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The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
It is a pleasure to speak under your chairmanship today, Mr Sharma. I congratulate my hon. Friend the Member for Harrow East (Bob Blackman) on securing a debate on such an important issue, and pay tribute to his work as chair of the all-party parliamentary group on smoking and health. He really has been tireless in holding not only Health Ministers’ feet, but the Prime Minister’s feet, to the fire and making sure that we keep tobacco control a top priority. I am also grateful to the hon. Members for City of Durham (Mary Kelly Foy), for North Antrim (Ian Paisley), for Strangford (Jim Shannon) and for Blaydon (Liz Twist) for their participation today. I welcome the chance to update the House on our progress towards a smoke-free future. I welcome the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) to her place, and look forward to working constructively with her on the tobacco and vapes Bill and other things. I hope there will be much that we can agree and collaborate on.
I want my legacy as Public Health Minister to be weighed and measured by everything we have done to protect the vulnerable in society. Critical to that, of course, is keeping our children safe. We already know that in the United Kingdom, smoking kills around 80,000 people every year, causing one in four cancer deaths; costing £17 billion a year in ill health, lost productivity and demands on the NHS and social care; and putting a huge burden on our health service. Like many others, I have been appalled in recent years to see the number of children vaping treble. It is estimated that no fewer than one in five children have now used a vape.
That is why, in October, the Prime Minister announced action across four areas: first, creating a smoke-free generation by ensuring that children turning 15 this year, or younger, will never legally be sold tobacco products; secondly, supporting existing smokers to quit through significant new funding and support; thirdly, protecting our children from vaping by reducing the appeal and availability of vapes; and fourthly, introducing new action to enforce these rules.
I will address each priority area in turn. First, let us be crystal clear: the tobacco and vapes Bill will save many lives. Unlike other consumer products, there is no safe level of nicotine consumption; it is a product that kills up to two thirds of its long-term users and causes 70% of lung cancer deaths. We are not doing this blind. We already know that action to increase the age of sale works. When the age of sale was raised from 16 to 18 years old, smoking rates for 16 and 17-year-olds in England fell by almost a third. This is a tried and tested policy, and while we have seen some progress, I know there is a lot more to be done—almost 13% in that age bracket are still smoking.
Our modelling suggests that this measure to increase the age of sale will reduce smoking rates in England among 14 to 30-year-olds to close to zero as early as 2040. I am sure that is not early enough for my hon. Friend the Member for Harrow East, and colleagues across this Chamber, who would like to see that happen sooner—as would I. Nevertheless, that is what the modelling suggests. It is progress in the right direction and will save many lives. I am committed to publishing an impact assessment very soon that will set out for colleagues a more complete picture of the costs and benefits of the Government’s smoke-free generation policy.
No one doubts that smoking massively increases the risk of stillbirth; a number of colleagues have raised that today. Smoking also causes asthma in children, and is strongly linked to dementia, stroke and heart failure in old age, as well as to disability and death throughout the life course. Non-smokers, including children, pregnant mums-to-be and their babies are exposed to second-hand smoke, putting them at serious risk through absolutely no choice of their own. This is not about freedom of choice; it is about protecting the vulnerable. Almost every minute of every day someone is admitted to hospital because of smoking, and up to 75,000 GP appointments can be attributed to smoking each month—that is over 100 GP appointments every hour. Reducing that burden will therefore save the NHS money that we can reinvest into research, frontline care and cutting waiting lists.
This measure is not just the right thing for our children’s health; there is a very strong economic case for it too. Analysis by Action on Smoking and Health has estimated the cost of tobacco to society to be £17 billion a year. That figure is out of date, and I think my hon. Friend the Member for Harrow East has just updated it—the Department is very swiftly trying to verify that—but the last published data showed that the directly attributable cost of smoking to society was around £17 billion a year. That dwarfs the £10 billion a year the Treasury receives from taxes on tobacco products.
That cost of £17 billion includes £14 billion lost to productivity through smoking-related lost earnings, unemployment and early death, as well a direct cost to the NHS and to social care of £1.9 billion and £1.1 billion a year, respectively. The cost of smoking to the economy and wider society is equivalent to the annual salaries of over half a million nurses, almost 400,000 GPs, 400,000 police officers, or 400 million GP appointments.
Reducing smoking rates will bring down those costs and help our economy to become more productive. The smoke-free generation policy could provide cumulative productivity benefits of a staggering £85 billion within the next 50 years. That is why the Government are taking such bold and historic action through the tobacco and vapes Bill.
As well as stopping children starting, our second aim is to do more to help current smokers to quit. Quitting smoking is the best thing a smoker can do for their health: someone who quits before turning 30 could add 10 years to their life. That is very reassuring to me; I started smoking at the age of 14 and gave up as my 21st birthday present to myself, by which time I was smoking 40 a day. I was a student—how did I afford it? I have no idea! I am so glad I stopped. For anyone who doubts how addictive it is, I turned 60 last year and still—
Dame Andrea Leadsom
Yes, I know. You can’t believe that, can you?
Even to this day, talking about smoking all the time, I sometimes think, “Ooh a cigarette.” That is how addictive it is—40 years on and I still think, “Ooh!” It is that addictive, and that is absolutely appalling.
We have announced that we will more than double the funding to local stop smoking services across England to a total of £138 million a year, which will help around 360,000 people to quit every year. We are backing these efforts with substantial new money to support marketing campaigns. These measures are easy, common-sense and cost-effective ways to help people to kick the habit.
As colleagues will know, I am passionate about helping new mums, mums-to-be, new parents, new families and their babies, which is why I have asked officials to redouble our efforts to tackle smoking in pregnancy. Women who smoke during pregnancy are two and a half times more likely to give birth prematurely, and smoking is a significant driver of stillbirth. I want to do everything I can to spare parents the awful and heartbreaking tragedy of losing a baby, which we have heard so much about in this place only recently.
On average, just over one in 10 mums smoke at the time of delivery, but that number is as high as one in five in certain parts of the country, as some colleagues have spoken about already. We know that pregnant women who receive financial incentives are twice as likely to successfully quit throughout pregnancy compared to those who do not, so we are working to roll out a national financial incentive scheme by the end of 2024 to help all pregnant smokers and their partners to quit. This will build on our work over recent years to develop high-quality stop smoking support for pregnant women and their partners, with programmes such as the NHS long-term plan commitments on maternal smoking and the saving babies’ lives care bundle.
Thirdly, as I said at the start of my remarks, youth vaping has tripled in recent years. One in five children have now used a vape. I am especially worried about the damage being done to children’s bodies by illegal vapes, which is a growing concern for mums and dads across the country. The health advice is clear: young people and those who have never smoked should not vape. We have a duty to protect our children from underage vaping while their lungs and brains are still developing. There is not yet enough evidence on the long-term impact of vaping on young brains and lungs. I will not stand by while businesses knowingly and deliberately encourage children to use a product that is designed to help adults quit smoking. Those business do so with full knowledge that our children will become addicted to nicotine—well, not on my watch.
We have announced that we will take tough new action to reduce the appeal and availability of vapes through the tobacco and vapes Bill. In our recent public consultation, we sought views on restricting flavours, point-of-sale displays and packaging. On a visit to retail outlets in Hackney, I saw sweet counters and vape counters side by side, with the vapes in pretty packaging with cartoon characters and in little things that look like Coke cans. These vapes are not designed for 60-year-old smokers; they are designed for children, to get them addicted to nicotine.
The consultation has revealed something we already know: there are serious and justifiable environmental concerns over disposable vapes. It is a simple truth that more than 5 million disposable vapes are either littered or thrown away in general waste every week. That number has quadrupled in just the last year. Being sold at pocket-money prices, easy to use and widely available, disposable vapes are, of course, the product of choice for children. More than two thirds of current youth vapers use disposable products. We must and will take action.
Fourthly, a strong approach to enforcement is vital to ensure that our policy actually takes effect. The underage and illicit sale of tobacco, and more recently vapes, is undermining the work the Government are doing to regulate the industry and protect public health. We are cracking down on this evil and illicit trade by backing enforcement agencies including Border Force, HMRC and trading standards with £30 million extra per year. We will introduce powers in the tobacco and vapes Bill to give on-the-spot fines to tackle underage sales. I am pleased we can count on the strong support of trading standards officers right across the country.
Our public consultation closed on 6 December and we received nearly 28,000 valid responses. I am happy to assure all colleagues that we will publish our response in the coming weeks, ahead of the introduction of the tobacco and vapes Bill. I believe that our actions in this space show that the Government are willing to take tough, long-term decisions to protect our children and safeguard the health of future generations.
I will now answer some of the questions raised by hon. Members today; I thank them again for their contributions. In response to my hon. Friend the Member for Harrow East, our public consultation closed on 6 December and within the next few weeks we will publish the consultation. Of course we will then bring forward the Bill, which is, as everybody knows, a top priority for the Prime Minister.
As for the point about a polluter pays levy, the Treasury has looked at that in detail, but so far it has decided against it. I absolutely assure colleagues that I will take that point away and consider it again.
I thank the hon. Member for City of Durham for her invitation to visit her constituency, which I would be delighted to accept. She highlighted the fact that the discrepancy in life expectancy between different parts of her constituency is 50% attributable to smoking, which is a shocking figure. That is not uncommon around the country, so we need to tackle that issue.
I say gently to the hon. Member for North Antrim that when the legal age for smoking was raised, it reduced illicit tobacco sales by 25%; the evidence suggests that far from increasing criminality, raising the legal age for smoking decreases it.
The hon. Gentleman also asked a question about Northern Ireland specifically. I am pleased to tell him that in the Bill we propose to give Northern Ireland the powers to regulate in the same way as the rest of the United Kingdom. There has been a lot of consultation with the devolved Administrations and once the Stormont Assembly—which I urge him to get back up and running —is back up and running, Northern Ireland will be able to legislate to have exactly the same regime as the rest of the United Kingdom.
Ian Paisley
I do not know whether it is relevant, Mr Sharma, but for the completeness of the record I ought to have referred to my registered interests. I chair a charitable trust on employment and skills development that is named after Tom Gallaher, a leading industrialist of his age who was a tobacconist. I should just declare that on the record.
On the point that the Minister has just raised, may I ask her to go back to the Department and get advice for us? If Northern Ireland is restricted from regulating on this issue, because of our EU connection through the Windsor framework, even the Assembly would not be able to legislate on it, in the same way that the Danes were unable to do it. I really seek advice on that from the Minister.
Dame Andrea Leadsom
I am very happy to write to the hon. Gentleman on that point to give him absolute clarity.
I thank the hon. Member for Strangford for his contribution today. I very much enjoyed the visit that I made to his constituency, which was a long time ago—indeed, many years ago. He spoke about the importance of the four nations working together. I completely agree with him; the UK is much stronger together. I hope that in my remarks I have answered his other questions.
I also thank the hon. Member for Blaydon for her support for the Bill and for pointing out that it is vital, particularly in the north-east where smoking prevalence is higher than average in many other parts, that we really take steps to tackle the issue. I echo her expression of gratitude to local councillors, the NHS and to Fresh, the charity in her constituency, for the work that they have done to try to tackle smoking.
As I have said to the hon. Member for Birmingham, Edgbaston, I hope we can work together constructively to ensure that we introduce these changes as soon as we can.
In closing, I will quickly address the New Zealand Government’s announcement that they will no longer introduce the smoking measures that had been planned there. There have been many calls, not least from the tobacco industry—I wonder why!—for us to row back on our plans following that decision. In response to those calls, I stress that the New Zealand plans included a licensing scheme to limit quite significantly the number of retailers able to sell tobacco and plans to limit the amount of nicotine in consumer products. Our Government are introducing a smoke-free generation, by protecting future generations from the harms of smoking while leaving current adult smokers the freedom to continue smoking if they choose to do so.
Jim Shannon
I thank the Minister for her response to the debate. In my contribution, I gave a couple of examples from Canada that we had followed here, and I urged the Government here to follow the new ideas in Canada to dissuade people from smoking. Has she had an opportunity to look at some of the Canadian legislation? I am very simple: if I see something good, I think, “Let’s do it”. If it works there, it should work here as well.
Dame Andrea Leadsom
I absolutely agree. We should always keep an eye on what other nations are doing.
I reiterate that our position remains unchanged. This will be world-leading, and we want to be a trailblazer in the absolutely crucial area of protecting future generations; protecting the health of our nation; protecting our future children and babies; and, at the same time, protecting our NHS. Let other nations follow our example. I look forward to working with colleagues right across the House as we bring that to fruition, and I thank them for their contributions.