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The Parliamentary Under-Secretary of State for Health (Steve Brine)
Like the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), I congratulate my hon. Friend the Member for Dartford (Gareth Johnson) on securing another timely debate. Only a couple of weeks ago we had an excellent three-hour debate in the main Chamber on the Government’s new—I suppose it is still new—tobacco control plan. I want to say a little about the state of the evidence as we see it on e-cigarettes and how they fit into our plans to cut smoking further. I will touch on vaping by young people, which a few hon. Members have mentioned, and our approach to regulation.
E-cigarettes were a popular subject during the debate in the main Chamber on the TCP. Every speaker bar none mentioned them in one way, shape or form, so there is a lot of interest in them across the House. That reflects the radical changes in popularity of alternative nicotine delivering products in recent years. We have moved from a position where the nicotine delivery market—if I can call it that; I think we need a better term—is dominated by the traditional cigarette, to one where we have a much wider range of nicotine delivering products.
About 2.4 million people in England use e-cigarettes. That represents huge growth over the past decade. However, we cannot be complacent. My hon. Friend referred to the number of smokers; there are still 7.3 million smokers in this country. Two hundred people die every day due to smoking and it is still the biggest preventable killer in our country. The financial burden that that puts on the NHS in England and other public services is obviously huge, but that is dwarfed by its impact on people’s lives and the unnecessary loss of loved ones. Let us remember that a regular, long-term smoker loses an average of 10 years of their life due to their habit. It is a high cost.
The tobacco control plan sets out stretching ambitions to reduce, during this Parliament, adult prevalence to 12% or less; the prevalence of 15-year-olds who regularly smoke to 3% or less; and that of pregnant smokers—an issue rightly raised by a number of hon. Members—to 6% or less. We have been somewhat criticised for that not being ambitious enough, which is why I stress the words “or less”. They are not targets; they are the absolute maximum that I expect, and we want to do better and beat them. We want to reduce the burning injustices that see some of the poorest in our society die significantly earlier than the richest in our society, so the plan will focus on people in routine and manual occupations, where rates are higher. We want to focus on other groups particularly affected by smoking, such as people with mental health conditions, those in prison and pregnant women.
In the previous debate on smoking, colleagues on both sides of the House highlighted the increasing role that e-cigarettes play in helping people to quit smoking. We heard all sorts of examples from right hon. and hon. Members of parents, friends and family members who have used e-cigarettes to wean themselves off smoking, which is always good to hear. Let us be clear that quitting smoking and nicotine use completely is the best way to improve health, as was said in the opening remarks of that debate. However, the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco. The Government outlined in the new plan that we are committed to supporting consumers to stop smoking and to use less harmful nicotine products.
E-cigarettes have become by far the most popular smoking quitting aid in the country. The evidence shows that they can help smokers to quit, particularly when combined with additional support from local stop smoking services. That is why, as part of the TCP, the Government asked Public Health England to include messages about the relative safety of e-cigarettes in its quit smoking campaign for Stoptober. I look forward to seeing how that played out when the data are available. There has never been a better time to quit and I am hopeful that many people took up the challenge this Stoptober. I am pleased to say that the Stoptober campaign highlighted e-cigarettes for the first time among the array of tools that smokers can use to improve their chances of successfully quitting. Public Health England, for which I am responsible, is already preparing its new year quitting campaign, and I am sure that hon. Members will be pleased to know that it will reprise those messages. It is through consistent messaging that we hope to reverse the harmful, mistaken and increasingly widespread belief that vaping is no safer than smoking.
My hon. Friend rightly raised the issue of independent evidence on e-cigarettes. I reassure him that the Government are utterly committed to rigorous scrutiny of the evidence on e-cigarettes. We do not do non-evidence-based policy making and nor should we. In that spirit, I highlight highly reputable organisations such as Cancer Research UK, led by the brilliant Sir Harpal Kumar, and the Royal College of Physicians, which hon. Members have mentioned. They rightly support e-cigarettes as a measure to stop people smoking, to ultimately move to no nicotine dependency.
I commend the work of the UK e-cigarette research forum, an initiative developed by Cancer Research UK in partnership with Public Health England and the UK Centre for Tobacco and Alcohol Studies. The forum brings together policy makers, researchers, practitioners and the non-governmental organisations to discuss the emerging evidence and knowledge gaps on e-cigarettes. There are big knowledge gaps, which the hon. Member for Ipswich (Sandy Martin) mentioned a number of times. Such groups will allow us to keep strengthening the evidence base on e-cigarettes, which hon. Members have called for. We look around the world for our evidence base, and I note with interest that the New Zealand Ministry of Health recently published a position statement on e-cigarettes that recognises their potential contribution to achieving its “Smokefree 2025” goal.
The public rightly have genuine concerns, however, about the benefits and potential long-term dangers of e-cigarettes and new, so-called novel tobacco products. We take those concerns seriously, as any responsible Government would, and we outline in the plan that the Department will monitor the impact of regulation and policy on e-cigarettes and novel tobacco products in England, including evidence on safety, uptake, the health impact and effectiveness of these products as smoking cessation aids, to inform our actions and regulate their use. That has to be the right thing to do. Public Health England will also update its evidence report on e-cigarettes and other novel nicotine delivery systems annually until the end of the Parliament in 2022.
In the spirit of independent scrutiny, I warmly welcome the recent announcement by the Science and Technology Committee, which hon. Members have mentioned. It is chaired by the right hon. Member for North Norfolk (Norman Lamb), who I spoke to recently but who is unable to be here, and will hold an inquiry to examine the impact of electronic cigarettes on human health, the suitability of regulations guiding their use, and the financial implications of a growing market, both for business and for the NHS. This is an excellent opportunity for an independent view of the risks and benefits of e-cigarettes. What is there not to like about that? I say that as a Minister: people are doing the research for me and paying for it. The Government have a statutory duty—we will not leave it all to everyone else—to conduct an implementation review of the Tobacco and Related Products Regulations 2016 by the end of May 2021, to assess their impact, and we will do that.
I will touch on the regulatory framework introduced by the EU tobacco products directive, which my hon. Friend the Member for Dartford mentioned. The directive has enabled us to regulate e-cigarettes to reduce the risk of harm to children, protect against any risk of re-normalising tobacco use, and provide assurance on relative safety for users and legal certainty for businesses. The inclusion of e-cigarettes in the directive ensures that we can sensibly regulate these products. The directive is not perfect and nobody pretends that it is, but it gives a sensible basis for regulation. My hon. Friend asked me to put March 2019 in my diary—it is inked in. With one leap we will be free and we will be able to take back control, as the phrase goes. It will be an opportunity for us to look at every regulation that we are subject to, review them and go through them with a fine-toothed comb, and he has my assurance that I will do so in every area for which I am responsible.
I recognise that there are real concerns that vaping is a gateway for youth smoking, as my hon. Friend the Member for Gordon (Colin Clark) touched on. However, there is no great evidence in the UK that vaping is leading young people to smoke. There is some evidence that some young people experiment with e-cigarettes, but that regular e-cigarette use is confined almost entirely to young people who have smoked, so it is the gateway out as opposed to the gateway in. To ensure that that remains the case, we have implemented domestic age-of-sale legislation that prevents the sale of e-cigarettes to under-18s and we have prohibited the advertising and promotion of e-cigarettes in the major media streams, including TV, radio, newspapers and the internet. By and large, the banned media streams are those with the largest reach, and by controlling them we have significantly reduced children’s exposure to marketing and images of those products. The Government have no plans to ban advertising in other media, but we keep everything under review.
There is a vibrant e-cigarette market in the UK—in many ways it is a business success story—with nearly 2.4 million users. The industry is worth nearly £l billion to the UK economy. It started out as small, independent, non-tobacco-industry organisations—a cottage industry—intent on designing solutions for people to get the benefits of nicotine delivery without the harms of smoking.
My Department will continue to work closely with the vaping sector through the Independent British Vape Trade Association. The Department does not work with the UK Vaping Industry Association because of its links to the tobacco industry. Her Majesty’s Government take their duties seriously, as they should as a signatory to the World Health Organisation framework convention on tobacco control. I feel that I should put on the record that, under article 5.3 of that convention, we have committed to protect our public health policies from the commercial and other vested interests of the tobacco industry. The guidelines for the implementation of article 5.3 permit parties to engage with
“the tobacco industry only when and to the extent strictly necessary to enable them to effectively regulate the tobacco industry and tobacco products.”
I will briefly mention another innovation, namely heat-not-burn products, which the shadow Minister asked about. Two heat-not-burn products have been notified for use on the UK market as novel tobacco products. It is important to stress that, even in comparison with e-cigarettes, that market is relatively new and very small-scale in the UK. We simply do not know enough about those products. We will continue to adopt a pragmatic, sensible and cool-headed approach to regulation, based on the best possible public health advice, which I receive from advisers including Public Health England. As part of that approach, my Department has asked the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment to give a view about those products’ potential harm reduction in comparison with conventional smoking. The committee is due to respond later this year. I hope that that helps the shadow Minister, who I know will remain on my case—that is not in doubt.
We will discuss Brexit today, tomorrow, the day after and probably the day after that, too. There are concerns among people in the industry and e-cigarette users about the introduction of the EU tobacco products directive impacting on e-cigarette innovation and consumer choice. As stated in the tobacco control plan, the Government will review where the UK’s exit from the EU offers opportunities to reappraise tobacco and e-cigarette regulation to ensure that it continues to protect the nation’s health.
The hon. Member for Ipswich spoke excellently, as always. I congratulate him on quitting and not going back; that is excellent. The hon. Member for Linlithgow and East Falkirk (Martyn Day) talked about innovation and, as always, made a calm and sensible speech. I congratulate him on getting his birthday on the record—that, too, is now inked in our diaries.
The shadow Minister referred to “something new and shiny”. This is literally something new and shiny, but it is not for Ministers to get carried away by new and shiny things in any way, shape or form. The Government have been criticised both for being too tough on e-cigarettes and for being too lenient. That suggests to me that we have the balance about right while we look for more evidence. We have proportionate regulation that allows us to protect children, and that is absolutely right. We keep the evidence under constant review.
Gareth Johnson
I mentioned previously to the Minister that he may wish to meet the vaping industry. I am glad that he has the Brexit date in his diary, but I wonder whether he will be kind enough to indicate whether he is willing to put in his diary a meeting with the vaping industry.
Steve Brine
I mentioned that we work closely with the Independent British Vape Trade Association, which I am perfectly happy to meet, but I also mentioned that we take the WHO framework convention seriously. The door is always open to people we can meet. That is all part of us trying to understand the evidence base.
To conclude, we are clear that e-cigarettes can play a useful role in helping people to quit smoking. As my hon. Friend the Member for Dartford said, the majority of smokers want to quit, and we should help them. E-cigarettes are one of a variety of stop-smoking tools available to support them.