale to 21 in the United States among 18 to
20-year-olds. University College London estimates that increasing
the legal age of sale from 18 to 21 would immediately result in
95,000 fewer smokers aged 18 to 20 in 2022, and an additional
77,000 fewer smokers over the long term, to 2030. That would
reduce smoking prevalence among 18 to 20-year-olds to 2%,
compared to 9.6% without the intervention. It would be simple and
inexpensive to introduce, as ongoing enforcement costs are
already factored into the existing age regulations. This is the
regulatory measure that would have the biggest impact on reducing
smoking prevalence among young adults.
Compared to non-smokers aged 18 to 20, smokers in this age group
are more likely to be from lower socioeconomic backgrounds. As
such, the effect in increasing the age of sale would be
particularly beneficial in poorer and more disadvantaged
communities. It could also have knock-on benefits. Smoking during
pregnancy, for example, is concentrated among young,
disadvantaged mothers, and whether a woman smokes during
pregnancy is significantly affected by her wider environment.
Discouraging experimentation and the uptake of smoking among
young, disadvantaged people would prevent smoking in young women
who may go on to become pregnant, as well as their male partners,
friends and family members. That then reduces the likelihood that
young women and their children will be exposed to toxic
second-hand smoke during, or indeed after, pregnancy.
In keeping with the current age of sale legislation, raising the
age to 21 is not about criminalising those under that age, but
about making it much more difficult for them to get hold of
tobacco. Increasing the age of sale is supported by a majority of
the adult population, with 63% in favour and just 15% opposed.
The support is consistent among Conservative, Labour and Liberal
Democrat voters—I do not have figures for the Democratic Unionist
party. That is also true for those aged 18 to 24, among whom 54%
support the measure and just 24% oppose, and for 11 to
18-year-olds, of whom 59% support and 14% oppose.
Given the strength of the evidence and the public consensus that
this is the right thing to do, I and other members of the
all-party parliamentary group urge the Government to launch a
public consultation on raising the age of sale. It is
particularly important to encourage children and young adults,
who will be most affected by the policy, to participate.
Experience of smoke-free law implementation in England in 2007
showed that a public consultation can help raise awareness and
bolster compliance with legislation. For example, 98% of all
premises and vehicles inspected in the first nine months after
the law was implemented complied fully with the legislation, and
81% of business decision makers thought the law was a good
idea.
When the Government rejected the amendment to the Health and Care
Bill that would have provided the power to raise the age of sale
to 21 by regulation, they said that they would like to review the
evidence base for increasing the age of sale to 21 in more
detail. That seems to me and others a very good idea. The best
way to do that would be by carrying out a consultation, which is
what we are calling for in the revised amendment on Report. I
urge the Minister not to wait for the debate but to give her
support to the consultation now.
My final question for the Minister is this: will she give a
commitment to conducting a consultation on raising the age of
sale from 18 to 21 within three months of Royal Assent of the
Health and Care Bill? That brings me to my conclusion, Mr Bone. I
welcome the opportunity to have this debate and look forward to
contributions from right hon. and hon Members and the replies
from the Front Benchers.
09:52:00
(City of Durham) (Lab)
It is a pleasure to serve under your chairmanship, Mr Bone. I pay
tribute to the hon. Member for Harrow East () for securing the debate and for his work as chair
of the all-party parliamentary group on smoking and health, of
which I am vice-chair.
Two years after the Government stated their ambition to make
England smoke-free by 2030, projections show that they will miss
that target by seven years, and double that for the poorest in
society. Despite a promise of further action on tobacco, we are
still waiting for the new tobacco control plan, which the
Government pledged to publish this year. In the absence of that
new plan, the Health and Care Bill is a timely opportunity to
take the first step towards a smoke-free 2030.
Despite the urgency of the issue and my best efforts in
Committee, the Health and Care Bill fails to make a single
mention of tobacco or smoking. To correct that oversight, I
tabled amendments to the Bill, based on recommendations made by
the APPG on smoking and health, including proposals for a
“polluter pays” levy, health warnings on cigarettes and inside
packaging, and to close the loophole allowing e-cigarettes to be
marketed at children. Those measures are all low-cost or
revenue-generating, are popular with the public and could be
implemented quickly and easily by the Government. Although the
Government expressed support for the principle behind the
proposals, they rejected every single one, saying that they
wanted to wait and see the evidence.
The Government have cited the need to wait for the publication of
the post-implementation reviews of the Standardised Packaging of
Tobacco Products Regulations 2015 and the Tobacco and Related
Products Regulations 2016. The Government were required by law to
publish those by May 2021. That has now drifted to an aim to
publish by the end of the year. Will the Minister say how much
longer we will have to wait for the Government to start taking
action to deliver the smoke-free 2030 ambition? She should know
that if the APPG’s amendments are not adopted in the House of
Commons, they will be retabled in the other place.
Today I want to briefly make the case for my proposals and
address the Government’s arguments against them. The first
proposal is to include health warnings on cigarettes and
cigarette papers. Substantial research supports their
implementation, and they are already under consideration in
Canada, Australia and Scotland. Such warnings would be cheap and
easy to implement through a simple amendment to the Standardised
Packaging of Tobacco Products Regulations 2015. The Government
said they were sympathetic to the aims of the measure, but they
are not willing to adopt it, citing the need to conduct further
research and for more evidence. Warnings such as “smoking kills”
have been shown to be effective on billboards and tobacco packs,
so why would they not be effective on cigarette sticks, too?
Adding warnings to cigarette sticks is also important because
young people in particular are likely to begin smoking with an
individual cigarette rather than packs. There have also been at
least eight peer-reviewed academic studies published since 2015
that specifically looked at warnings on sticks and found them to
be effective, particularly in making cigarettes less attractive
to younger adolescents and never-smokers.
Cigarette pack inserts that provide health information have been
required in Canada since 2000. Substantial evidence shows that
they are effective, and research supports their use in the UK,
too. The Government have already acknowledged in the prevention
Green Paper that there could be a positive role for inserts
giving quitting advice in tobacco products. Pack inserts are easy
and cheap to introduce and, as the Government have acknowledged,
could be implemented by a simple revision of the Standardised
Packaging of Tobacco Products Regulations 2015. Again, the
Government refuse to adopt the amendment, citing the need for
further research and public consultation and to wait for the
recommendations of the post-implementation review of the SPOT
regulations, yet there is no guarantee that the review will
contain concrete recommendations. Indeed, the 2019 review failed
to do that. My concern is that the measure needed will just get
kicked into the long grass, putting the 2030 ambition at
risk.
There are currently no controls on the use of branding to promote
e-cigarette products, some of which, particularly e-liquids, are
branded in a way that is clearly attractive to children through
the use of bright colours, sweet names and cartoon characters.
Research by YouGov for ASH found that in 2021, 3.3% of 11 to
17-year-old never-smokers have tried e-cigarettes once or twice;
0.5% use them less than weekly; and 0.2% use them more than once
a week. Although those percentages seem low, it still amounts to
174,900 never-smokers trying e-cigarettes. Another 26,500 carried
on using them, and 10,600 used them more than once a week. The
ASH YouGov survey of adults and young people found that
standardising the packaging of e-cigarettes and refills reduces
the appeal of vaping to young people, particularly young
children, while having little impact on adult smokers’ interest
in using the products to quit smoking. Frustratingly, the
amendment was voted down by the Government in Committee.
A further issue that must be addressed is that although it is
illegal for e-cigarettes to be sold to children under 18, it is
not illegal for them to be given out as free samples to
under-18s. That loophole fails to deliver on the spirit of the
legislation, which is designed to protect children from nicotine
addiction. Clearly, the legislation needs amending to ban the
sale and free distribution of any consumer nicotine product to
under-18s. The Government inexplicably voted down that proposal
in Committee. They said that they did not have a firm or robust
evidence base at present to suggest that there was a widespread
problem. As stated, around 174,900 never-smokers aged 11 to 17
have tried e-cigarettes and another 10,500 use them more than
once a week. Does the Minister genuinely think that we should
wait until their use of e-cigarettes becomes a significant
problem before taking action to remove this loophole?
Finally, I want to talk about flavourings. The ban on flavourings
in smoking tobacco was introduced because flavourings,
particularly menthol, make it easier for young people to start
smoking and increase the likelihood that they will become
addicted smokers. However, the flavour ban only prohibits
characterising flavours, which are subjective and difficult to
measure, making the ban easy to circumvent and complex to
oversee. Legislation in Canada bans all flavours, which is easier
to implement and enforce. There is good reason to do that, as the
tobacco industry has introduced several innovations that have
exploited loopholes in the regulations to undermine the impact of
the ban. For example, Japan Tobacco International launched a
range of alternative products containing menthol, but which they
claimed complied with the law. Figures in the Express revealed
that 12 months after the ban came into force in 2020, the company
had sold more than 100 million packs and made around £91.65
million in profits from menthol brands.
In addition, modified smoking accessories have been introduced,
including cards, filter papers and filters, that are designed to
add a menthol flavour to both hand-rolling tobacco and cigarette
sticks. UCL’s smoking toolkit study found no decline in the
proportion of smokers in England reporting menthol cigarette
smoking following the introduction of the ban, and it suggested
that smokers of menthol cigarettes were able to take advantage of
the loophole. The flavour ban is clearly failing to prevent the
sale of flavoured tobacco, which is why I propose extending the
ban to all tobacco flavours, not just those described as
characterising.
Again the Government oppose the measure, claiming that
“it is not clear how a ban on flavours would be enforced in
practice”.––[Official Report, Health and Care Public Bill
Committee, 28 October 2021; c. 815.]
That is not logical as it is much easier to enforce a complete
ban on flavours than on only those defined as characterising,
which is very subjective.
Does the Minister agree that the tobacco industry is making a
mockery of the current flavour ban? Will she commit to closing
the loophole by removing the limitation to only include flavours
defined as characterising as soon as possible and extending the
ban, which currently only applies to cigarettes, to all tobacco
products and smoking accessories?
10:02:00
(Rugby) (Con)
It is a pleasure to serve under your chairmanship, Mr Bone. I
join the hon. Member for City of Durham () in congratulating my hon.
Friend the Member for Harrow East (), as the chairman of the all-party parliamentary
group on smoking and health, on securing an important debate, and
I compliment his outstanding record in the subject area of
smoking cessation. As he will know, I chair a separate APPG—the
all-party parliamentary group for vaping—which I established in
2014. I do not vape, have never smoked and have no personal
interest in vaping, but I set up the APPG after meeting with a
proprietor of a small business in my Rugby constituency, who was
concerned that impending legislation from the EU—the tobacco
products directive—might mean that his customers would not have
access to a product that had enabled many of them to finally stop
smoking.
Another reason for getting involved was that a member of staff in
my office had tried every mechanism available to him—patches and
other routes—to quit smoking, but the only thing that had worked
was vaping. Since setting up the APPG for vaping, we have heard
from many members of the public about the benefits of vaping in
enabling them to stop smoking, and the support that has been
given to that position by Public Health England’s assertion in
2015 that vaping was 95% safer than smoking combustible
tobacco.
I believe that two points should be integral to the treatment of
vaping in the forthcoming tobacco control plan. First, there is
the recognition of relative risk and harm reduction products,
which was mentioned by my hon. Friend the Member for Broxbourne
( ). Secondly, there is the
fundamental importance of distinguishing between combustible
tobacco, which we all know and have heard in the debate already
is extremely harmful, and the far less harmful non-combustible
alternatives that are available. The new plan should continue on
the progressive path that the UK has forged over the last few
years by continuing to recognise the importance of reduced-risk
products in reducing smoking prevalence in our country. It is
absolutely essential that we do not conflate smoking combustible
tobacco with vaping. That position is not helped by the fact that
we regularly see in public places signs telling people that
smoking is not permitted and nor is vaping. Signage and messages
such as that are putting it in people’s minds that there is an
equivalent harm between smoking and vaping, when we know that is
not the case. They are entirely separate activities and should be
treated as such.
It was concerning to read through some of the documents from the
recently concluded framework convention on tobacco control COP9
meeting and see a concerted effort by some to treat vaping as
smoking. The hon. Member for City of Durham mentioned that
concern. We should push back against such messages at all costs.
Earlier, and by contrast, it has been pleasing to see the
Government acknowledge the importance of vaping. They did so in
the 2017 tobacco control plan and I believe the case for vaping
has increased since that time. Of the estimated 3.3 million
vapers in the UK, 1.8 million are ex-smokers and the balance are
smokers who also vape. We need to recognise that category of
people, who reduce their exposure to tobacco by continuing to
smoke from time to time but who also use vaping as an alternative
device. If we assume that when they are vaping they might
otherwise be smoking, their use of vaping products at that time
helps their health.
Vaping has played a significant role in recent years in reducing
smoking prevalence. If the Government are serious about their
2019 commitment to getting smoke-free by 2030, the role of vaping
should be reinforced and supported through the new tobacco
control plan. However, as we have heard, we know that
approximately 7 million people continue to smoke in the UK and we
need to do all that we can to help the many people who have tried
to move from cigarettes to safer, reduced-risk products, as my
hon. Friend the Member for Broxbourne said.
Over the past year the APPG for vaping has conducted two
inquiries, with two reports, which I know the Minister has seen.
The first focused on the UK’s position at the recent COP9 and the
second analysed the opportunities available for tobacco harm
reduction policies post Brexit. I thank the Minister for her
receipt of our reports and for meeting the members of the APPG
ahead of COP9 last week. I know that all Members, not just the
members of APPGs, will be interested to hear from the Minister
some of her thoughts on the outcome of COP9. She will, I know,
acknowledge the delay in publishing the tobacco control plan that
we expected this summer, as mentioned by my hon. Friend the
Member for Harrow East. Can the Minister confirm that the
post-implementation review into tobacco-related products will be
published beforehand, as recommended by the APPG in its most
recent report? I hope that she can also confirm that the new plan
will not be published prior to the publication of Office for
National Statistics data for 2021 on smoking prevalence. We
understand that that was something that her predecessor
intimated.
The APPG’s expert recommendations on how we can achieve a
smoke-free 2030 can embrace the ideas to help eliminate smoking,
tackle inequalities and help level up and strengthen consumer
confidence in vaping by tackling some of the misinformation that
is currently prevalent. Our report called for the tobacco control
plan to ensure that we meet our 2030 smoke-free target by setting
out a clear plan to achieve it, embracing the concept of tobacco
harm reduction and, as mentioned previously, ensuring that the
post-implementation review of the tobacco and related products
regulations is published ahead of time. It is imperative that the
evidence gathered through the process is properly considered,
transparently disclosed and used to best effect before we set out
our new policy direction under the new tobacco control plan. The
new plan should be used as an opportunity to introduce a
multi-category approach that, as we heard earlier, encourages
switching to less harmful alternatives when a smoker is unable or
unlikely to quit entirely. As we have heard, we know that it is
the process of combustion that carries the harm in cigarettes, so
we need to fully analyse all the non-combustible reduced-risk
products available on the market and align our regulations for
all of these products—as has been advocated for by the Royal
College of Surgeons.
Finally, we should use the new tobacco control plan as an
opportunity for the UK to cement its place as the world leader in
tobacco harm reduction. I have been on calls with representatives
of other countries; we have a lead in this area that other
countries look to and it is important that we maintain that. I
know the Minister will agree that that means allowing sensible
communication on the benefit of vaping, rather than banning their
promotion and looking at the transposed EU tobacco products
directive. That way, we can make sure that they are fit for
purpose for our more progressive approach to tobacco control and
harm reduction. By making these changes we will give ourselves a
real chance to reach our smoke-free 2030 target. Without bold
leadership—which I know the Minister will provide us with—there
is a danger that we will miss that target; as a consequence, we
will miss the opportunity to help those 7 million people who
still smoke get off tobacco for good.
10:12:00
(Strangford) (DUP)
I congratulate the hon. Member for Harrow East () on securing this important debate. He and I share
many interests in common in this House, and this is one of them.
I welcome the new Public Health Minister to her role. It is vital
that smoking should be at the top of the Government’s list of
priorities. Although Northern Ireland and the devolved nations
are responsible for our own public health policies, the
Government in Westminster retain responsibility for important
UK-wide policies. Ensuring that the Minister understands the
importance of urgent action on smoking is therefore vital for
ensuring that we make the progress we need to make in Northern
Ireland.
Last year, a review of Northern Ireland’s progress in the 10-year
tobacco control survey, published in 2012, was released. Although
we met our target in ensuring a minimum of 5% of the smoking
population accesses smoking cessation services annually, that was
the only target from the 2012 strategy that had been achieved,
which is disappointing. Quite clearly, we are not hitting our
targets at a population level. Results from Northern Ireland’s
health survey show there has been no significant change in
smoking rates from 2018-19, with 17% of the adult population
still smoking—the highest rates in the UK. This is extremely
disappointing and, as my party’s health spokesperson, I am
concerned about what is happening.
Of most concern, however, is that we are failing the most
disadvantaged smokers. The target was to reduce smoking rates
among manual workers from 31% to 20% by 2020. We are far from
this, with rates among manual workers still at a very stubborn
27%. Similarly, rates of smoking in pregnancy have barely
declined over the years, despite that having been a priority in
the strategy, as the hon. Member for Harrow East mentioned. We
had hoped to reduce levels from 15% in 2010 to 9% by 2020.
However, the proportion of pregnant women who smoke at the time
of delivery is still a very disappointing 14%. We all know that
that puts women and their babies at risk of serious and avoidable
harm. We are, however, doing better with children and young
people—another priority area. Smoking rates among 11 to
16-year-olds have been halved to 4% since 2010. We had set a
target of 3%, which was missed. We are not there yet, but that is
one area of improvement.
Although smoking rates have declined among children and young
people, analysis by Cancer Research UK estimates that 10 children
under 16 take up smoking every day across Northern Ireland. If
that does not worry you, Mr Bone, it should. Children who live
with smokers are almost three times more likely to take up
smoking than children from non-smoking households, which creates
a generational cycle of inequality, with smoking locked into
disadvantaged communities. It is clear to me, in the statistics
that are put forward, that disadvantaged communities are one of
the areas that the Government and the strategy need to
address.
A third of smokers in Northern Ireland still report smoking
inside their home, which demonstrates that there is much further
to go in creating smoke-free communities and protecting children
and others in the household, but progress is being made. I trust
that hon. Members saw the recent announcement that, not before
time, Northern Ireland will join the other UK nations in banning
smoking in cars carrying children. That overdue but welcome
measure will help to protect our young people and prevent the
creation of a new generation of smokers.
Smoking is a significant challenge in Northern Ireland,
particularly in our most disadvantaged communities, which have
faced so much adversity in the last 18 months. Those problems are
not specific to Northern Ireland, however, as smoking and the
inequality that it causes are challenges for the whole UK. Our
job is not over yet. Northern Ireland and the whole UK have much
further to go on smoking, and there is no time to lose.
I trust that the Minister agrees with all hon. Members and will
be even more steadfast in her conviction by the end of the
debate. The recent Budget and spending review was an opportunity
to go much further in achieving the smoke-free society that we
need. Regrettably, that was not realised. Tax increases are one
of the most effective interventions that we have to reduce
smoking rates and uptake, although that may not be all hon.
Members’ opinion. Vitally, they are also the only intervention
proven to reduce inequality.
I am convinced, like the hon. Member for Harrow East, that
increasing the cost of tobacco products through taxes drives down
smoking rates, increases tax revenues and reduces the cost to
public finances and society. I hope that the Minister will give
us some reassurance. It is an intervention that we should make
the most of. The Chancellor’s announcement that the duty
escalator rate on all tobacco products would increase by 2% above
inflation, and by 6% above inflation on hand-rolling tobacco was
welcome, but we could and should have gone further.
There is still a major gap in excise tax rates between factory
made cigarettes and hand-rolling tobacco, which makes the latter
more affordable and encourages smokers to trade down to it rather
than quitting. That disparity has made hand-rolling tobacco
increasingly popular over the years, which should have been
addressed by the Chancellor. It is not the Minister’s
responsibility, but I am keen to hear her thoughts on it and what
discussions she may have had with the Chancellor. In 1998, fewer
than one in five smokers mainly rolled their own cigarettes, but
that number is about one in three in Northern Ireland today. I
would welcome that issue being addressed through tax revenue.
Tobacco taxes are a reserved issue, so I hope that the new
tobacco control plan will commit to maintaining high duty rates
on tobacco products, as the last one did. I also hope that the
Chancellor will seize future opportunities to increase duty rates
for tobacco products.
I have repeatedly raised the issue of licensing for tobacco
retailers in this House and I will do so again. In Northern
Ireland, since 6 April 2016, retailers have been obliged to
register with the tobacco register of Northern Ireland; the final
deadline for doing so was 1 July 2016. That built on a similar
scheme already in place in Scotland, and a scheme is due for
implementation in Wales. Since 2018, we have implemented a
track-and-trace scheme that requires every retailer to have an
economic operator identifier code registered to their business
and a facility identifier code for each store or premises that
stores tobacco.
Since leaving the EU, the UK has established and launched its own
system, with Northern Ireland operating in the UK and EU systems.
That makes it easy for all nations in the UK, including England,
to not just implement a retail register scheme, but go further
and implement a comprehensive retail licensing scheme. Retail
licensing is the obvious back-up to the tracking and tracing of
cigarettes and would help to tackle the illicit trade that gives
smokers access to cheap tobacco.
In Northern Ireland, there has been a serious issue with
paramilitaries using illegal tobacco as one of their revenue
streams. Those who sell it have no compunction about selling it
to children too. The illegal trade makes it not just less likely
that smokers will quit, but more likely that children will start.
That double whammy greatly concerns me. The Police Service of
Northern Ireland is aware of that and is taking steps to address
the issue.
I urged the Minister’s predecessors to ensure that their
officials were in contact with the devolved nations on retail
licensing and I do so again. Will the Minister ensure that her
colleagues at Her Majesty’s Revenue and Customs talk to their
equivalents in Northern Ireland, Scotland and Wales about their
experiences with tobacco retail licensing and the lessons that
they have learned regionally from the experiences of the devolved
nations?
I am conscious that other hon. Members want to speak. England
remains an outlier on this important measure that could help to
tackle illicit trade and protect children from tobacco. My
absolute priority is stopping children’s access to tobacco. We
can and should address those issues collectively, bringing
knowledge from the nations that we represent—the four regions of
the great United Kingdom of Great Britain and Northern Ireland.
If we do so, I am confident that we can and will deliver policy
that helps not only us but the constituents that we serve. That
is our duty.
10:20:00
(Northampton South) (Con)
I thank my hon. Friend the Member for Harrow East () for securing the debate. I recently joined the
all-party parliamentary group for vaping, but I have taken an
interest in that area ever since it became a matter of not
infrequent discussion when I was a Member of the European
Parliament, especially in relation to the EU tobacco products
directive and some of the flaws therein. We need a serious debate
about advertising practices related to vaping and misinformation
about the use of e-cigarettes and vaping products. That is
especially significant for me as the Member of Parliament for
Northampton South, which has a nationally high smoking rate of
18.8%.
The Government’s tobacco control plan must be based on the
significant and growing body of evidence that vaping is an
effective alternative for smokers. I thank the Secretary of State
for Health and Social Care and his team for announcing that the
Medicines and Healthcare products Regulatory Agency has updated
its guidance on medical licensing for e-cigarettes, allowing them
to be prescribed to those trying to quit smoking. However, there
is still a public perception that vaping is as harmful, or more
harmful, than smoking. The rate of smokers switching to vaping
has slowed over the last 18 months, largely because of misleading
media articles and junk science causing concerns over the quality
of e-cigarettes. Some 53% of smokers believe that vaping is as
harmful or more harmful than smoking, according to a 2021
Government updated evidence summary. There needs to be concrete
and clear information on passive vaping to counter the public
misconception that it is harmful.
It is clear that the Government and industry must push back
against those misconceptions, and the forthcoming tobacco control
plan must set out to tackle them. I encourage the Government to
look at some of the proposals put forward in Canada and New
Zealand, which hon. Members have mentioned. These countries are
introducing approved health claims and messaging about switching
from smoking to vaping, alongside some nicotine health
warnings.
We must make a clearer distinction between smoking and vaping.
There must be clear standards that differentiate smoking from
vaping in public spaces—and importantly in work spaces. The last
thing that someone attempting to quit smoking wants is to stand
around in the same vicinity as smokers. Employers should have
specific workplace vaping policies that balance the needs of
vapers and smokers. The parliamentary estate could lead the way
in adopting and implementing this policy.
Finally, I ask the Minister to support online vape retailers.
Retailers and manufacturers must be able to responsibly promote
their products online, and to highlight the health and cost
benefits of switching to e-cigarettes. At this point, I suppose
that my wife would say, “Il meglio è nemico del bene”—the best is
the enemy of the good. I am not unaware that there are drawbacks
and problems with nicotine intake. However, given the damage that
smoking does to people’s health and the sad personal experiences
that we have heard today, that expression must be borne very much
in mind.
Vape retailers are unable to use their own websites and social
media platforms to communicate the benefits of vaping to
customers. The barriers faced by online vape retailers are
disproportionate and should be removed to allow effective
communication with those attempting to stop smoking, which is
critical, by switching to vaping. Compared with methods such as
patches, which were used when as a county council leader I took
part in the return of public health to local government in 2009
to 2013, vaping’s effectiveness is clear. We are in all
seriousness talking about saving lives.
10:25:00
(North Antrim) (DUP)
I declare an interest as the chair of The Gallaher Trust, which
was set up half a dozen years ago in the wake of the closure of
tobacco production in Northern Ireland. It was named after Tom
Gallaher, a huge industrialist in Northern Ireland who created
tens of thousands of jobs. Although the charity has absolutely
nothing to do with the promotion, sale or development of
tobacco—it is a skills development charity, of which I am an
honorary and unremunerated chairman—I think it is important to
put my interest on record, because of the association that people
may draw from that.
I congratulate the hon. Member for Harrow East () on securing the debate. He has presented the
arguments in the way that he always does, very persuasively. It
is important that we have had a very good, healthy debate. It has
showed that we are probably all on the same page. We want to get
to the same finish line, but there are differences in nuance and
in how we get there. I think it is important that we explore
those differences and we try to get there in the best, most
efficient and effective way.
Any tobacco control plan must be evidence-based, not based on
emotions. Evidence is key. Innovations to support quitting
smoking are crucial to the plan. We have heard something of the
detail from the hon. Member for Rugby () and others who are very keen
that we develop innovation to ensure a systematic quitting of
smoking. The evidence shows that high punitive taxation policies
simply do not work. For someone growing up in a deprived society,
whose parents have low wages, and where cigarettes—a lawful
product in the local shops—are nearly £15 a pack, the temptation
to purchase a pack for a fiver from someone round the local pub
is huge and significant. The real thrust of any tobacco control
plan must go hand in hand with a plan that addresses criminality.
Aside from one or two vague mentions of criminality, that is what
is absent from the plan.
We have to focus on criminality. We can tax this product until it
squeaks even more, but unless we address the criminality that
lies behind illegal product and illegal product sales across the
United Kingdom, I am afraid that consumption rates will stay at a
very high, stubborn level. I do not believe that there are fewer
than 10 million smokers in the United Kingdom. I think that
anyone who believes that is in cloud cuckoo land. Walk down any
street in this city and count the first 100 people. I would say
that in excess of 20 people on average are smoking. That is a
rudimentary calculation. In other places it is considerably
higher—in night culture, for instance. Let us face the fact that
smoking consumption is probably at a much higher rate than the
figures suggest. Therefore, all the punitive taxation policies
that have been adopted by the United Kingdom—and they are the
highest in the world—are not addressing the stubborn fact that
people are continuing to smoke.
Let us pivot and get on to other counteracting measures. Where do
those other measures rest? I believe there is a role for
partnership with experts. Three things need to be done. We need
to explore, develop and ensure that new products are brought to
the market expeditiously. We need to engage a huge amount of
effort in education, especially for young people and women. We
need to make sure there is adequate, sensible and robust
enforcement against criminality.
As has been mentioned today, there is a full range of new
products already on the market to ensure that less harmful
products are available to smokers, helping them to reduce their
habit and get away from smoking. I applaud companies that have
created e-cigarettes, nicotine patches, heated products and
vaping, to encourage people away from the very harmful addiction
to tobacco and nicotine. Those less harmful alternatives must be
pursued and we must encourage their use, not discourage it.
Indeed, the points that were made earlier regarding
misinformation about those products should be addressed sensibly
by central Government. There must be co-operation with
responsible companies that want to make their lawful product and
pay tax on it. That co-operation should allow research and
development to happen, to enable them to get away from
manufacturing the single product that they currently produce.
Some mention has been made today of the levy, and it was
suggested that there should be a new levy on tobacco
manufacturing companies. As I said earlier, we in the United
Kingdom pay the highest taxes in the world on a pack of
cigarettes—I think that 90% of what we pay for cigarettes goes to
the Government—but that high tax has not solved the problem by
reducing consumption. What happens is that people are driven
towards buying unlawful products, thinking that that is a
harmless activity. Many people who purchase cheap cigarettes
think that they come over from mainland Europe in a white van and
do no one any harm, but of course most of those products are
illegally made. They are not made by the tobacco companies. What
is inside those products is beyond tobacco and therefore,
incredibly, they are even more harmful than cigarettes. People do
not necessarily realise it, but selling those products is a huge
and significant crime in our kingdom.
In the last number of years, over £1 billion-worth of illicit
cigarettes have been sold in the United Kingdom. This is not a
problem exclusive to Northern Ireland; in fact, we are the
minority. This is a multi-million pound problem across the whole
United Kingdom, and we have to get to grips with it as soon as we
can. That multi-million pound crime syndicate needs to be broken
up and destroyed.
Regarding taxation, in 2019-20 tobacco alone accounted for £11.25
billion of the Government’s revenues. However, if we set against
that the criminal sales of tobacco, we see that the Government
lost almost £3 billion in tobacco revenue. There is a huge gap
that could be made up. On the point about a levy, if there was
proper enforcement against the criminals, an extra £3 billion
would be available—legitimately raised from legitimate sales—for
things such as the promotion of education, research and
development. Imposing another levy on the tobacco companies is
lazy and would not address the problem of crime; indeed, that
problem would continue to grow. Until we face up to that, we will
keep coming back to this House—year in and year out, decade in
and decade out—and inflating taxation but seeing consumption
remain stubbornly high.
Let us address the real issue of properly attacking the
criminals. In 2020, HMRC gathered an additional £1.4 billion
through its border control activities. That was an untapped
source of new revenue, which came about largely as a result of
Brexit and having more control of our borders, but also because
of the pandemic and the inability to travel to and from the
continent to bring illegal products in. The Government were able
to raise revenue under those circumstances. With a little bit of
ingenuity, they could continue to raise that additional £1.4
billion in previously untapped sources by clamping down on gangs
and gathering the revenue that the public are entitled to have
gathered on their behalf; that is something that HMRC should do
proudly.
As Members know, there is a £10,000 on-the-spot fine for
criminals engaged in evasion of tax on tobacco. People might say
that that is a very high fine, but it is not. A case of illicit
cigarettes is worth hundreds of thousands of pounds in illicit
sales to a criminal, and a van full is worth over £1 million. Why
is the on-the-spot fine not something like £50,000 or £100,000,
in view of the sums that the criminals make? For every van that
HMRC captures, at least 20 or 30 get through, so let us make sure
that we have proper enforcement. The high price of a pack of
cigarettes simply encourages people, especially those with less
disposable income, to purchase illicit products.
I understand the point that was made about the age limit, but if
we are going to change the age limit for smoking, we have to look
at the whole panoply of age limits across the United Kingdom—for
alcohol consumption, driving, betting and smoking. It would be
incredibly difficult to enforce different age limits rather than
having a standardised one. If a 20-year-old tells a shopkeeper
that they are 21 and they want to buy a pack of cigarettes, that
would be incredibly difficult to enforce. Shopkeepers already
find it hard to tell an 18-year-old from a 14-year-old in some
circumstances.
Let us make sure that we have a standardised age for sales rather
than different ages for different products. I do not think the
Government are looking at that point, but it will no doubt gather
momentum, because it seems to be an easy solution. None of these
easy solutions work. Hard attacks against criminal enterprises
are where we will make a significant difference.
We need to avoid the danger of virtue signalling—I am not saying
any of that has gone on today; we have had a good, positive and
practical debate—and move towards evidence-based solutions,
including by encouraging companies to make less harmful product
available to the public, by enforcing and controlling the
legitimate enterprises of business and by ensuring that criminals
are not allowed to get away with their multibillion-pound
criminal enterprise. Otherwise, we should really go the whole hog
and ban tobacco altogether in the United Kingdom. To achieve some
of the goals that have been set out, that is where this debate
has to be taken. It is not being taken there at present, but we
need to get real on this.
10:37:00
(Nottingham North)
(Lab/Co-op)
It is a pleasure to serve with you in the chair, Mr Bone. I add
to colleagues’ congratulations to the hon. Member for Harrow East
() on securing the debate, and on his leadership on
this issue in Parliament through the all-party group and beyond.
He made an outstanding case in his opening speech and set the
tone for a debate that will, I hope, be practical and
impactful.
The hon. Gentleman characterised his all-party group as a
critical friend. That is very much the case, and in that sense it
is the best example of a parliamentary group. It has been very
impactful, especially through its most recent reports, which I
will borrow from liberally. I hope to continue in the spirit of
cross-party support that he and my hon. Friend the Member for
City of Durham () have established. There is
not much politics in this area, and I think the less politics,
the better. This is a big prize for the nation’s health, and
together we can find a lot of the solutions. The hon. Gentleman
led the debate in that spirt.
My hon. Friend the Member for City of Durham is the leading
Labour figure on this issue, as she showed during our very long
proceedings in the Health and Care Bill Committee—you shared in a
significant portion of those, Mr Bone. I thought her amendments
were excellent and I was proud to support them. I had hoped that
the Government would be minded to accept them, and the ideas are
still good ones. The hon. Member for Harrow East has kindly
offered the Minister another opportunity to do so during the next
stage of proceedings on the Bill, and I dare say the noble Lords
may offer similar opportunities. The Government need to pick up
these ideas, the vast majority of which are very basic things on
which I think there is complete consensus. I hope to hear from
the Minister about some progress.
The hon. Members for Rugby () and Northampton South () made points about vaping. It
is important to keep talking about vaping in debates such as
this—if nothing else, about some of the misinformation that the
hon. Member for Northampton South mentioned. Vaping does work as
a quit aid. Of course, we do not want people to start, and we
always need to say that. I am unable to recall by rote the phrase
that the hon. Gentleman’s wife used, but I will sometimes take
95%, certainly when it comes to health. With the things that my
constituents disproportionately lose their lives to, 95% seems
like pretty good progress. I hope that that is part of the
tobacco control plan, and that the Government focus on improving
quality and standardisation in the market. From looking in shops,
I know how difficult it is to find the same product twice.
That tells us about the vagaries in that market, which could be
greatly improved.
When the hon. Member for Strangford () was speaking, I was struck by the fact that much of
what he said about Strangford could equally be said about
Nottingham North. He could have said “Nottingham North” instead
of “Strangford”, and we would have heard the same thing. Health
is a devolved matter, and it is important to respect that, but I
hope we can move forward, by consent, as four nations on this
matter. That would resolve some of the issues around illicit
tobacco mentioned by the hon. Member for North Antrim (), as well as building public support and
understanding. We would not want massive variances on this issue,
so I hope we can reach a consensus.
I agree with the hon. Member for North Antrim that we need to be
evidence-based and to promote innovation. In my view, the
evidence strongly shows that tax works as a driver for reducing
smoking, and it has done for consecutive decades. I am not blind
to the increased risk of illicit tobacco and I am aware of it in
my community, but I do not see this as an either/or situation. We
can have a higher tax regime and be very serious about organised
crime, and I would support that approach.
This is a really big prize for our country. As we have heard, 7
million people, or about 15% of adults, smoke, which has
devastating consequences for illness and death. In 2019-20, more
than half a million UK hospital admissions were attributed to
smoking. We have made great progress over recent decades—that
should be a point of great pride for all parties—and we have the
lowest rates of smoking since records began. However, there must
be a recognition that these gains are not equal, and I hope the
Minister will say that that will be a focus for the next tobacco
control plan.
Poor communities, such as mine, have benefitted less. In 2019,
fewer than one in 10 professional and managerial workers
smoked—that is well on the way to the smoke-free 2030 target of
less than 5%—compared with nearly one in four workers in routine
and manual occupations. That is a serious variance, and it is a
big part of the reason why the life expectancy gap between the
richest and the poorest has widened in recent years.
A child born in Nottingham today is expected to live for seven
years fewer than one born in Westminster today. Looking at
healthy life expectancy, rather than pure life expectancy, the
gap is probably double that. If we were to tot up all the
environmental factors involved, half of the difference is
attributable to smoking. “Levelling up” is the phrase of the day,
and this is a real levelling-up issue that I hope we can all
coalesce around. That is reflected in the fact that three
quarters of the public support the smoke-free 2030 ambition. As
politicians we can see that, for once, the right thing is also
the popular thing, which is rarely the case. We should take that
opportunity.
In Health and Care Bill Committee debates, we explored these
issues at length. I hope the Government will revisit the
amendments that were proposed, and we will certainly be doing so.
I hope the Minister will tell me that I am wrong and being
uncharacteristically cynical, but I am anxious that we will not
see a new tobacco control plan in the next six weeks. If that is
the case, why not use the Health and Care Bill in front of us as
a vehicle?
As the Minister is pulling together a tobacco control plan, I
hope she will actively consider some of Opposition Members’
suggestions for that plan. First, there must be a resumption of
the promotion of stopping smoking. Over the past 11 years, this
Government have stopped evidence-based behaviour change
campaigns, which have virtually disappeared. It is no surprise
that quit attempts have reduced by a quarter. Such campaigns are
good investments, and we have lost them from the public health
grant. We need them to be returned.
I mentioned vaping, and that point has been well explored. We
need access to stop smoking services, which have really good
evidence bases on their impact. We know that they are most likely
to be used by people in occupations where smoking remains
stubbornly high, but we have lost them as the public health grant
has been clobbered over the past decade. I know for an absolute
certainty that any savings we have made there have been hoovered
up by losses in the health service, and I hope we can do a bit
better there. Three weeks ago, in the Budget, we did not hear
about a reversal of those cuts in funding to public health, and
that is really disappointing. However, if there is a financial
issue here—as I say, I do not think there should be, because this
should be seen as an investment rather than a cost—we can, as
colleagues have said, help the Minister to pay for those services
and still have some change left over for an uplift in the poorest
communities through a levy based on the “polluter pays”
principle. I hope that the Minister will mention that.
The hon. Member for Broxbourne ( ) asked the hon. Member for
Harrow East whether the tax system could be a way of promoting
changes within the tobacco industry. I think that is exactly
right. When I meet representatives of the tobacco industry—I know
it is out of fashion these days, but I meet anybody who asks me
to meet them—they all tell me that they want to stop selling
tobacco products to people. The tax system is a really good way
of making good on that, and of taking the eye-watering profits
that come through the system and investing them in effective ways
of stopping people smoking. That would be a very good thing for
everybody.
In the meantime, however, let us close the loopholes in tobacco
control. The first, as my hon. Friend the Member for City of
Durham says, is that the packaging of e-cigarettes clearly shows
they are being pushed to children. Secondly, hon. Members were
shocked—although they should not be—that companies can give out
vaping products to under-18s for nothing. That loophole is
clearly outside of the spirit of the law, so let us do better
there. The final point is about characterising flavours in
tobacco, such as menthol. That should be a real problem for the
Government, and indeed for Members of this House. The regulations
that we passed had a clear intent, but they are being routinely
circumvented to the point where, if hon. Members had their phones
in front of them, they could find menthol products in seconds.
This will not do, and it behoves the Government to come back to
those regulations and make good on them, either by making them
more effective or by promoting greater enforcement.
I know that colleagues are keen to hear the fullest response
possible from the Minister, so I finish by reiterating Opposition
Members’ support. I think we can do something really impactful
here, and we should use this tobacco control plan to do so. The
sooner we see a draft, the better, so we can begin that work.
10:47:00
The Parliamentary Under-Secretary of State for Health and Social
Care ()
It is a pleasure to serve under your chairmanship, Mr Bone.
First, I thank my hon. Friend the Member for Harrow East () for securing this important debate and for sharing
his personal story with us. I also thank members of the all-party
parliamentary group on smoking and health for their tireless work
on tobacco control, as well as the APPG on vaping for their
work.
The UK is rightly recognised as a world leader on tobacco
control. That is because it has invested in a range of
interventions over the past two decades, including a strong
regulatory framework that has led to, among other things, the
introduction of standardised packaging, the end of tobacco
displays, and protection from the harms caused by second-hand
smoke. Thanks to those interventions, smoking rates in England
are down to a record low of just under 14%. However, although we
celebrate that success, there are still around 6 million smokers
in England, and therefore there is more to be done.
As we have heard, addictions are very powerful, and if we want to
get to a smoke-free 2030, we need to break the link between a
nicotine fix and smoking lit tobacco.
I could not agree more with my hon. Friend. The burden of tobacco
harms is not shared equally: smoking rates are far higher in
poorer areas of the country, and among the lowest socioeconomic
groups. Alongside the tragedy created by illness and early
deaths, the NHS bears the heavy financial burden of £2.5 billion
every year from smoking. In 2019-20, smoking was responsible for
nearly half a million hospital admissions and around 64,000
deaths.
The Government have set the bold ambition for England to be smoke
free by 2030. To support that ambition, we have been building on
the successes of our current tobacco control plan. We will soon
publish a new plan with an even sharper focus on tackling health
disparities. That new plan will form a vital part of the
Government’s levelling-up agenda and will set out a comprehensive
package of new policy proposals and regulatory changes, to enable
us to meet our smoke-free 2030 ambition.
We are, of course, carefully considering the recommendations of
the all-party parliamentary group on smoking and health. Our new
tobacco control plan will look to further strengthen our
regulatory framework. We are exploring various regulatory
proposals, including those put forward as amendments to the
Health and Care Bill. We will conduct further research and build
a robust evidence base in support of such measures, and will
include the strongest proposals in the new plan.
One continuing concern is that one in 10 pregnant women are still
smokers at the time of delivery, which is something that the
Government are determined to tackle. The maternity transformation
programme contains some important measures, and we have made a
commitment under our NHS long-term plan that pregnant mothers and
their partners will be offered NHS-funded treatment to help them
to quit. I know that issue is close to the heart of my hon.
Friend the Member for Harrow East. Our new plan will continue to
have a strong focus on pregnancy and will encourage more
innovation and new approaches to help mothers to quit.
The evidence is clear that e-cigarettes are less harmful to
health than smoking. It remains the goal of the Government to
maximise the opportunities presented by e-cigarettes to reduce
smoking while managing any risks. Our regulatory framework
enables smokers to use e-cigarettes to help them to quit, but we
do not want to encourage non-smokers and young people to take up
those products. In the current tobacco control plan we have
actioned the MHRA to help bring medicinal e-cigarettes to the UK
market. On 29 October, the MHRA published updated guidance to
encourage manufacturers to do so.
Stop-smoking services remain at the heart of our tobacco control
strategy, producing high quit rates of 59% after four weeks.
Since 2000, they have helped nearly 5 million people to quit. We
have protected the public health grant over the course of the
spending review, to ensure that local authorities can continue to
invest in stop-smoking services and campaigns specific to their
areas. We will continue to support local authorities to
prioritise those services.
The UK has been recognised as a global leader in tobacco control.
We are proud to be a member of the World Health Organisation
framework convention on tobacco control. My officials played an
active role in the ninth conference of the parties—COP9—last
week, and reaffirmed our commitment to deal with the global
tobacco pandemic. It was a robust meeting, with more people
attending than ever. In my video statement to COP9, I set out the
UK commitment to having comprehensive tobacco control policies,
including a strong regulatory framework for e-cigarettes. Our
commitment to the WHO FCTC is further demonstrated through the
overseas development funding we contribute to the FCTC 2030
project, which is now entering its sixth year. That project
directly supports the implementation of the WHO FCTC in 31 low
and middle-income countries, helping to reduce the burden of
death and disease from tobacco.
I will now address some of the issues raised by right hon. and
hon. Members. My right hon. Friend the Member for South West
Wiltshire (Dr Murrison) talked about restrictions imposed during
covid. Covid has highlighted the health disparities across the
country. Our ambition to be smoke free by 2030 will play a major
role in tackling those disparities. I would like to reassure my
hon. Friend the Member for Harrow East that I am conscious of the
urgency of the publication of the tobacco control plan. However,
I am determined that the plan will have robust and effective
measures. He also highlighted measures that the APPG would like
to see included. Along with my officials, I am looking carefully
at each measure put forward.
Tobacco taxation was raised by my hon. Friends the Members for
Harrow East and for Broxbourne ( ), as well as the hon. Member
for North Antrim (). That is a matter for Her Majesty’s Treasury.
However, the Department continues to work with HMT to assess the
most effective regulatory means to support the Government’s
smoke-free 2030 ambition, which includes exploring a potential
future levy.
Will the Minister give way?
I am a bit short of time.
On raising the age from 18 to 21, we know how important the
period between the ages of 18 and 21 is for those who may
experiment with tobacco. We will include a focus on protecting
young people and adults from the harms of tobacco within our
tobacco control plan. As I have already indicated, I am ambitious
for our new plan.
On the Health and Care Bill, at this stage we do not feel that it
is the right Bill for the suggested measures without a full
assessment. Members should rest assured that they will be fully
considered as the tobacco control plan is finalised.
The hon. Member for City of Durham () and my hon. Friend the
Member for Rugby () asked about the
post-implementation reviews. The Department will publish its
response in the coming months. I make no excuse for the delay. We
had more than 5,000 responses to that review, and that was
coupled with the pressures that my Department has experienced on
covid-19. I reassure colleagues that it is on our agenda and we
will publish in due course.
The hon. Member for City of Durham also asked about the
investigations into menthol. The Office for Health Improvement
and Disparities is investigating a range of cigarettes to
determine if the flavour of menthol is noticeable. Once that
study is complete, we will explore whether further action is
needed against companies that have breached regulations.
My hon. Friend the Member for Rugby asked a number of questions.
I understand that the ONS will publish smoking prevalence data
for 2020 next month.
As I have already said, COP9 was one of the best attended
conferences of the parties so far. I understand that there was a
real buzz and an appetite to address the harms from tobacco and
implement the framework convention on tobacco control, which I am
sure will be welcomed by everybody in the room.
My hon. Friends the Members for Rugby and for Northampton South
() spoke about e-cigarettes.
The Government are clear that we only support the use of
e-cigarettes as a tool for smokers who are trying to quit, not as
a route for people to take up smoking by another means. Our
approach to e-cigarettes has been and will remain pragmatic and
evidence-based.
My hon. Friend the Member for Northampton South talked about the
environment that those who are attempting to quit find themselves
in. Vaping is not covered by the smoke-free legislation. It is
down to individual businesses to determine how they consider the
guidelines.
I extend my thanks to hon. Members for their participation in
today’s debate. It has been very constructive and there is
clearly cross-party support. I reiterate the Government’s
commitment to a smoke-free 2030. As we build back better from the
pandemic, our aim is to make smoking truly a thing of the past
and level up society.
10:58:00
I thank my hon. Friend the Minister for her reply. I also thank
the Opposition Front-Bench spokesperson for his strong support. I
thank every colleague who has participated in the debate. We all
share the same view: smoking must be eliminated and we must get
to a smoke-free 2030. All the advancements in legislation on this
subject have come from the Back Benches, and they will continue
to come from the Back Benches. If the Government refuse to act,
we will continue to press further.
In answer to the hon. Member for North Antrim (), the “polluter pays” principle is key. When we raise
tobacco tax at the point of delivery, the individual who smokes
pays, but if we continue to tax the profits, we can pass the
benefits on in terms of prevention. I thank colleagues for their
contributions today. We have had a very good debate. No doubt the
debate will continue, on both the Health and Care Bill and other
measures.
Question put and agreed to.
Resolved,
That this House has considered the delivery of the Tobacco
Control Plan.
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