The Secretary of State for Health and Social Care (Victoria Atkins)

- View Speech - Hansard -

Copy Link

- - Excerpts

I beg to move, That the Bill be now read a Second time.

Before I start, I should declare an interest: before I was elected to Parliament, I used to prosecute serious and organised crime, including organised crime gangs who attempted to import illicit cigarettes.

For a moment, I would like us to imagine that we are not in this historic and magnificent Chamber but instead standing at the entrance of a local hospital. A patient comes through the doors, struggling to breathe; smoking sent their asthma spiralling out of control. A minute later, another patient passes by; smoking caused the heart disease that they are battling. A minute later, another person comes in, and then another. That vicious cycle repeats itself nearly every minute of every day in our national health system, because here in the United Kingdom almost one hospital admission a minute is the human cost of smoking.

Smoking leaves people with premature dementia. It puts them in care, attached to oxygen, for the rest of their life. It increases the risk of stillbirth by almost 50%. It is responsible for 75,000 GP appointments every month, and it takes about 80,000 lives every year.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I thank my hon. Friend for bringing to the Chamber his professional experience and the real-life consequences for his patients. If I may, I will unpack some of the details behind that invaluable intervention. The premise behind the Bill is exactly as he says—to stop the start—because there is no safe level of smoking and no safe tobacco product. In fact, it is the only product that, if consumed as the manufacturer intends, will kill two thirds of its long-term users.

The Bill is not about demonising people who smoke or stopping them from buying tobacco if they can do so today. It will not affect current smokers’ rights or entitlements in any way. Indeed, we want to help them to quit. We are supporting them by almost doubling funding for local stop-smoking services. Instead, the Bill is looking to the future, to give the next generation the freedom to live longer, healthier and more productive lives.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am extremely grateful to my right hon. Friend. I will genuinely come to that, because I know that that is a concern that colleagues have. I will develop my arguments, if I may, but I also remind him of my declaration of interest and, believe you me, I have no interest whatsoever in making life easier for smoking gangs. That is why as part of the package I will announce further funding and investment for law enforcement agencies both at the border and at local level.

Some have said that it is concerning that we are banning things. I totally understand the concerns of fellow Conservatives. We are not in the habit of banning things—we do not like that. We will bring these powers in only when we are convinced—following a no doubt robust debate, with the intellectual self-confidence that we have on the Government Benches—that there is no liberty in addiction. Nicotine robs people of their freedom to choose. The vast majority of smokers start when they are young. Three quarters say that if they could turn back the clock, they would not have started. That is why, through the Bill, we are creating a smoke-free generation that will guarantee that no one who is turning 15 or younger this year will ever be legally sold tobacco, saving them from the misery of repeated attempts to give up, making our economy more productive and building an NHS that delivers faster, simpler and fairer care. It is our responsibility—indeed, our duty—to protect the next generation. That is what the Bill will do.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

That is a brave submission from the hon. Lady, given the debate in the Chamber yesterday. I certainly will not take lectures from Labour on this legislation. We are bringing it forward because we have looked carefully at the evidence. What is more, we have tempered it so that existing adult smokers will not be affected. If the message from the Labour party is that it wants to ban smoking for adults completely, it should make that argument. We have tempered this carefully to ensure that it only deals with future generations.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am extremely grateful to my right hon. Friend and close Lincolnshire neighbour. He knows that on any piece of legislation I will always want to listen to and do business with colleagues. The principle behind this legislation is that these emerging generations will never take up smoking. That is the point.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I will just finish this point. We are bringing forward this legislation so that we stop the start from 2027. Future generations will not have that addiction to nicotine.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

Yes, I can assure the hon. Lady, because the illicit trade is often the greatest in the most deprived areas of the country, and I am about to develop exactly how we will help law enforcement. I very much understand the concerns across the House about ensuring that the illicit trade does not flourish.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

To be clear, is my right hon. Friend suggesting that we repeal the Misuse of Drugs Act 1971, under which cannabis is prohibited? Although I have no experience of it, I understand that the consumption of marijuana also involves the consumption of tobacco and cigarette papers. The point is that we are trying to move away from the idea that current youngsters will be able to buy their cigarettes legally in shops from the age of 18 in 2027, precisely because we want to ensure that they can lead longer, healthier lives. In a moment I will come to some of the myths that the tobacco industry has put around about the impact of introducing age restrictions on cigarettes, which will be interesting evidence for those who are concerned about that.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am extremely grateful for the hon. Gentleman’s support. We understand the level of lobbying that has been undertaken by both the vaping industry and the tobacco industry. We know that the vaping industry has pushed that as one of its lines. In the current vapes market, when walking into a local shop or a newsagent the vape products can be seen on sale next to the till, often next to the sweets—the part of the shop that children will be very attracted to, if my experiences are anything to go by. The industry markets them in very cynical ways. We are saying that it is already unlawful to sell vapes to under-18s, but we want to take the powers in this legislation to consult on flavours, design and so on, to ensure that vapes are sold as they are intended—to help adult smokers to quit, because no child should ever vape.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am going to make a little progress, if I may, because I want to come to the age of sale.

On the point raised by my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) about the age of sale and the black market, tobacco industry representatives claim that there will be unintended consequences from raising the age of sale. They assert that the black market will boom. Before the smoking age was increased from 16 to 18, they sang from the same hymn sheet, but the facts showed otherwise. The number of illicit cigarettes consumed fell by 25%, and smoking rates for 16 and 17-year-olds dropped by almost a third. Consumption of illegal tobacco plummeted from 17 billion cigarettes in 2000-01 to 3 billion cigarettes in 2022-23. That is despite the further controls that this House has put in place in the meantime. Our modelling suggests that the measures in this Bill will reduce smoking rates among 14 to 30-year-olds in England to close to zero as soon as 2040. I hope that many of us in the Chamber today will still be here in 2040. This is our opportunity to play that part in history.

Thanks to constructive engagement with colleagues across the devolved Administrations, the measures will apply not just in England but across our entire United Kingdom, saving lives and building a brighter future. Having listened carefully to colleagues’ concerns about enforcement, we are making sure that local authorities will be able to keep every penny of the fixed penalties they bring in to reinvest in rigorous enforcement. In other words, we are looking not just at national enforcement, but at helping our very important and valuable local trading enforcement officers to keep the proceeds from the fixed penalties they hand out.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I thank my right hon. Friend. Yet again, she reminds us what a brilliant local constituency MP she is. She has drawn out the voice of young people. When I pose questions about our NHS and the future I want to build for it—reforming it to make it faster, simpler and fairer—one thing I think about is the voice of younger people. If they are in work paying their taxes, they are paying for our NHS at this moment and they will be the users of it in the future. Part of my role as Health Secretary is to ensure that it has a sustainable funding model, that we are doing everything we can to increase productivity, and that we move the demand curve so that it celebrates its next 75 years.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

The hon. Gentleman raises a very fair point. Interestingly, the latest survey of retailers shows—I think I am right in saying it—that the majority of retailers support this policy, but he knows just how carefully the Government have listened to the concerns of retailers. My hon. Friend the Member for Stockton South (Matt Vickers) has led a relentless campaign on this issue, and I was really pleased that the Home Secretary was able to announce in recent weeks a specific crime relating to violence against retail workers.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

First of all, I completely reject my hon. Friend’s suggestion that he is a dinosaur. He brings a great energy and effervescence into the Chamber—or indeed any social situation. He articulates really well the struggle of addiction to nicotine and how tough it can be to give up. That is not a judgment on anyone; the substance is designed to addict. That is how the sales pitch is made. What we are trying to do is stop children being ensnared in that way. He is also right that at the moment the evidence suggests that vaping is a good way to help existing smokers to quit. If you do not smoke, please do not vape. Certainly, children should never vape. What we have tried to do with the Bill is build a balance in, so we are taking powers to look at packaging, flavours and so on. There will be a thorough consultation before any regulations are set, because we want to ensure that we are helping adults to quit, but in a way that is considered and well designed. I am extremely grateful to him for raising that point.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I thank my hon. Friend for bringing the City of Westminster right into the Chamber. There are, in fact, five times more people in England today smoking non-cigarette tobacco, which includes cigars and shisha, than there were a decade ago. Worryingly, the greatest increase is in young adults. That is why we have said that tobacco in all its forms is a harmful product, and that we therefore wish to ensure we are consistent in the policy and the messaging that this is about helping young people to stop the start.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am going to make some progress and then I will give way.

As I have said, the tobacco industry questions the necessity of the Bill on the grounds that smoking rates are already falling. It is absolutely correct that smoking rates are down, but as I said, there is nothing inevitable about that. Smoking remains the largest preventable cause of death, disability and ill health. In England alone, creating a smoke-free generation could prevent almost half a million cases of heart disease, stroke, lung cancer and other deadly diseases by the turn of the century, increasing thousands of people’s quality of life and reducing pressure on our NHS. An independent review has found that if we stand by and do nothing, nearly half a million more people will die from smoking by the end of this decade. We must therefore ask what place this addiction has in our society, and we are not the only ones to ask that question of ourselves. We know that our policy of creating a smoke-free generation is supported by the majority of retailers, and by about 70% of the public.

The economic case for creating a smoke-free generation is also profound. Each year smoking costs our economy a minimum of £17 billion, which is far more than the £10 billion of tax revenue that it attracts. It costs the average smoker £2,500 a year—money that those people could spend on other goods and services or put towards buying a new car or home. It costs our entire economy by stalling productivity and driving economic inactivity, to the extent that the damage caused by smoking accounts for almost 7p in every £1 of income tax we pay. As Conservatives we are committed to reducing the tax burden on hard-working people and improving the productivity of the state, which is why this Government have cut the double taxation on work not once but twice, giving our hard-working constituents a £900 average tax cut. That is a moral and principled approach.

Having celebrated the first 75 years of the NHS last year, I am determined to reform it to make it faster, simpler and fairer for the next 75 years, and part of that productivity work involves recognising that we must reduce the single most preventable cause of ill health, disability and death in the UK. This reform will benefit not just our children but anyone who may be affected by passive smoking, and, indeed, future taxpayers whose hard-earned income helps to fund our health service. Today we are taking a historic step in that direction. Creating a smoke-free generation could deliver productivity gains of £16 billion by 2056. It will prevent illness and promote good health, help people to get into work and drive economic growth, all the while reducing pressure on the NHS.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

No, because, as I have said, the modelling suggests that among the younger generation smoking levels will be close to zero by 2040. As for the hon. Gentleman’s point about tax, I do not remember him voting against the Government’s furlough scheme and other support during covid; nor do I remember him complaining that we were trying to help people with the cost of living. We as Conservatives understand that this is sound money, rather than the magic money tree that will somehow fund Labour’s £28 billion black hole.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am, of course, responsible for healthcare in England, so I will not trespass on the health needs of people in—as I think my hon. Friend said—Montreal. As for the Bill, it is intended to help children and young people to end their addiction to nicotine, which we know is one of the most addictive substances. As I said earlier, we should not assume that decreases in smoking rates such as those we have seen are inevitable; indeed, I have cited countries in which we have seen an increase. We also know that tobacco is being consumed in ways that are different from the ways in which it was consumed, say, 20 years ago. My hon. Friend the Member for Cities of London and Westminster (Nickie Aiken), for instance, mentioned the rise of non-cigarette tobacco smoking. We are trying to address that, for the health of the individual as well as the wider health of society.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I have already taken an intervention from the hon. Member for North Antrim (Ian Paisley). I will take one more, from the hon. Member for York Central (Rachael Maskell), and then I will make some progress—although I will give way to my hon. Friend the Member for Dartford (Gareth Johnson) in a moment.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

The House has already legislated to ensure that vapes cannot be sold to people under 18. However, as we are seeing in our local shops, the vaping industry is finding ways of marketing its products that seem designed for younger minds and younger preferences. Once the Bill has been passed, that age limit will be maintained for vaping but, importantly, from January 2027 onwards we will not see the sale of legal cigarettes or tobacco to those aged 18 or less.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

No; I want to make some progress. I want to say something about the measures on vaping because, as Members have already demonstrated today, there is a great deal of interest in the subject.

As any parent or teacher will know, there has been a dramatic and dangerous increase in youth vaping. At least one in five children have tried it. Many will say that the solution is simply to enforce the law, and of course that is a vital component, which is why we are investing £30 million in our enforcement agencies and hitting cynical businesses that sell vapes to children with on-the-spot fines. However, we must and will go further, because vaping damages our children’s future. It could damage their lungs while they are still developing, intensify the long-term pressure on the NHS, and damage their concentration at school—a point that many teachers have made.

We cannot replace one generation addicted to nicotine with another, and vapes are cynically marketed towards our children. They are sold at pocket-money prices, they share shelf space with sweets, they are branded with cartoon characters, and they are given flavours such as cotton candy and watermelon ice. Our children are being exploited, and we cannot and will not let that continue. The Bill will give us powers to crack down on child-friendly flavours and packaging and to change the way in which vapes are displayed in shops—measures on which we will consult.

Through separate environmental legislation we are banning the disposable vapes that young people favour and that do so much harm to our planet. Some 5 million are thrown away, either in bins or on our streets, every single week. That is equivalent to some 5,000 lithium car batteries from electric vehicles being thrown away every year. We have a responsibility to tackle the harm to our planet that is perpetrated by the vaping industry. While vapes can be helpful in assisting adult smokers to quit, our message remains clear: if you do not smoke, do not vape, and children should never vape.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I thank my hon. Friend for highlighting that. I give a commitment here at the Dispatch Box that we will consult. We are very conscious of the complexities of this issue. We want to get it right, and my hon. Friend has my absolute undertaking that we will consult before regulations are brought before the House.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

If the hon. Gentleman wants to dive in before I conclude, I will let him do so.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I thank the hon. Gentleman for raising a really important point. May I, through him, thank the new Northern Irish Health Minister, who has been very collaborative in bringing forward what needs to be brought forward as quickly as possible, given the historical context, so that we can have the Bill aligned across the United Kingdom? Our intention is absolutely as the hon. Gentleman describes: it applies throughout the United Kingdom. Of course, if he or his colleague in Belfast have concerns that there may be ways in which it could somehow be circumnavigated, we will listen carefully, but I should be clear that our intention is that the Bill applies to all children and young people across the United Kingdom, because we want to protect children living in Northern Ireland just as much as those in England, Wales and Scotland.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

My hon. Friend gives me the ideal opportunity to talk about my favourite criminal offence: cheating the public revenue, which is a criminal offence with very settled law. It has a maximum sentence of life imprisonment, and I have deployed it myself against the organised crime gangs to which I referred at the beginning of my speech. A sensible prosecutor will always look at that criminal offence, because it is settled law and good law, and it has a maximum sentence of life imprisonment for those who indulge in it.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

I am going to conclude. In fairness, I have been generous with my time.

We want to build a brighter future for our children and grandchildren, which means moving from the tossing sea of cause and theory to the firm ground of result and fact. The result of this legislation will be to free future generations from the tyranny of addiction and ill health. The facts include that parents worry about youth vaping and want us to take on the tobacco and vaping industries. The result and facts of this change will save hundreds of thousands of lives, reduce pressure on our NHS and increase millions of young people’s chances in life. The decisions we make today will stand the test of time. For those many reasons, I commend the Bill to the House.

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

Just to be clear, we will consult on this. It is a simple question that requires a simple answer: will Labour consult further?

Victoria Atkins

- Hansard -

Copy Link

- - Excerpts

The hon. Gentleman is not listening. He has been asked repeatedly whether he supports the concept of a consultation on vaping in order to ensure that these regulations are drawn up properly. He is not listening. He refuses to answer the question. We on this side of the House are clear: we want to get this right and we will consult. I am simply asking whether he will answer the questions that he has been asked.

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- View Speech - Hansard -

Copy Link

- - Excerpts

I want to start by thanking the many lung cancer and asthma charities, particularly ASH, for their advice, research and support. I personally pay tribute to the chief medical officer for England for his commitment to making the strongest possible case for this life-changing legislation, and to Health Ministers across the UK for their collaboration in what will be a UK-wide solution for future generations.

I was very disappointed with the hon. Member for Ilford North (Wes Streeting), who opened for the Opposition. I have said it before and I will say it again: I like the hon. Gentleman. He once said on air that that was death to his career! Why would he have said that, Madam Deputy Speaker? But I am really disappointed today, because he was not listening. My hon. Friends had some very sensible questions about consultation, and they raised very serious points about flavours for vapes and how they might help adults to quit. He was not listening; he was making party political points. In fact, he barely said anything sensible about the legislation. All he did was talk politics. I appreciate the fact that Labour Members have been whipped to support the Bill. On my side, colleagues are trusted to make their own decisions on something that has always been a matter for a free vote. [Interruption.] He sits there shouting from a sedentary position, political point-scoring yet again.

The hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) raised a very serious question about stop smoking services. I can tell her that the Government have allocated £138 million a year to stop smoking, which is more than doubling. The Government’s commitment to helping adults to stop smoking is absolutely unparalleled.

I thank the hon. Member for East Renfrewshire (Kirsten Oswald) for her support for the Bill, and for the collaborative approach of the Government in Scotland in their work bringing forward this collaboration among all parts of the United Kingdom.

I pay particular tribute to my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health Committee for his excellent speech and his strong case for long-term policies that will prevent ill health and thereby reduce the pressures on the NHS, which is so important. He asked when we will see the regulations and the consultation on vaping flavours, packaging and location in stores. It is our intention to bring forward that consultation during this Parliament if at all practicable.

I thank my right hon. Friend the Member for Bromsgrove (Sir Sajid Javid) for his tribute to Dr Javed Khan for his excellent report into the terrible trap of addiction to nicotine. My right hon. Friend made the point that it is simply not a free choice, but the total opposite.

I thank the Liberal Democrats and their spokesman, the hon. Member for St Albans (Daisy Cooper), for saying that they will support the Bill on Second Reading. I am not quite sure where they are going on the smoking legislation, but I am grateful for their support on vaping. I hope to be able to reassure them during the passage of the Bill.

The case for the Bill is totally clear: cigarettes are the product that, when used as the manufacturer intends, will go on to kill two thirds of its long-term users. That makes it different from eating at McDonald’s or even drinking—what was it?—a pint of wine, which one of my colleagues was suggesting. It is very, very different. Smoking causes 70% of lung cancer cases. It causes asthma in young people. It causes stillbirths, it causes dementia, disability and early death. I will give way on that cheery note.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I am grateful to my hon. Friend, who makes such a powerful point and speaks with such authority. Similar points were made by my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who as a paediatrician spoke with great expertise on this matter. It is absolutely true: it is a false choice. It is not a freedom of choice; it is a choice to become addicted and that then removes your choice.

Every year, more than 100,000 children aged between 11 and 15 light their first cigarette. What they can look forward to is a life of addiction to nicotine, spending thousands of pounds a year, making perhaps 30 attempts to quit, with all the misery that involves, and then experiencing life-limiting, entirely preventable suffering. Two thirds of them will die before their time. Some 83% of people start smoking before the age of 20, which is why we need to have the guts to create the first smoke-free generation across the United Kingdom, making sure that children turning 15 or younger this year will never be legally sold tobacco. That is the single biggest intervention that we can make to improve our nation’s health. Smoking is responsible for about 80,000 deaths every year, but it would still be worth taking action if the real figure were half that, or even a tenth of it.

There is also a strong economic case for the Bill. Every year, smoking costs our country at least £17 billion, far more than the £10 billion of tax revenue that it draws in. It costs our NHS and social care system £3 billion every year, with someone admitted to hospital with a smoking-related illness almost every minute of every day, and 75,000 GP appointments every week for smoking-related problems. That is a massive and totally preventable waste of resources. For those of us on this side of the House who are trying hard to increase access to the NHS and enable more patients to see their GPs, this is a really good target on which to focus. On the positive side, creating a smoke-free generation could deliver productivity gains of nearly £2 billion within a decade, potentially reaching £16 billion by 2056, improving work prospects, boosting efficiency and driving the economic growth that we need in order to pay for the first-class public services that we all want.

I know that hon. Members who oppose the Bill are doing so with the best of intentions. They argue that adults should be free to make their own decisions, and I get that. What we are urging them to do is make their own free decision to choose to be addicted to nicotine, but that is not in fact a choice, and I urge them to look at the facts. Children start smoking because of peer pressure, and because of persistent marketing telling them that it is cool. I know from experience how hard it is, once hooked, to kick the habit. I took up smoking at the age of 14. My little sister was 12 at the time, and we used to buy 10 No. 6 and a little book of matches and —yes—smoke behind the bicycle shed, and at the bus stop on the way home from school. [Interruption.] Yes, I know: I am outing myself here.

Having taken up smoking at the age of 14, I was smoking 40 a day by the age of 20, and as a 21st birthday present to myself I gave up. But today, 40 years later—I am now 60, so do the maths—with all this talk of smoking, I still feel like a fag sometimes. That is how addictive smoking is. This is not about freedom to choose; it is about freedom from addiction.

There is another angle. Those in the tobacco industry are, of course, issuing dire warnings of unintended consequences from the raising of the age of sale. They say that it will cause an explosion in the black market. That is exactly what they said when the age of sale rose from 16 to 18, but the opposite happened: the number of illicit cigarettes consumed fell by a quarter, and at the same time smoking rates among 16 and 17-year-olds in England fell by almost a third. Raising the age of sale is a tried and tested policy, and a policy that is supported not only by a majority of retailers—which, understandably, has been mentioned by a number of Members—but by more than 70% of the British public.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

As I have said ever since I met my hon. Friend at the age of 18, he is always right. I can never disagree with him.

I want to say a few even more furious words about vaping. It is just appalling to see vapes being deliberately marketed to children at pocket-money prices and in bright colours, with fun packaging and flavours like bubble gum and berry blast, and with the vape counter right next to the sweet counter.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I am grateful to my right hon. Friend for raising those really important points. As I will come on to, we will be putting £30 million of new money each year into trading standards and our enforcement agencies to clamp down on enforcement, and we are making it illegal to sell cigarettes to anybody turning 15 this year. He asks why. It is precisely because we are trying to bring in the Bill with a decent amount of notice so that people can prepare for it, precisely to protect retailers and allow all the sectors that will be impacted to be able to prepare.

I come back to the area where I am seriously on the warpath: targeting kids who might become addicted to nicotine vapes. I went to Hackney to visit some retail shops, where I saw the vape counters right next to the sweet counters. I saw that it is absolutely not about me—it is not about trying to stop me smoking. It is about trying to get children addicted through cynical, despicable methods. Sadly, for too many kids, vapes are already an incredible marketing success. One in five children aged between 11 and 17 have now used a vape, and the number has trebled in the last three years.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The hon. Lady is aware that there is already very restrictive advertising for smoking and vaping. We are very concerned that some advertising is breaching advertising standards regulations, and I will write to retailers specifically about that.

Parents and teachers are incredibly worried about the effect that vapes are having on developing lungs and brains. The truth is that we do not yet know what the long-term impact will be on children who vape. Since I was appointed, I have done everything I can to ensure that this Bill will protect our children. The Government’s position is clear: vaping is less harmful than smoking, but if you don’t smoke, don’t vape—and children should never vape.

We will definitely make sure that people who smoke today continue to have access to vapes as a quit aid, which will absolutely not change, but we cannot replace one generation that is hooked on nicotine in cigarettes with another that is hooked on nicotine in vapes. That is why we are using this Bill to take powers to restrict flavours and packaging, and to change how vapes are displayed in shops. To reassure the Chair of the Health and Social Care Committee and my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry), we plan to consult on that before the end of the Parliament, if practicable. The disposable vapes ban will likely take effect in April 2025—those regulations have already been published.

These are common-sense proposals that strike the right balance between helping retailers to prepare, giving sufficient notice and protecting children from getting hooked on nicotine, while at the same time supporting current smokers to quit by switching to vapes as a less harmful quit aid, supported by £138 million a year. Our approach is realistic for those who smoke now and resolute in protecting children. I am convinced that, just like banning smoking in indoor public places and raising the age of sale to 18, these measures will seem commonsensical to all of us in 10 years’ time. In decades to come, our great-grandchildren will look back and think: why on earth did they not do it sooner? I urge all right hon. and hon. Members to vote for this Bill as the biggest public intervention in history. I commend the Bill to the House.

Question put, That the Bill be now read a Second time.

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- Hansard -

Copy Link

- - Excerpts

Do you want me to ask both questions now?

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Could you talk us through ASH’s assessment of the economic cost to the UK economy of smoking? Secondly, what is your view on the importance of restricting vaping for children?

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Would you state your latest research for the record, though? Obviously, this Committee is here to provide the evidence on the record.

Deborah Arnott: I would rather not summarise it now, but it will come very quickly and we can provide it to the Committee in advance of publication, so the Committee will get the full details.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I am also interested in the impact of smoking and vaping on children’s hearts and lungs in particular. I would very much appreciate hearing the professional assessment of you both of the particular vulnerability of children’s lungs and hearts, as compared with adults. I know that the Opposition spokesman and I share that grave concern, as do a number of colleagues. My second question is: do you expect the smoke-free generation policy to stop young people starting smoking?

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q I asked a specific question about children’s asthma and children’s heart damage. Could I urge our witnesses to respond to that question?

Dr Griffiths: Thank you, and apologies if we did not cover that as clearly as we could have. Obviously, there is no such thing as a safe cigarette, there is no safe number of cigarettes to smoke, and there is no safe age to start smoking at all. We would emphasise our concern for children starting to smoke, because the damage starts as soon as you start smoking. There is no safe number of cigarettes to smoke. Combined with that, the fact that nicotine is so addictive that it leads to most people—over two thirds of those who start—becoming long-term smokers, worries us enormously. In terms of both the risk and the damage of starting smoking, the number of people who start and the fact that they go on to adopt a lifelong smoking habit caused by nicotine is of deep concern to us.

Sarah Sleet: It is worth thinking about children’s wider environment. Children who live in households where the adults smoke are four times more likely to smoke themselves, and find it much harder to give up. Children are getting into a cycle of deprivation and damage to their long-term health right from the very beginning. For children, stopping smoking availability is going to be profoundly helpful for their future lives, their ability to contribute to the economy and their overall prospects. This Bill, which tackles the issue from childhood up, will be one of the most profoundly important health interventions that you can make.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Some people say that the smoking generation does not need to be raised a year higher every single year. Can you say for the record what your view is of that? Does it need to keep lifting each year?

Dr Griffiths: We support the Bill exactly as it is written at the moment. It is really important to recognise that, as proposed, it does not inhibit anybody who is currently a smoker from purchasing tobacco, but it does take us on a really clear and, I believe, a transformative path to a smoke-free generation.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I understand that, but why?

Dr Griffiths: Because it is a really clear path to make sure that we move to a situation where we have a generation that is prohibited from buying cigarettes, and who are disincentivised from doing so.

Sarah Sleet: We have heard today the evidence about just how harmful and destructive smoking is, particularly for people in more deprived areas. If we really want to tackle that, we need to remove smoking as a normalised, available, legal option going forward. This seems to me a very measured and thoughtful way of introducing a smoking ban that will take hold. It is very important for our children going forward.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you so much for being here, and also particularly for the work that the NASUWT has done in terms of the impact on schools. Could you expand on that a bit further? I have done a couple of visits ahead of this Bill. I met enforcement officers, for example, who gave me anecdotal evidence that teachers say that pupils will return to the classroom with their eyes spinning and unable to concentrate because of the heady nature of whatever it is they have just been vaping or smoking. There was another anecdote about a school where children decided to drink the vape fluid and the school actually had to have a sort of emergency evacuation as a result of that.

Could you therefore expand on that, in terms of the specific health impacts and, at the one end, the ability of children to concentrate on the class when they are spaced out on vapes, and, at the other end, the very real risk to children from doing something stupid with a vape that was entirely unintended, with disastrous consequences?

Patrick Roach: I very much appreciate your remarks about the research that the NASUWT has undertaken. We come at the problem of vaping from the point of view of our members in classrooms, in schools the length and breadth of the country. What do teachers need in order to be able to teach effectively and what do they believe that pupils need in order to learn effectively? They need good order in the classroom.

My perspective is not that of a medical practitioner or of someone wanting to assume that I have the knowledge about the impact of vaping on a child’s physical development. Our concern is the impact on a child’s educational development, participation and achievement. The reality is that everything you have mentioned there is absolutely right, whether it is about the way in which vaping products might be unintentionally used by pupils; or about how they seek to conceal them about their person; or, indeed, the drinking of vaping fluids, as if somehow that will get the high without necessarily being detected; or about the use of vaping products as a stimulant, which impacts not only on concentration but on behaviour and, indeed, on a child’s wellbeing in the classroom.

Matthew has already referenced the difficulty of detecting vapes sometimes, because they can dissipate very quickly; and they can also trigger fire alarms in schools. We have had plenty of examples of teachers and headteachers reporting that their school has had to evacuate the building not just on one or two occasions in a day but multiple times—five or six occasions. That is a loss of learning not just for one pupil or class of pupils but the entire school. We are really concerned about the impact of all that.

Teachers are not just concerned about a child’s educational development, though; they are also concerned about a child’s wellbeing in the round. Teachers are reporting the very damaging impact that vaping can have on a child’s mental and physical development, just as smoking can. That is one of the reasons we have spoken out—and we are pleased that the Government have responded—to say that we need to be doing more to strengthen the enforcement of rules around vaping, access to it and the availability for school-age pupils. We need to do as much as we possibly can to prevent any school-age pupil from getting access to vaping products, whether in or outside school. We are pleased that the Bill seeks to do just that.

Matthew Shanks: I absolutely echo and reinforce what Patrick has said. Also, as school leaders we are looking after teachers, but we are caring for families as well. The Bill will help families to understand that it is not okay for their children to vape. Anecdotally we have parents saying to us that they let children vape at home, because it is better than them smoking or being out on the streets; parents do not see the harm in it. It is really important that that is recognised. The banning of tobacco sale was interesting in terms of the prescription of it; I would posit that at the moment vaping is seen as safe by the general public.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q I really appreciate your being here—thank you. I would like to tackle the fact that young people tend not to consider either their own mortality or their health and wellbeing. The majority of young people tend to take those for granted, and yet there is a complete correlation: the age at which you take up smoking—or, indeed, vaping—is when you are young and feel pretty immortal, or are at least not concerned about later life.

Could you give us a view, as an Age UK representative, of the sort of advice that older people who have smoked all their lives and are now bearing the brunt of the decisions they took would give to those who argue, “It’s a matter of personal choice. Everyone should be free to smoke if they want”? What would an older person say to that young person?

Paul Farmer: I think a lot of people would say that they wish they had never started. Those are certainly the conversations we have been having with older people in preparation for this session. The reason for that is that, as you enter into your later life, you start to understand the consequences of smoking through your personal experience. The list is frightening.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q For the record, can you outline some of those experiences? Obviously this is a public evidence session and we are looking to make the strong case for this Bill.

Paul Farmer: Very clearly, there is the relationship between smoking and multiple forms of cancer, COPD, pneumonia, heart disease, aortic aneurysm and stroke, vascular diseases, diabetes, rheumatoid arthritis, hip fracture, cataract and macular degeneration—and dementia. In a society where we are increasingly debating dementia’s impact, I think the relationship between smoking and dementia is a really important context.

These are in and of themselves very challenging physical health conditions, but we can also see the correlation with people who experience multiple long-term conditions. I think many older people who experience those multiple long-term conditions—who have to live with the impact of them often because they smoked in their early life—would say this impacts on the individual being able to do the things they want to do in their later life. There is a severe detriment on pursuing their ambitions of later life as a result of having smoked in earlier years.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My last point: may I just pursue that—

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you. Would that older person suffering those consequences say: “Yes, it was all a matter of free choice”?

Paul Farmer: I think different people will have different opinions about choice, and whether it was as a result of choice. I think what many older people have been telling us is that if they had known about the damaging consequences of smoking, they would not have started in the first place and would certainly have considered it in a greater way.

I want to pay huge tribute to colleagues at British Heart Foundation, who I know you have just heard from, who I think have taken the best way of trying to campaign over a long term on this issue. This is a long-term issue. Sadly today’s generation of older people is seeing the consequences of what has not happened.

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- Hansard -

Copy Link

- - Excerpts

Q I appreciate you being here. Can you give me an idea of the LGA’s view of a licensing regime? That is not proposed in the Bill, but some people say that licensing would be a better alternative than the measures we are proposing here.

Cllr Fothergill: Certainly. Although we fully support the Bill, we think there could be one or two changes, which I have already referred to—we would like to see amendments—and there is the option of a licensing scheme, which we would support. If it was done on a similar basis to liquor licensing, we would be able to enforce that, because it would be backed by legislation. Of course, we would need to make sure that trading standards were fully funded for that. We would support that, if it was something that the Government brought forward.

Greg Fell: I cannot speak for the LGA’s position; ADPH does not have a formal view on licensing. I would broadly support it, but there is a danger that putting that into the mix delays getting the Bill through Parliament and turned into an Act, and getting the Bill through Parliament is arguably the most important thing.

I would broadly support that, but I come back to the complexity. Vapes are sold in hairdressers and beauty parlours and so on, so we would need to think it through. Arguably, if we are going to get into a licensing scheme, that should be for tobacco and nicotine-containing products, not just vapes; I would personally go to tobacco as well. Critically, the resourcing to make it work properly would need some very careful thought and consideration. All of that would need to be in the mix, but broadly I would support it, with those caveats.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q You have already said that you do not think the penalties are high enough, but do you think that the enforcement rules as they are, with the proposals to change the packaging, move the location of vapes and so on, will make it easier or harder to enforce? Do you think that enforcement officers will have sufficient time to train and gear up to meet the challenge of the legislation?

Cllr Fothergill: Specifically on vaping, we support the move to plain packaging, moving them away from the counter and restricting flavours—we support all those things. I have to say that we recognise the role of vaping in helping people to give up smoking, but where children and younger people are involved, we want to move the vapes away and make them less accessible. Trading standards will enforce that, as long as there are clear definitions of what can be sold, where it can be sold and who it can be sold to. A lot of the work that they do is evidence-led, so they will work on people who are giving them tip-offs or where they are seeing that there is a trend in an area where those products are being sold. As long as we are resourced and we recognise that a lot of that evidence-led work is required, it is entirely achievable.

Greg Fell: I have a fairly similar view. Largely, trading standards do this work now. The easier and simpler we can make it, and the more we make sure that it is resourced appropriately, the better, but they largely do this job now pretty well.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q You made a very good case for the age of sale rising each year, but as the LGA, do you think that will be tricky for enforcement purposes? An argument is often made that if you were 40 and I was 41, we would go into a store and I would have to buy your cigarettes for you. What would you say to that as an argument for continuing with the smoke-free generation legislation?

Cllr Fothergill: We have to be very careful that we do not spook ourselves out of doing something that is absolutely right. If people get to the age of 40 and have to show that they are 40 to be able to buy cigarettes, that is what they should do. I am sorry to say that I am 67. I have to show a bus pass every time I get on a bus to show that I am old enough to travel for free.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q I beg people to ask me my age when I am buying a drink, and they just will not.

The additional things—heated tobacco, shisha and so on—that come under this legislation include cigarette papers. We all know that they can be used for rolling joints and other purposes, and that cigarette papers contain carcinogens. However, some have quite a strong desire to exclude them—I do not know why. What is the view of the LGA and ADPH on that point?

Cllr Fothergill: We believe that the scope of the Bill as it is currently written is right, and that is what we would support. We would not want to see anything excluded. Every time there is a change to smoking legislation, we hear the argument that it will increase the amount of illicit trade coming into the country. That is not a reason not to do it. It is our responsibility as trading standards to enforce, and although people always use that argument, we have to do the right thing and enforce by properly funding trading standards.

Greg Fell: If I had £1 for every time I have heard the illicit trade argument, neither of us would be here. The heat-not-burn—the clue is in the title—is a tobacco product, and I would treat it like a tobacco product. It may be safer than burned tobacco—we do not know. I would like to see some independent research. However, I would not delay the Bill until I see independent research. I would personally argue to not allow exclusions. It may seem much harder to enforce, but there will already be some tricky points in enforcement; we already know that we need to resource that properly. I would keep the simplicity and not allow exclusions.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you so much for being here and for all you do in the north-east. It is fantastic.

As you will know, rates of smoking during pregnancy in the north-east are some of the highest in the country. Do you think this legislation will help to reduce those very high numbers? The rate is somewhere in the region of 14% in the north-east.

Ailsa Rutter: We have made really good progress in the north-east in reducing maternal smoking; that has come through very good collaboration between our local maternity services and our local authorities, as well as the fantastic leadership from key people in the local maternity and neonatal system, the LMNS, and the direction from directors of public health.

As with anything, there is not one magic solution; it is about taking comprehensive measures. The tobacco age of sale increase will undoubtedly have a really positive impact on reducing maternal smoking. It needs to be coupled with important things that we must continue to do as well, so we also welcome the increased investment for stop-smoking services.

We hugely welcome—thank you—the reinvestment in the evidence-based health harms campaigns. We are thrilled that nationally you are using our fantastic “smoking survivors” TV advert featuring Sue Mountain. The role of financial incentives is also really important; we know that they have a very strong evidence base. This will have a positive impact on maternal smoking.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you so much for being here. You will be aware that, in putting together legislation, huge effort is made to be balanced and not excessive and to make it doable and achievable, nowhere more so than for those who are trying to enforce it.

May I press you a bit further on the point that Preet made about whether the fines are sufficient? You have said that it is a bit complicated and will require some lead-in time—which is obviously provided, with the 2027 date—to give appropriate training to shop staff. The quantum of the fine was intended to enable on-the-spot fines, rather than having lengthy litigation because the person who incurs the fine does not have the cash and needs to go away, may or may not pay it, may or may not have to be pursued, may or may not have to go to court, and so on. Understanding that there are different views on all sides, is the balance just about right or, if you could have put your own wish list together, are there things that you would have done differently?

Adrian Simpson: We would have liked to see more education provided to retailers who might have broken the rules. A fine can be life-changing for someone who is given one, so we like to see whether there might be a way around that; perhaps the shop worker could be educated first, rather than going straight to a fine, if at all possible. We would like to see that balance of education before strict enforcement, if possible. That would be our wish.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q You mentioned that your members are used to working with Challenge 25. Do you see the Bill working in the same way? As the age of the smoke-free generation rises from year to year, will your colleagues in the retail sector manage to look at two different customers and ask the one that they are concerned about to verify their age?

Adrian Simpson: I think you made a wise point earlier, Minister, about the difference between a 40 and a 41-year-old. That is absolutely our concern: how will we do that? We hear a lot of things about artificial intelligence and new technology for age verification, but a lot of it is still down to human interaction—whether a human can tell the difference between 40 and 41, which can be difficult. That is certainly one of our biggest concerns. Again, we are keen to avoid situations where there could be a touchpoint for violence against shop workers.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q You will have heard Mr Fothergill from the LGA saying that he has to show his bus pass every time he wants free transport. Do you feel that that is where the solution lies?

Adrian Simpson: There certainly needs to be a bit more research into what the best methods are to keep this age restriction going. It is a new challenge in the retail sector. We have never had anything like this before, and the UK is a leader in this area. I think that, at the beginning, it will be about us all working together to try to get the age restriction going and to make sure that it is enforced, because—this is one point that I would like to make—our members are obviously very compliant and want to do the right thing. These household names are very protective of their reputations; they want to be good and to do the right thing for society. However, I certainly think that, with this new system that might come in, there could be some teething problems. We hope not, but that can naturally happen with all new systems.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q May I just clarify, then, that your members support the uplift in age, year on year? As you will no doubt be aware, there are some who challenge that and say, “Well, it shouldn’t keep escalating,” but the British Retail Consortium does support the idea of the increase, year on year, of the smoke-free generation, as so many of our other expert witnesses have done today. Would that be right? I do not want to put words in your mouth.

Adrian Simpson: It was definitely a point that came up quite a lot when we were debating this with members themselves. I would say that we are cautiously welcoming it, just because it will then bring about a level playing field for all retailers—because we know that these measures are not necessarily directed at our members, who are, as I say, in the legitimate, responsible retail sector. It will bring about a level playing field but, as I say, we might still need to see how it would operate in practice, I suppose, before we give it our wholehearted support.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q It is great to see you—thanks for coming today. I think you are saying that at the moment the fine is set at the right level. It is a really important issue: by no means do we want it to appear to be a cost of doing business. Our previous witness was suggesting that for some shop workers it is a very significant sum and is quite problematic for them, so perhaps there should be training in the first instance.

We have sought to get the right balance, with a £100 fine that can be reduced to £50 if it is paid on the spot. For any of us, a day when we have to dish out £50 because we have done something wrong is a significant bad day. On the other hand, there is an escalation process to criminal prosecution. I am really keen that we get the balance right up front, notwithstanding that there will be powers to change it. Can I press you a bit further: is this or is this not the right place to start?

John Herriman: Can I make a broader point, and then maybe Kate can come in on the specifics? This is all about the market surveillance activity that allows you to understand what is happening on your local high streets and your ability to take enforcement action where necessary, whether that is a £100 fine or a prosecution. Fundamentally, that is the challenge at the moment. It is about the ability to have the right level of market surveillance and the right level of enforcement activity. I am sure it is a question that will come up. It is a challenge for trading standards at the moment, because over the past decade or so it has had significant cuts, in the region of 50%.

There are two halves to this question. First, is this the right legislation and are the amounts right? Secondly, legislation is only as good as the ability to enforce it. It feels as though the legislation is right—I will let Kate comment further on that—but the ability to enforce it is critical.

Kate Pike: Absolutely. Whenever we look at a new piece of regulation—as I think somebody mentioned earlier, we enforce more than 300 pieces of legislation across the spectrum—we ask, “Do we have the powers to enforce?” In the Tobacco and Vapes Bill, yes, we do. “Are there criminal penalties in there?” Yes, there are. The key things from our point of view—the building blocks—are there.

Across the spectrum, how many businesses sell tobacco? The impact assessment for the Bill says that there are something like 60,000 or 70,000 across the United Kingdom. On that spectrum, there are big businesses that know what they are doing and do not need a lot of support from us. There is a big chunk in the middle that might need a bit of support and guidance—they may make a mistake, but we can support them, help them and train them. Then there are a small amount at the other end that are the dodgy ones. We need to focus our enforcement efforts on them, because we will never be able to put one trading standards officer outside every business to be watching all the time.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q It is clear to me, having done a visit with enforcement officers, that some so-called specialist vape shops and some newsagents just have the vapes next to the sweets. It is a free-for-all: you get your bubble gum and your vape there. Is that problematic? Will this legislation mean that enforcement officers shut them down? Will there be enough powers and resources to ensure that this can no longer happen?

Kate Pike: The Bill will have enabling regulations on vapes, with powers and criminal sanctions. That is good, but the specifics around where the vapes are positioned in store will be down to the next stage. We get calls all the time from people saying, “There’s a shop in my area called Toys and Vapes—do something about it!” There is actually no legislation that we can use to tackle that.

If you do not want the vapes next to the sweets, legislate for it. We will enforce what it says in the legislation, but we cannot make it up. People are always saying, “That’s not right,” but we cannot enforce morals. We can only enforce the law, so get it in there. If you do not want the vapes there, for very good reasons, give us legislation and we can enforce it.

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- Hansard -

Copy Link

- - Excerpts

Q I thank all you chief medical officers for being here; we appreciate it. You will understand that your witness evidence is crucial to easing the passage of the Bill. I would like to get you on the record talking, first, about the start of life. The shadow Minister has just asked about pregnancy and, only this week, I was talking to a neonatal nursing lead, who said of the pregnancies of women who smoke that the children had a low birth weight and go on to have severe learning difficulties throughout their lives. That is heartbreaking, but also has significant implications for NHS and educational services, and for whole-life costs to the taxpayer. I would be grateful for your comments on that.

At the other end of the age range, elderly people who have smoked all their lives end up with decades of ill health brought on by a lifetime of smoking. I would be grateful, too, if you talked about some of the health outcomes for those who have smoked all their lives—some of the horrors of that. Sir Chris, you told me an anecdote of when you were a young vascular surgeon. For the record, it is important to talk about some of the heartbreak for those who wish they could stop smoking.

Professor Sir Chris Whitty: I completely agree with all the points you made. Starting off with the beginning of life, there are clear and significant increases in stillbirths, premature births, birth abnormalities and long-term effects from smoking just in the pre-birth period. Then, of course, if parents are smoking around babies and small children, that affects lung development and, if children have asthma, that will trigger asthma effects. Young children are significantly affected by passive smoking from their parents. The parents, of course, want the best for their children, but the problem is that they are now addicted to a product that has taken their choice away. We get those problems right from the very beginning, and we have talked about some of the issues in young pregnancies and where that leads.

Moving to the other end of the age spectrum that you were talking about, the full horrors of smoking for most people start to take effect from middle age onwards. At this point, people get a range of things. Everyone knows about lung cancer, I think, and most people know about heart disease, but there are effects on stroke or increases in dementia, which are significant—one of the best ways to delay dementia is not to smoke or to stop smoking at an early stage. That is a huge problem for all of us. Smoking also exacerbates any problems people have with diabetes—it makes that much worse—and people have multiple cardiac events leading to heart failure. In heavy smokers, we see extraordinary effects, like people having to lose their limbs. As you and I discussed, it is a tragedy to be on a ward with people with chronic obstructive airways disease, or on a vascular ward as a vascular surgeon with someone who has just had an amputation, weeping as they light up another cigarette, because they cannot stop, because their choice has been removed. I cannot hammer that point home firmly enough: this is an industry built on removing choice from people and then killing them in a horrible way.

Sir Francis Atherton: Minister, you also pointed out the cost to the NHS. In Wales, we estimate that we have about 5,500 deaths every year from smoking-related diseases. If we look at admissions to hospital, about 28,000 in the over-35 group is about 5% of overall hospital admissions. That is an enormous burden to the NHS. On a more personal basis, in a former life I was a GP, and I remember sitting with an elderly gentleman who at the end of his life was suffering with chronic obstructive pulmonary disease. There is no worse death than not being able to breathe when just sitting there. I remember sitting with him as he was trying to talk to me and trying to express that same level of regret that Sir Chris talked about. If you talk to any smokers towards the end of their life, who are facing such terrible ends to their life, the sense of regret that you hear as a doctor is quite overpowering.

Professor Sir Michael McBride: It is estimated that in Northern Ireland there are more than 2,000 deaths each year directly attributable to smoking cigarettes; over the past five years, smoking makes up 12% of all deaths in Northern Ireland. Sir Frank and Sir Chris have clearly described the horrors of the impact that it has at an individual level, and as doctors we have all experienced that. We have all had those conversations with individuals who look back on a lifetime of regret.

On a more personal level, I also think at this moment about the impact that premature death, and the morbidity and mortality associated with smoking, has on families and children. My own father died at 46 years of age, when I was 16, from acute myocardial infarction as a consequence of a lifetime addiction to smoking cigarettes. So, we need to bear in mind the very human costs, family costs and wider societal costs as well. It is not just the cost to the health service, but the societal cost, the family cost and the cost to the wider economy.

Professor Sir Gregor Ian Smith: We should never forget the societal cost that Sir Michael just spoke about. I am the child of two smokers who died in their mid-60s from smoking-related disease. We see it all too often in Scotland. In fact, in Scotland we still have 9,000 deaths a year attributed to tobacco addiction and smoking. That is one death every 61 minutes that families suffer across Scotland as a consequence of addiction to smoking.

As a clinician, one of the diseases that I had become quite specialised in treating and led a lot of work on is chronic obstructive pulmonary disease. That is a smoking-related disease that people develop, often at too young an age, and begins to really impair their ability to participate fully in life—not only in employment, but in the pastimes that they love. Gradually, over time, it becomes worse.

Sir Frank touched on the sense of regret that people have that they ever started smoking in the first place and find themselves in this position. Beyond that, there is an even sadder element: many of the people who experience these chronic life-limiting illnesses have not only regret that they ever started, but guilt about the burden that they place on the health service and their family because of the illness and disability that they develop. That guilt sometimes reaches to the extent that they do not seek full care. Many people’s attitude is, “I deserve this. I started smoking; I need to pay the consequences.” That is a terrible psychological position for any person to find themselves in. Removing the starting point for that addiction, so that people will not experience that through their life, is the aim of the Bill.

Let me make one last point. We talk about the health impacts of all this. The Scottish burden of disease study projects that over the next 20 years, up until 2043, we will see a 21% increase in the general burden of disease across our population in Scotland, despite having a falling population during that time. Much of that projected burden of disease is smoking related; it relates to cancers, cardiovascular disease and neurological conditions such as dementia, which are all influenced by smoking. It is absolutely necessary for us to address this in a preventive way, and I believe that the Bill is a very good way of doing that.

Professor Sir Chris Whitty: I want to reinforce the point that Sir Gregor just made, with which I am sure the Committee fully agrees, that individual smokers should never be blamed for the situation they are in. An incredibly wealthy, very sophisticated marketing industry deliberately addicted them to something, at the earliest age it could get away with it, and they have had their choice removed. It is important that people do not feel guilt and come forward for care, and that no one blames them for a situation that was deliberately put on them by industry marketing.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q I think we might be out of time, but I have one more question. In the passage of the Bill, there is a concern that some may wish to fix flavours on the face of the Bill, rather than allow the powers. Sir Chris, can we have a comment on the record on how damaging that would be?

Professor Sir Chris Whitty: That would be very damaging, because we know that this is one of the most innovative marketing industries in the world. That is how they have managed to sell to people something that will addict them and then kill them. If we give them room for manoeuvre by nailing things down, they will find a way around it, because they always have found a way around regulations. I am absolutely supportive of the comment you have just made.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you so much for being here today. As I said to the chief medical officers, you will appreciate that your words can be very helpful in smoothing the passage of this very important Bill. I would like to talk to Kate, please, about the impact of smoking on mothers who are pregnant. What is the impact on their babies, on the delivery of the baby, and on the baby’s health outcomes? If you could give us an outline, that would be very helpful.

Kate Brintworth: It is important to start with the fact that we know that smoking is the single biggest modifiable risk factor for pregnancy, and we know that every women who gets pregnant wants the best for her baby. As a midwife, I have never sat in front of a woman who does not want the absolute best for her baby. It is important to build on what Chris Whitty said around the removal of choice. Women will go to extraordinary lengths to protect their bodies and babies to ensure that their children have the best start in life, and yet the quit rates that we see in pregnant women are between 30% and 40%, showing how difficult it is for women to extricate themselves from the situation in which they find themselves.

The effects are devastating: stillbirths are increased by 47%; you are twice as likely to have a baby that has not grown properly; and you are 27% more likely to have a baby that is born pre-term. You are more likely to have complications of pregnancy, such as bleeding, the placenta not forming properly or the waters that surround the baby breaking earlier with the risk of infection, so there are immediate effects that we can see. If a baby is small, it goes into labour more vulnerable to the stresses of labour, so we can have more complications there. If a caesarean section is needed, the mother is more vulnerable to recovery and it can be a much harder road to recovery for her, with the risk of infection and blood clots, but also for the baby. If the baby is born early, obviously the risk then is that the baby and mother are separated and you have this unnecessary trauma to a family of a baby having to go into a neonatal unit. The risks that come from prematurity are well-documented for children, for educational attainment and for their lung and health development, but when the children go home, they are more at risk of sudden infant death syndrome—up to three times more—in a smoking household.

There are then the long-term effects. We have already heard about asthma, chest infections and obesity. All those are heightened in children born into smoking households. You have a situation where children are at risk and women are at their most vulnerable when they are pregnant, and it really feels like it is our duty to support this Bill to protect the most vulnerable in our society, because there are the effects of having a child born with possible behavioural problems and malformations, which have been described. Those are really shocking events. I was talking to service users yesterday who have had children in the neonatal unit, and it is incredibly shocking when your pregnancy ends early and you are separated from your baby. There is a mental health impact on the family. There is also the point that this affects those coming from the most socioeconomically deprived backgrounds, for whom having any kind of health challenge makes it a much higher bar to fight.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q That is very harrowing to hear. Could you further expand on the impact on families of losing a baby due to stillbirth as a result of smoking? How does that impact on their mental health? As you said, parents will do everything they can to protect their baby, but the addiction to cigarettes is so strong that for many it must lead to them blaming themselves for the death of their baby.

Kate Brintworth: The birth of a child is so happily anticipated by every person who gets pregnant. From the moment that you see a thin blue line, you are having a baby. You have hopes and dreams for the expansion of your family, but not just for that individual family: a baby is born, and it is a niece, a nephew, a grandchild, a cousin. It really ripples out across the entire family. When there is then a 35% risk of miscarriage and a higher risk of ectopic pregnancy and, as you said, the absolutely awful, tragic and devastating news that your baby has died when it reaches term, that is something that no parent should ever have to face unnecessarily. It just feels like the worst thing you ever have to do as a clinician to tell someone that their baby has died. Every time I have ever had to do that, it has been the worst point in my career. It is difficult to explain how destroying it can be for families, and we see the long-term sequelae in terms of mental health, to the point where we have put in extra perinatal mental health support for families that have suffered that kind of trauma.

Professor Sir Stephen Powis: Can I pick up on the health inequalities aspect, because I think that is really important and I have the figures in front of me? In 2021-22, 21% of pregnant women in the most deprived areas smoked at the time of delivery, compared with 5.6% in the least deprived areas. That is a really stark difference. Smoking is widely accepted as the most significant driver of health inequalities in the UK. Detailed analysis has concluded that 85% of the observed inequalities between socioeconomic groups could be attributed to smoking. We spend a lot of time in the NHS quite rightly targeting our interventions and support to deprived areas to address health inequalities. At a stroke, this Bill would have the greatest impact that we could possibly see.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Thank you both so much for being here. As I said to the other medical professionals, your words today will be incredibly valuable in ensuring the smooth passage of the Bill. Professor Turner, could you explain to us what happens to a baby born addicted to nicotine in terms of the withdrawal symptoms and the impact on its health and development?

Professor Turner: There is not a lot of research on that. Certainly, we know that if you are in utero and your mother is smoking, you will get the harmful effects of nicotine. That is a very good question—I honestly do not know what the effects on the unborn child would be. Certainly, we know that children born to parents who are addicted to morphine or cocaine have learning difficulties. I have to be honest and say that I might have to get back to you on that one, but I can assure you that it is not good to be in utero and exposed to nicotine.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q Professor Hawthorne, from a GP’s perspective, could you talk us through the impact of second-hand smoking on childhood asthma and how that presents in terms of the innocence of the child and the impact of something being done to them?

Professor Hawthorne: We have known for a long time that passive smoking increases the risk of not just asthma, but upper respiratory tract infections and ear infections. It is very much part of a GP’s role when they are consulting with such patients coming in with these infections to ask about parental smoking. It is interesting that the responses are nearly always the same. If the parent smokes, they will always say, “But I only ever smoke outside.” Of course, one has to take that as it is, but I suspect that they are probably not always smoking outside. It is definitely a well-recognised link, but I am seeing it a bit less than I used to.

Everybody knows about the dangers of smoking. A lot of my patients, when I talk to them about needing to stop smoking, already know what I am saying. Quite often, I will say to them, “Well, you know what I am going to say next, don’t you?”, and they will say, “Yeah, I know. I need to stop smoking.” The conversation then proceeds from there.

We also have evidence that, in general practice consultations, a short intervention can be very effective. We know that people are very pressed for time, and there is only so much we can cover in a 10-minute appointment, especially if the patient is coming with three different problems. But there is good evidence that with even a very short intervention—I think in about 10% of cases—patients will actually stop smoking. It is always worth talking about, and if I get the time, I have a much longer spiel, because you need to think about the behavioural and addictive aspects of smoking. We go through, “When are you most likely to want to smoke? Is it after a meal, when you are on the phone or when you first get up in the morning?” We talk about what else they can do instead. I had one patient who went and dug the garden whenever she wanted to smoke. It is that kind of conversation.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q We know that it takes up to 30 quit attempts to actually give up smoking. Can both of you give us a clue as to what is it about the 30th attempt that finally gets people over the line? Specifically to Professor Turner, is it being pregnant or having a partner who is pregnant? Is that the thing that makes people finally achieve their goal?

Professor Hawthorne: For adults, it is having that heart attack that maybe you could have avoided if you had stopped smoking before. Again, that is part of the conversation I have with patients. I say, “You are a heavy smoker, and you are at risk. Wouldn’t it be better if you stopped smoking before you have the heart attack, rather than after?” There are things like that, for sure.

We also operate a cycle of change psychological model—the Prochaska and DiClemente model. Essentially, it is a bit like having a clock face. We work out where the patient is on the clock face, and we are trying to get them round the clock to 12. If they are at somewhere like 2 o’clock, that is them saying, “Yeah, I know it is bad for me, but really no way am I going to do anything.” By 4 or 6 o’clock, they are saying, “Yeah, I know it is bad for me. I have tried a few times but it is just hopeless.” By quarter to, they are saying, “I’ve really got to do something”, and by five to, they are coming in and saying, “Doctor, you have to help me stop now.”

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Q And is that related to their declining health?

Professor Hawthorne: Not necessarily. It is about pushing people psychologically around that clock face. I try to work out where they are on the clock face and see if I can nudge them a bit further round, until one day they come and say, “I’ve got to stop now. What can you do to help me?”

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Thank you.

Professor Turner: As Kamila says, there are myriad drivers—teachable moments. Sometimes, when your child is admitted to hospital with an asthma attack, that might be the thing that makes both parents say, “That’s it.” It might be that the grandmother says to her daughter, “You’ve got to stop for your child.” Legislation might also be one of those teachable moments that make people reflect on their 29 past unsuccessful attempts and think, “I’m going to do it again.” There is no one thing, but there are clearly teachable moments, as we all have when we change our behaviour. As I suggested, I think this legislation will be one of those.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Thank you very much. One last question: do you think the financial incentives for pregnant women and their partners would help?

Professor Turner: I think this is extremely contentious, but the evidence is that it does—sorry, you did ask me about pregnancy before. Pregnancy itself can be one of those opportunities to quit. Those parents who continue smoking—12% in Cumbria—feel terribly guilty. Anything we can do for that person, who has been addicted since she was 15 or 16, can help them to quit. There is no doubt—in Dundee, the trials have shown that, if you give mums incentives, in terms of vouchers rather than money, it helps them to quit, particularly if they are from deprived communities.

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- Hansard -

Copy Link

- - Excerpts

Clauses 1, 37 and 48 change the age of sale for tobacco products, herbal smoking products and cigarette papers so that no one born on or after 1 January 2009 will legally be sold those products in England and Wales, Scotland, and Northern Ireland, respectively. That replaces the existing legislation, which sets the age of sale at 18 years old. The clauses are core to the ambition of being the first country in the world to create a smoke-free generation, which is supported by the public, including a majority of retailers: nearly 70% of people support our plan to create a smoke-free generation. But why is it necessary?

First, this new age of sale will save tens of thousands of lives. Tobacco is devastating for the health of smokers. It is the single biggest preventable cause of death, responsible for about 80,000 deaths in the UK each year. Smoking causes one in four cancer deaths, including 70% of lung cancer cases. It is not just those who smoke who experience the harms; second-hand smoke also causes enormous harm to children, through no choice of their own.

There is no safe age to smoke. We know that 75% of smokers would never have started if they had the choice again, and those who start smoking as a young adult lose an average of 10 years of life expectancy. As we heard from the chief medical officer for England in his oral evidence session, individual smokers should never be blamed for the situation they are in. An incredibly wealthy and sophisticated marketing industry deliberately addicted them to something, at the earliest age it could get away with, and they have had their choice removed.

Secondly, this measure will boost our economy. Each year, smoking costs our economy a minimum of £17 billion, which is far more than the £10 billion income per year that the Treasury receives from taxes on tobacco products. That is equivalent to 6.9p in every £1 of income tax received. Therefore, reducing the prevalence of smoking will reduce these costs, helping our economy to become more productive.

On that note, reducing smoking will also cut the burden on the NHS. As Sir Stephen Powis outlined in his oral evidence, smoking impacts the NHS at all levels. Almost every minute of every day, someone is admitted to hospital with a smoking-related disease and over 100 GP appointments every hour are because of smoking. Reducing this burden will allow us to invest more in vital care, focus on major conditions and cut waiting lists.

Thanks to years of decisive Government action and stop-smoking support, smoking rates are coming down, but we want to build a brighter future for our children, grandchildren and great-grandchildren. I know that there are concerns about this policy, which were discussed at length on Second Reading. I want to reassure all colleagues that this policy is not about taking away people’s rights. There is no liberty in addiction and nicotine robs people of their freedom to choose.

I also urge all members of the Committee not to be taken in by the tobacco industry’s claims that the black market for tobacco products will boom. Before the legal smoking age was increased from 16 to 18, the tobacco industry sang from that same hymn sheet, but the facts drowned them out. The number of illicit cigarettes consumed actually fell by 25%, and smoking rates for 16 and 17-year-olds dropped by almost a third. In fact, consumption of illegal tobacco has plummeted from 17 billion cigarettes in 2000-01 to 3 billion cigarettes in 2022-2023.

To crack down on illicit tobacco and under-age tobacco and vape sales, we are putting an extra £30 million of new funding per year over five years into our enforcement agencies and we are working closely with enforcement colleagues to ensure that these measures are successfully implemented. And we have not forgotten current smokers. The measures in the Bill are accompanied by a suite of measures to support current smokers to quit. They include nearly doubling the funding for local stop-smoking services with an additional £70 million each year over the next five years, providing a new financial incentives programme to support pregnant women and their partners to quit, and providing additional funding for stop-smoking campaigns and to ensure that retailers and the public understand the changes in the law.

On Second Reading, there were also discussions about what products were in scope of the new restrictions. Let me clarify matters by saying that the new age of sale restrictions will apply to all tobacco products, including tobacco that is smoked, smokeless or chewed. When it is smoked, tobacco kills up to two thirds of its long-term users, and all smoked tobacco, including in shisha and cigars, is harmful. There is also clear evidence of the toxicity of heated tobacco in laboratory studies; the aerosol generated by heated tobacco contains carcinogens. I know that some of our colleagues have championed heated tobacco products as a smoking quit aid, but there are less harmful tobacco-free products that can support people to quit smoking.

Tobacco products such as paan, betel quid and chewing tobacco are also covered by the Bill. Tobacco that is not smoked is not a safe way to use tobacco. Using smokeless tobacco increases the risk of both mouth cancer and oesophageal cancer.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

First, I pay tribute to my hon. Friend for his very long-standing campaign to stamp out nicotine and tobacco. He is absolutely right that we will need to make it very clear to members of the public, retailers and health organisations our intention to stamp out all tobacco products, because they are all unsuitable for our smoke-free generation. I will make a note of his concern, take it away and make sure that the legislation makes things as clear as it possibly can.

The Bill also applies to cigarette papers, as do current age of sale restrictions. Their bleaches and dyes add to the volume of smoke and the range of toxicants in the smoke, contributing additional risks to smokers. Likewise, herbal cigarettes are included in the legislation, as they are harmful to health. Although their smoke does not contain nicotine or tobacco, it does contain cancer-causing chemicals, tar and carbon monoxide similar to a tobacco cigarette.

I will briefly mention clause 41, which amends the Scottish legislation to include herbal smoking products under provisions for age of sale, age verification policy, sales by under-18s, proxy purchasing and vending machines. With their harms outlined above, it is right that herbal smoking products be included within the current and future tobacco control legislation. By extending this legislation, Scotland will be aligned with the other UK nations. This measure will also support the effective implementation and enforcement of the Bill by providing consistency for enforcement officers, industry, retailers and consumers across the UK.

To complement the smoke-free generation policy, we are also bringing forward clause 2, which makes it an offence for someone over the age of 18 to purchase tobacco products, herbal smoking products or cigarette papers on behalf of someone born on or after 1 January 2009 in England and Wales; this is known as proxy purchasing. Proxy purchasing of these products by an adult for someone under age is already prohibited; the clause makes it an offence for any adult to buy these products for someone in the smoke-free generation—that is, born on or after 1 January 2009. That means someone might be caught by the offence if they are also too young to be sold the products themselves, but we did not want to overcomplicate the application of this offence.

We hope this measure will send a clear message to stop people trying to buy products for people under the age of sale. Proxy purchasing in Scotland and Northern Ireland will also be updated through clauses 37 and 48 to align with the new age of sale. These provisions are essential to ensure there are no loopholes in the age of sale legislation, and build on what we have found to work in the current age of sale legislation.

Finally, I present clause 49 to the Committee. The clause amends a provision in the Health and Personal Social Services (Northern Ireland) Order 1978 to provide the Department of Health in Northern Ireland with the power to amend the definition of “sale” to mean “sale by retail”. If the power is used, only sales from a retailer to a customer will be caught by the tobacco age of sale offence, which will therefore not include business to business sales, such as sales between a wholesaler and a retailer. This measure would bring the type of sales caught by the tobacco age of sale offence in Northern Ireland in line with those in England, Wales and Scotland. Fundamentally, the clauses included in this group are essential to implementing the smoke-free generation policy.

There is both strong cross-party and cross-nation support for these measures. It is clear that we all acknowledge the need to protect future generations from the harms of smoking. No one wants their children to ever start smoking. In England alone, it could prevent almost half a million cases of heart disease, stroke, lung cancer and other deadly diseases by the turn of the century, increasing thousands of people’s quality of life and reducing pressures on our NHS. Thanks to the collaborative work we have undertaken with the devolved Administrations, we have produced a Bill that will save lives right across the United Kingdom. I therefore commend these clauses to the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I appreciate the clear cross-party support for the measures in the Bill. I understand that hon. Members will have views on ways to amend or strengthen it, but I urge the Committee to appreciate how little time we have. As we heard clearly from last week’s evidence sessions—from the chief medical officers from all parts of the United Kingdom and from so many medical professionals—this is a very good Bill, so let us not make the perfect the enemy of the good. Let us get this through.

I very much appreciate the welcome of all colleagues, and I assure them all that I will take away any suggestions and requests and come back with clear answers. Where something is relatively simple to do, we will seek to do that, but equally, as Members will appreciate, it is not always possible to accept every suggestion, no matter how well-meaning—and I absolutely accept that, in this Bill, it is always well-meaning.

I will answer the points that hon. Members specifically raised. The hon. Member for Birmingham, Edgbaston asked about how we will encourage young people to quit smoking at an early stage. She will be aware that there are lots of measures to try to help people to stop, including the financial incentives that we are providing, particularly for those expecting a baby and their partners. There are also the quit aids to help people to swap to stop—to move to vapes, which I think we all recognise can be a useful quit aid. They are not harmless, but are less harmful than smoking cigarettes.

We are working at pace with online retailers on how to support them to ensure age verification, and I hope that we will be able to say more about that. The issue of duty-free sales is a tricky one, as my hon. Friend the Member for Harrow East will appreciate, because we do not want to put the burden of legality on the purchaser. The idea is that it should be illegal to sell, and, of course, we have jurisdiction only in the United Kingdom, but I take his points on board and will come back to him on that.

The hon. Member for York Central is right that we need to do everything we can to stop advertising. There are already very strict rules around advertising, and smoking and vaping are severely restricted when it comes to advertising to children. But I think—I hope that the hon. Lady will agree—that the vaping measures, including the powers to limit packaging, flavours and in locations in stores, will do a lot to reduce the appeal to children, which I know we are all incredibly concerned about.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My hon. Friend makes an extremely good point. She will be interested to know that I have recently written to the Advertising Standards Authority to ask about how well it considers enforcement to be working, and what more it can do to enforce the already strict regulations. I am happy to share its response, when it comes, with all members of the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I will give way to the hon. Member for York Central and then to the hon. Member for East Renfrewshire.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

With your permission, Dame Siobhain, I will take the intervention on the same subject from the hon. Member for East Renfrewshire.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

In response to all those points, I am extremely sympathetic to the need to clamp down on advertising. It seemed to me, when I came to the Bill, that it was important to get a “Where are we now?”-type assessment of what the current regulations say, how well they are being enforced and what more needs to be done. Like many colleagues, I am interested to hear what the Advertising Standards Authority has to say about that, and I am sure we will come back to this subject.

The hon. Member for York Central raised age verification. As she knows, retailers will be required to challenge and seek age verification from those who are born on or after 1 January 2009. As the Bill continues its passage, we will look at the amendments that have been tabled and consider whether there is a need to change that age verification requirement. At the moment, I think the Bill strikes the right balance. As I said at the beginning, it is essential that we make progress with the Bill in the short time remaining in this Parliament.

The hon. Lady’s points about the visitor economy were well made. It is essential that we ensure wide communication about the new measures in stores, at the point of sale; to retailers, who will have just over two years to enforce this legislation and undertake the training; and to members of the public. I commend the clauses to the Committee.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Clause 2 ordered to stand part of the Bill.

Clause 3

Tobacco vending machines

Question proposed, That the clause stand part of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The clause restates the ban on tobacco vending machines in England and Wales. This prohibition came into force in 2011 in England and 2012 in Wales through regulations made under the Children and Young Persons (Protection from Tobacco) Act 1991, which made it an offence for anyone who manages or controls premises to have a tobacco vending machine available for use. The offence applied to selling both tobacco products and herbal smoking products from a vending machine. Herbal smoking products were included due to their harmful nature when smoked.

The prohibition was originally introduced because tobacco vending machines were largely unsupervised and allowed under-age access to tobacco. In 2010, 8% of 11 to 15-year-olds who regularly smoked said that vending machines were a usual source of cigarettes. This policy has successfully reduced smoking rates among young people and has been effective at enabling the age of sale restrictions to be implemented and enforced properly.

The existing legislation has been restated to provide a coherent narrative in the Bill on tobacco measures and to assist with the tidying of the statute book. I therefore commend the clause to the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The purpose of clause 3, as with a lot of the clauses that we will debate in line-by-line consideration of the Bill, is to tidy up the statute book for the whole tobacco regime, both to align all four nations and to make sure there is a clear understanding of the law where it relates to tobacco, tobacco products and vaping. The fundamental purpose is to tidy up the statute book by restating it with clarity at this critical time.

My hon. Friend the Member for Sleaford and North Hykeham made a point about vaping and vending machines. As she will be aware, the Government are taking powers in the Bill to look at issues such as location of sale, packaging and flavours. It was felt that it was important to have further consultation under those powers to look at issues such as whether vaping products should be sold in vending machines. It will be debated at a future time under those regulations. The key point is that we have clarity in the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I will get back to my hon. Friend on that point, which is a good one. This clause and many others are intended to tidy up the statute book, rather than to introduce new subjects that would be more appropriately considered somewhere else.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I am grateful to the hon. Lady for her views. As I said earlier, I will take away all the views expressed in Committee and reflect on them. I am grateful to her for her comments.

Question put and agreed to.

Clause 3 accordingly ordered to stand part of the Bill.

Clause 4

Sale of unpackaged cigarettes

Question proposed, That the clause stand part of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Clauses 4 and 38 restate that it is an offence if tobacco retailers do not sell cigarettes in the packaging in which they are supplied. Selling unpackaged cigarettes is currently an offence in England, Wales and Scotland under the Children and Young Persons (Protection from Tobacco) Act 1991. The prohibition was originally introduced to reduce smoking among children, because there was evidence that children were purchasing single cigarettes. As with clause 3, we have included these provisions to help to tidy up the legislation related to the age of sale for tobacco products, so that it is clear for tobacco retailers, enforcement agencies and other relevant parties across the UK.

The clauses ensure that the sale of loose cigarettes continues to be prohibited and that cigarettes are sold in the appropriate packaging. Additionally, clause 38 inserts the definition of “retail packaging”, aligning with the definition used in England and Wales. I commend the clauses to the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I do not have all the answers to hon. Members’ questions. The purpose of the clause is to restate and clarify the statute book, so the answer to many of the “Why haven’t you done this or that?” questions is that the intention was to tidy up the statute book rather than address all the other potential issues that could be solved. I will certainly come back to hon. Members with the answers to their questions.

As colleagues will appreciate, there are thousands of potential add-ons to the legislation, but it is important to remember that the core purpose of the Bill is to create the smoke-free generation. On those well-made points and suggestions, I do not know whether they were considered and ruled out or whether they were not considered, but I will come back to hon. Members with answers.

Question put and agreed to.

Clause 4 accordingly ordered to stand part of the Bill.

Clause 5

Age of sale notice at point of sale: England

Question proposed, That the clause stand part of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Clauses 5 and 6 introduce a requirement for age of sale notices in England and Wales to align with the new age of sale for tobacco products. Additionally, clause 42 provides Scottish Ministers and clause 50 provides the Department of Health in Northern Ireland with the powers to make provisions about warning statements. Warning statements are notices that reflect the new age of sale requirements. Age of sale notices currently must state in a prominent position:

“It is illegal to sell tobacco products to anyone under the age of 18”.

Clauses 5 and 6 update the wording of the notices so that they now reflect the requirements of the new age of sale. They will therefore state:

“It is illegal to sell tobacco products to anyone born on or after 1 January 2009”,

alongside the Welsh translation of the statement in Wales.

Additionally, under clauses 5 and 6, the Secretary of State and Welsh Ministers have been granted powers to introduce further requirements on the size or appearance of the notice. This allows for colour requirements and other changes to be introduced in the future should they be needed. Clauses 42 and 50 provide Scottish Ministers and the Department of Health in Northern Ireland with the same powers to set requirements.

Similar powers on the appearance of the age of sale notices have previously been included in legislation and regulations have been made, but these powers broaden the scope of the provisions. We do not anticipate requiring further amendments beyond the text of the age of sale notices prior to the change in the age of sale.

The updated wording on age of sale notices will support tobacco retailers in implementing the new age of sale restrictions by helping to clarify and underline it for customers and staff. I therefore commend the clauses to the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The hon. Lady makes a fair point. The clarity of the single message is, on balance, considered to be more important. If it is absolutely clear that products may not be sold to anyone who meets the 1 January 2009 criterion, that clarity and simplicity makes the message more punchy.

Question put and agreed to.

Clause 5 accordingly ordered to stand part of the Bill.

Clause 6 ordered to stand part of the Bill.

Clause 7

Sale of vaping products to under 18s

Question proposed, That the clause stand part of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Before I speak to the clauses, I want to set out, for the purposes of clarity, what we mean when we refer to vapes. Different terminology is used in law, depending on whether we are referring to legislation for England and Wales, for Scotland or for Northern Ireland. However, although there may be minor differences in terminology, the products are the same. When referring to vapes, e-cigarettes or nicotine vapour products, I will use the generic term “vapes” throughout.

Vaping is never recommended for children. It risks addiction and unknown long-term health impacts while their lungs and brains are still developing. These clauses are important to ensure that vaping products and nicotine products cannot easily be accessed by children.

Clause 7 will mean that it continues to be an offence to sell a nicotine vape to a person under the age of 18 in England and Wales, and anyone found guilty of the offence will be liable to pay a fine of up to £2,500 if convicted. The clause will also extend that age of sale restriction to non-nicotine vapes, as we know that children are accessing those products. The provision on non-nicotine vapes will come into force in both England and Wales six months after the Bill receives Royal Assent, to allow retailers time to introduce the measure. The clause provides businesses with certainty about whom they may legally sell products to, and reinforces our health advice that children should never vape.

Clause 8 will mean that it continues to be an offence for a person aged 18 or over to buy, or attempt to buy, a nicotine vape on behalf of a person under the age of 18. The clause will also extend those restrictions to non-nicotine vapes. Non-nicotine vapes may be used as a gateway for children to start using nicotine vapes, which is why the clause extends the scope of the current restrictions to include non-nicotine vaping products.

Clause 9 will close an existing loophole and make it an offence to give away a vaping product, or a coupon that can later be redeemed for a vaping product, to someone under the age of 18 in England and Wales. Given the clear and unambiguous health advice that children should not vape, and the fact that under-18s cannot legally be sold a nicotine vape, it is completely unacceptable that the industry is not prohibited from giving free samples of vapes to children. That loophole needs to be closed to ensure that we can protect children from addiction and potential health harms.

Clause 44 will amend Scottish legislation to extend existing regulation-making powers to prohibit or restrict the free distribution and nominal pricing of vapes to cover nicotine products such as nicotine pouches. Regulation-making powers on the sale of nicotine products to under-18s, on proxy purchasing and on free distribution to under-18s are provided for England and Wales in clause 10 and will be discussed separately.

Similarly, clause 51 will give the Department of Health in Northern Ireland regulation-making powers to prohibit the sale of non-nicotine vaping products to persons under 18. That will align with measures in the Bill for England and Wales and with measures already in place in Scotland for this offence. To ensure alignment across the UK, clause 53 will provide the Department of Health in Northern Ireland with regulation-making powers to prohibit the free distribution of nicotine products and non-nicotine vaping products to those under the age of 18. I commend clauses 7 to 9, 44, 51 and 53 to the Committee.

Government amendment 25 to clause 53 was tabled at the request of the Health Minister in the Northern Ireland Executive. It will change the mode of trial and maximum penalty for an offence of free distribution of nicotine products or non-nicotine vaping products in Northern Ireland, removing the potential for anyone convicted of the offence to be imprisoned. Instead, on conviction, the penalty will be a fine not exceeding level 5 on the standard scale in Northern Ireland. That small change will align the penalty that could be imposed with the penalty for the age of sale offence for vapes in Northern Ireland. I am sure that the Committee will agree that that is a more proportionate penalty for the offence. For those reasons, the UK Government accept the amendment.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Once again, I thank all hon. Members for their thoughtful and considered remarks —I really do appreciate them. Essentially, the questions are pretty much around the product notification and the availability of quit aids to under-18s. Hon. Members may not have spotted this, but the notification of vapes to the MHRA is something on which we are taking powers. There will be a further consultation on that point because it did not come under the scope of the original consultation. We will have the powers to require notification of vapes to the MHRA.

The other point that has been raised by a few colleagues is, “How do we help under-18s to stop smoking?” Under the MHRA, there is licensed nicotine replacement therapy, which is licensed for 12 to 18-year-olds. Of course, all under-18s can go to their local stop-smoking services.

To the point from the hon. Member for York Central about whether young people should be able to access vaping as a quit aid, my instinct would be, “No, absolutely not,” and I think that that would be her instinct also. However, I must slightly correct the record: it is certainly not the Government’s position that vaping is in any way safe; it is merely less harmful than smoking. I would reiterate that if you don’t smoke, don’t vape. And children should never vape, so they should not be turning to vaping, even as a quit aid. In my view, that would also be the thin end of the wedge, because people would simply say, “Well, I am only vaping because I am trying to stop smoking.” I cannot imagine that ever being a suitable way to help children to stop.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My hon. Friend raises an important point. The legislation covers non-nicotine vapes, and unfortunately, as has been pointed out, a number of illicit so-called non-nicotine vapes have up to 30% nicotine content, which has completely undermined the argument for those. Quite clearly, they are designed by the industry to get people hooked on the idea of vaping so that it can get people on to higher nicotine levels in due course. That is why the legislation covers non-nicotine vapes and all tobacco and vaping products.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The key point is that legal vaping products must be notified to the MHRA. If they are compliant, they go ahead. If they are not compliant, they go away and make themselves compliant. That is how the system works at the moment. With illicit vapes, it is an entirely different issue. I can point the hon. Lady to the evidence. When the age of smoking was raised from 16 to 18, the number of illicit cigarettes reduced significantly, so it is our expectation and hope that the same will be true with illicit vapes.

At the same time, as the hon. Lady will be aware, there was an announcement to impose an excise duty on vapes. A benefit of that, which she and I remarked on after the evidence sessions last week, is that we hope that that would enable His Majesty’s Revenue and Customs to enter the vape market into the track and trace that already exists for cigarettes and therefore to have much better control over what products come on to the market. I am sure we will talk further about that during the passage of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

As the hon. Lady will know, the MHRA is not an enforcement body; enforcement is for trading standards. As I mentioned earlier, there will be new resources for trading standards, as well as new training and guidelines. Also, fines will go direct to local authorities, which employ enforcement officers, so there will be a huge ramping-up of enforcement on illicit vapes, non-compliant vapes and so on. That is the place for enforcement.

On the MHRA and notification of other types of vapes, there will be powers, and the consultation will take place in due course.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I am frantically looking through my pack here. Clause 10 covers nicotine pouches, so we will come on to that—[Interruption.] The Whip is saying it will be after lunch, if that is not too much of a sneaky “get out of jail” card. With the hon. Lady’s acceptance, I will defer that until later.

Question put and agreed to.

Clause 7 accordingly ordered to stand part of the Bill.

Clauses 8 and 9 ordered to stand part of the Bill.

Ordered, That further consideration be now adjourned. —(Aaron Bell.)

The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)

- Hansard -

Copy Link

- - Excerpts

Welcome back, everyone.

Clause 10 provides regulation-making powers for the Secretary of State for Health and Social Care in England, and Welsh Ministers, to extend the offences relating to the sale, purchase and free distribution of vapes to other consumer nicotine products, such as nicotine pouches. Clause 43 gives Scottish Ministers the equivalent regulation-making powers. Part 3 of the Bill provides for similar measures for Northern Ireland, which will be discussed separately. The measures will ensure that we have a consistent approach across our nations to protecting children from accessing other nicotine products and being exposed to the health harms and addictive nature of nicotine. They also address a point that was raised earlier by hon. Members.

Nicotine is a highly addictive drug, and we must not replace one generation addicted to nicotine with another. Giving up nicotine is very difficult, because the body has to get used to functioning without it. Withdrawal symptoms can include cravings, irritability, anxiety, trouble concentrating, headaches and other mental symptoms. Evidence also suggests that the brain in adolescence is more sensitive to the effects of nicotine, so there could be additional risks for young people.

Under current legislation, there are no mandatory age restrictions on other consumer nicotine products. Although data suggests that the use of other nicotine products is low overall, there is a growing trend of use, particularly among adolescent boys, and there are indications that industry is beginning to encourage the uptake of other nicotine products. As we work to tackle youth vaping, it is important that there are not loopholes that can be exploited to put children at risk of nicotine addiction through the use of other nicotine products. That is why we are including powers to extend age of sale, proxy purchasing and age verification requirements to other nicotine products.

Clauses 10 and 43 are an important part of our work in ensuring that the collective package of measures in the Bill succeeds in protecting children from potential health harms. I therefore commend them to the Committee.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

I wholeheartedly endorse almost everything I have heard. I share hon. Members’ concerns and applaud them for their commitment to solving the issue of nicotine pouches. As my hon. Friend the Member for Harrow East rightly pointed out, should the industry find a way around something in the Bill, we would have to legislate again with primary legislation. The right thing to do, therefore, is to take powers to make secondary legislation that gets on top of the issue and future-proofs us, so that right across the United Kingdom we can tackle this appalling scourge: the tobacco industry’s determination to get our children addicted.

Extraordinarily, the tobacco industry dominates the UK nicotine pouches market, and it claims to self-regulate—that is, it claims not to sell to under-18s. That is absolutely extraordinary. A recent study suggests that although nicotine pouch use is low among adults, with roughly one in 400 adults in Great Britain using them, nicotine pouches are increasingly popular with younger, largely male audiences. The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment has identified gaps in research and flagged that the long-term health harms are not known, but use by non-smokers is likely to be associated with some adverse health effects due to the nicotine.

We all know that other nicotine products need to be clamped down on. We will not need to consult on age of sale restrictions on nicotine products; we will be able to use regulations, hopefully in this Parliament, with implementation from 2025. It is certainly our plan to consult on all of this regulation to get ahead of nicotine pouches and other nicotine products with a view to implementing the regulations in 2025.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

The hon. Lady is absolutely right; they vary from 2 mg to 150 mg per pouch. I imagine that that variation would make it hard to provide a complete comparison, but she is quite right that education will be a big part of the implementation.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My hon. Friend makes a good point. The Bill takes powers to bring forward the age of sale restriction, and that in itself will not require further consultation. It is my expectation that, if possible, that will be brought forward in this Parliament. However, as has been explained, if we put something in the Bill, the industry will get around it by saying, for example, “This doesn’t contain nicotine”—except it does, as we have already seen.

The other thing I want to raise with hon. Members is that clauses 61 to 63, which will grant the ability to restrict flavours, packaging and location in store, will also apply to nicotine products. Those measures are clearly designed to reduce their attractiveness to children.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

All I can say to the hon. Lady is that she has heard me, and I am determined to bring that forward as soon as possible. There are good reasons for not putting the provision on the face of the Bill, which are to do with future-proofing. I can only give her my absolute assurance that, as soon as humanly possible, I will bring the regulations forward for consultation where necessary and for implementation where not.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My hon. Friend makes a good point, which I will take away and reflect on. We have obviously already aired the discussion about the benefit of taking powers as opposed to putting something in primary legislation, but she makes a good point and I will come back to her.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

My hon. Friend makes a really good point. We have heard about some of the heavy metals and other carcinogens in vapes. The Bill is so comprehensive in banning things such as cigarette papers, herbal cigarettes and so on precisely because of other things that people put into their lungs. As the chief medical officer for England said, it is fine to drink a glass of water but have you ever tried inhaling one? It is not such a pleasant experience. He made the point that although it might be perfectly safe to eat a non-toxic flavour, it could be very different to inhale it.

As we heard last week, the fact of the matter is that there simply is not yet the evidence to say what some of these products do to human beings when inhaled. It is absolutely right that we protect children from those effects, hence this Bill. I hope that one of the outcomes of this legislation will be that we get far more evidence via independent research into the potential harms of first-hand vaping and other consumption of nicotine as well as second-hand consumption, which I know a number of hon. Members are interested in. I am sure we will come back to that in due course.

Question put and agreed to.

Clause 10 accordingly ordered to stand part of the Bill.

Clause 11

Displays of vaping and nicotine products

Question proposed, That the clause stand part of the Bill.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Clause 11 provides a regulation-making power to allow the Secretary of State for Health and Social Care in England and the Welsh Ministers in Wales to introduce future restrictions or requirements on the display of vaping and nicotine products, and their packaging and pricing where they are offered for sale. Clause 45 provides the same regulation-making power to Scottish Ministers, and clause 54 provides the power to Northern Ireland.

At this point, I would like to reiterate our plans for future vaping regulations, including on vape displays. I have made a commitment to consult on future regulations. Any regulations made will be accompanied by clear impact assessments. We will introduce new regulations as soon as possible following the passage of the Bill.

We simply cannot replace one generation addicted to nicotine with another, and we know that giving up nicotine is so difficult because the body must get used to functioning without it. Withdrawal symptoms can include cravings, irritability, anxiety, trouble concentrating, headaches and other mental symptoms. Despite this very clear health advice, there has been a significant and alarming rise in the number of children vaping in this country. Data shows that the number of young people vaping has tripled in just the last three years, and now one in five children has used a vape. That is alarming and unacceptable.

Evidence shows us that vapes are currently far too easily accessible to children within shops. Vapes are sometimes displayed alongside sweets and confectionery in retail environments, and often promoted in shopfront windows. These products are too easily seen and too readily available to children, and we have a duty to protect our children from harm. These clauses therefore provide regulation-making powers for new restrictions on where and how vapes and nicotine products can be displayed within a retail setting, and ensure that we are aligned right across the United Kingdom. The display restrictions will include both packaging and pricing. Future regulations on point-of-sale displays will help to reduce the ease of access to vapes to children, and the degree to which vapes can be targeted at children. These are important clauses to help us tackle youth vaping and to protect children from addiction and future health harms.

Dame Andrea Leadsom

- Hansard -

Copy Link

- - Excerpts

Again, I appreciate the sentiments expressed and associate myself with all of them. The hon. Member for York Central requested that we put in primary legislation that vapes must be behind the counter. It is clear from the impact assessment and the consultation that that is the intention. However, as my hon. Friend the Member for Sleaford and North Hykeham points out, the reason for taking the powers is that doing so allows us to stay ahead of the next place they might be sold, for instance outside the shop, on a bus or outside a school—we can imagine all sorts of other ideas. It is important to have the regulations to get ahead of other ideas, rather than saying, “They shall be behind the counter.” That is why we are taking regulatory powers right across the Bill, so that answer holds for all the areas in which we are taking powers: we are taking them to stay ahead of an industry that has shown itself to be very imaginative and brutal in its determination to addict children. We need to stay one step ahead, and that is the plan.