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The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate the hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Harrow East (Bob Blackman) on securing this important debate. I also thank everybody for the constructive tone in which we have discussed what is an incredibly important subject and for the acknowledgement that if we are to meet what is a very stretching target, we will all need to work together.
The hon. Member for City of Durham has highlighted the excellent work being done through the smoke-free programme in County Durham to drive rates in her area down, and I know that she fully supports that. As she alluded to, the aim is to reach 5% by 2025 through the regional tobacco control plan that Fresh drives forward, but since the launch of that in 2005, the north-east has seen a massive—47%—drop in smoking rates. I know that those rates are still above the national average, but I wanted to highlight how much I agree with that localised approach to delivery, making sure that we can focus services on those living in the local area.
I congratulate people on their successes so far, but as several right hon. and hon. Members have said, we cannot be complacent. Smoking rates at the time of delivery are among the lowest the country has ever seen, and my hon. Friend the Member for Harrow East has a relatively low rate in his area. I appreciate the passion shown through the cross-party work that has taken place to bring together these recommendations, because, as many have highlighted, one of the big challenges is the variation—across different groups in our society, but also across different regions of the country. If we are going to target those with higher incidence, we are going to have to accept that some areas will probably need more help than others.
We need to work together, and yesterday I was incredibly pleased to go to the launch of this report. I found the speech by the hon. Member for Blaydon (Liz Twist) incredibly poignant. I could not agree more: specialist cessation to help young mothers quit is so important, and the hon. Member for Jarrow (Kate Osborne) has said that it was that point in her life that was pivotal in helping her make that decision. Yesterday, we listened to a respiratory consultant who said that she ran out of her office and downstairs to speak to a young mother who was pregnant with twins, to try to get her to stop smoking. I do hope that mother was able to quit, and I assure hon. Members that this is a particular focus of mine. I have already spoken to the chief medical officer about the new Office for Health Promotion making smoking, and particularly smoking in pregnancy, a real focus. As I said yesterday, we get more bang for our buck here: not only do we help Mum but, in this case, we helped twins—that is three people—and as I have seen through some fantastic smoking cessation work in Bolton, we often get a partner, a mother, or someone who is supporting Mum to quit as well. That helps everybody to move forward.
The report and its recommendations are excellent, and I have listened with interest to the remarks made by right hon. and hon. Members today. Smoking prevalence is at an all-time low—just under 14%, and almost half the rate it was back in 2002—and it is right to celebrate where we have come to, but it is also right to say that we have a long way to go. The continued support through stop smoking services across England has been pivotal: since 1990, these services have stopped 4.7 million people smoking. That is more people quitting than the combined populations of Birmingham, Greater Manchester and Leeds, which is quite a remarkable achievement.
Smoking is linked to half a million hospital admissions each year, so the role that the NHS and charities play in helping smokers quit is also essential. The NHS long-term plan commits to supporting smokers admitted to hospital to quit, as well as pregnant smokers—pregnant mums—and their partners. It also commits to helping long-term users of specialist mental health and learning disability services, and we are ensuring that there is sufficient training, with challenge groups making sure that people get the right interventions and the right help when they intersect with these services. Funded early-implementer sites and services are also being stood up, because we cannot be complacent and we cannot wait for these timelines. I heard strongly that people want interim targets, and we will look at that in the strategy. It is important that we try to keep on track and ensure that we keep our focus on 5%.
Smoking is responsible for an estimated 75,000 deaths in England each year. That is unacceptable because it does not just affect the individual; families and everybody around them also suffer. As many hon. Members pointed out, it has a substantial financial impact on the country as well as a health and emotional impact. As my right hon. Friend the Member for Clwyd West (Mr Jones) said, we have to go at things hard if we are to see that success.
I assure everyone that we are considering alternative products in the plan in so far as they are alternatives. Ultimately, we want people to quit, but as the hon. Member for Nottingham North (Alex Norris) said just a few moments ago, the indication is that e-cigarettes, for example, are 95% better than smoking, so let us be sensible about how we take people on this journey. My hon. Friend the Member for Windsor (Adam Afriyie) will be interested to hear that, although snus is currently banned under the regulations, we are undertaking a review and will consider the evidence base.
The Government will publish the new tobacco control plan, which will set out how we achieve this, and I am pushing hard to ensure that the strategy is published as soon as possible; I am ambitious to try to publish ahead of the recess in July. However, as I am sure all right hon. and hon. Members are aware, new data on smoking prevalence will be released in July and I want to have time to ensure that the plan takes appropriate, targeted action on that data. Anecdotal evidence causes me some concern that we may have seen individuals taking up smoking. The new plan, which will expand on the success of the 2017 plan, builds momentum to support communities and groups where rates are not falling enough. As I say, I am exploring many of the issues we have covered to guarantee that the new plan will be bold enough for smoke-free 2030.
We know that reductions in smoking at a national level mask the significant health inequalities that many right hon. and hon. Members have spoken about. Smoking remains very high in certain areas of the country, particularly in deprived areas and among communities who can least afford the financial effects—as if anyone can afford the health effects. For example, prevalence in Blackpool is nearly 24%; in Richmond, it is down at 8%.
Adam Afriyie
I am encouraged by the Minister’s words. Will she confirm that she sees this as part of the levelling-up agenda? Given that particular regions and social groups have more of a challenge than others, it seems to me that it collides well with the Prime Minister’s levelling-up agenda, certainly in terms of health inequality.
Jo Churchill
Indeed I do. Actually, the levelling-up agenda and our manifesto commitment to ensure five more healthy life years must be driven by achieving the targets we have set ourselves. Smoking has such a direct correlation with other illnesses. My right hon. Friend the Member for Clwyd West mentioned his interest with Cancer Research UK, and we know about the link to cancer, but there is also a link to chronic obstructive pulmonary disease as well as other respiratory challenges and so on. As I say, a disproportionate burden is borne by those disadvantaged families and communities.
I thank the hon. Member for Ealing, Southall (Mr Sharma) for making an interesting point. I assure him that we are focused on the need to make these interventions local. The local directors of public health and PHE drive plans in localities. I would like to think that we have taken, and can take, much learning from the successful local interventions of the past 18 months, such as with the vaccination programme. There are also clever uses of technology, where we have prompted people to take a vaccination. That might be interesting to look at in connection with recommendation 11, to which my hon. Friend the Member for Windsor (Adam Afriyie) alluded—I think it was him—requiring people to be prompted annually. They might look at that particular behaviour in order to modify it.
I could not agree more with the person who said that data saves lives—indeed, it does. The more we understand about the data held across the NHS, the more we can use it effectively to target interventions and to ensure that people get not only the right treatment but the right care, at the right point on their life’s journey.
In the new plan, we will ensure that we have a strong focus to drive down rates across the whole country, ensuring that they are level to where rates are the lowest, because everybody deserves to live in an area where we have targeted smoking rates and are achieving success. For too long, the harms from smoking have hit those areas that already face challenges. One in 10 babies is born to a mother who smokes. It is estimated that one in five new mothers smokes in Kingston upon Hull, compared with one in 50 in west London. It is those disparities that we need to tackle.
We must also close the gap seen among smokers with mental health conditions and smokers in routine and manual occupations. Could we be cleverer? Could we work in workplaces, for example? It is vital we continue to support interventions that make the most difference, helping people to cease smoking and encouraging them to move to less harmful products.
Liz Twist
We have not had much time to talk about mental health in any detail. Will the Minister ensure that funding is found to deliver the original NHS long-term plan commitment to provide tobacco dependence treatment to all smokers accessing secondary mental health services?
Jo Churchill
If I have time, I will come on to that—I will try to speed up.
Many Members will be pleased to know that, within the plan, we will recommit to our evidenced approach to e-cigarettes. The products certainly have a role in supporting smokers to quit, and we will ensure that they remain accessible to smokers while protecting non-smokers and young people.
The fight against tobacco is not one we can win alone. It requires a joint effort through the health and care system and working across Government. There are good examples of that, because while NHS England is working to roll out the tobacco dependence treatment and the commitments in the long-term plan—we know there have been some delays—we are putting effort into driving the agenda forward, funding seven early implementer sites across England and establishing services as we speak.
Other Departments, such as HMRC, are tackling illicit tobacco. Her Majesty’s Treasury has taken action to raise tobacco taxation. We have also introduced a ring-fenced grant of £1 million to support an HMRC and trading standards intelligence cell called Operation CeCe. That was operational earlier this year. We are also working with the Department for Environment, Food and Rural Affairs on the suitability of options for littering.
I shall have to come to a close, but I will address the question of my right hon. Friend the Member for Clwyd West about how we are working with the WHO. We are a global leader in tobacco control and were instrumental in the framework convention on tobacco control. We will continue to take our treaty obligations seriously, including the commitment under article 5.3. I was particularly proud that we have been recognised in that work. The recognised commitment to our global prevention work with the WHO is important.
I hope the Chamber is aware that I am determined to protect the population from the harms of tobacco. As we build back better, we must make smoking a thing of the past, to improve the health of the nation and level up society, freeing up the billions of pounds spent on smoking by disadvantaged families and protecting the NHS. Clearly, with investment and with us all pushing in the same direction, we can truly make that target.