(2 days, 17 hours ago)
Public Bill CommitteesI beg to move a manuscript amendment: Tuesday 7 January Until no later than 3.10 pm Professor Linda Bauld OBE, Bruce and John Usher Chair in Public Health, University of Edinburgh Tuesday 7 January Until no later than 3.30 pm National Trading Standards Tuesday 7 January Until no later than 3.50 pm British Retail Consortium Tuesday 7 January Until no later than 4.10 pm Department for Education’s Secondary Headteacher Reference Group Tuesday 7 January Until no later than 4.30 pm Medicines and Healthcare products Regulatory Agency Tuesday 7 January Until no later than 5.00 pm Royal College of Paediatrics and Child Health; Royal College of General Practitioners Tuesday 7 January Until no later than 5.20 pm Department of Health and Social Care
That the Order of the Committee of 7 January 2023 be varied by leaving out from “Aneurin Bevan University Health Board” to end of table and insert—
This amendment is in order to accommodate witness availability. It would take Professor Linda Bauld at 2.40 pm and move the witnesses representing the royal colleges to start at 4.30 pm. This will add an extra 10 minutes to the last two panels, concluding oral evidence at 5.20 pm.
Manuscript amendment agreed to.
I welcome the panel again, although I was not here for this morning’s sitting. We will now resume by hearing oral evidence from David Fothergill, chairman of the Local Government Association’s Community Wellbeing Board, Professor Tracy Daszkiewicz, executive director of public health and strategic partnerships and vice president of the faculty of public health at Aneurin Bevan University Health Board, and Alison Challenger, tobacco and vapes lead at the Association of Directors of Public Health.
For this panel, we have until 2.40 pm. The floor is now open to any members of the Committee who wish to ask questions, but we would traditionally ask the Opposition spokesperson to ask the first question, so, Dr Caroline Johnson, the floor is yours.
Q
My first question is: do the local authorities have the resources they need to enforce these measures, if brought in? If they do not, what further resources do they need?
David Fothergill: I will take that one, if I may. First, thank you very much for the opportunity to come and speak to you. From a local authority perspective, we welcome the legislation, and we welcome the fact that it has been cross-party legislation—with the previous Government, and now with the current Government. The legislation will only be as good as the enforcement, and the question you ask is really important: have we got the resources to do it? We have to be sure that it is not a new burden—on either local authorities or retailers—that we cannot fund.
Therefore we would ask that we have time to implement, because we need to be able to consult with our retailers and our public to make sure that we implement in the right way. We would ask that it is viewed as a new burden, so that we can have additional moneys coming into the local authorities. We would also ask that we set up an apprenticeship scheme for trading standards services, to ensure that we are bringing through new people into trading standards—and environmental health, of course; we have to mention them. However, with time, focusing on those three areas, we will have the resources to make this successful.
Q
David Fothergill: The important thing is that we have the right consultation and the right plan for bringing through new trading standards. I think we would be alarmed if you said you were going to introduce this on 1 January next year, but if you said we had two years or slightly longer to implement it I think we would be much more comfortable.
Q
David Fothergill: We argued at the previous Committee hearing under the last Government—I think you may have sat on that Committee—that we needed a licensing scheme to make it effective. We still hold that view. We think that it is right. What we should not do, though, is to overcomplicate this. We already have licensing schemes. Many of you will have sat on licensing committees at local authorities. We have good local people who license alcohol outlets, taxis, gambling and gaming. We believe that licensing is the right route to go. While we think the legislation should be consistent, we do think there need to be local variations we can look at, so that we can bring in what works for our communities, very much as we do with the alcohol schemes.
Q
Alison Challenger: The short answer is yes, I think they do. The need not to have children exposed to the marketing of vapes is very important. At the moment we see that children are exposed to that marketing and are encouraged to get access to vapes, so it is important that this is brought into the Bill. I think what is currently in the Bill will help us to address that significantly.
David Fothergill: I concur. From a local authority point of view, we have argued long and hard about vapes and have spoken with your colleagues in the Department for Environment, Food and Rural Affairs about disposable vapes, which we have been very concerned about; so it is great to see this legislation moving forward.
Q
Professor Tracy Daszkiewicz: From the public health community, it is widely accepted and supported. It gives us a great opportunity not only to increase the conversation, but to broaden it. How we embed the legislation into practice will be key: making sure that we are getting it to the point of delivery where we can effect change in terms of protecting our populations in the most effective way, making sure that we have a focus on smoking cessation, that we have a consistent and unified approach, and that we have the agility and adaptability to target different cohorts and different populations effectively. From the public health perspective, though, the Bill is hugely supported.
Alison Challenger: Similarly, from the Association of Directors of Public Health, the Bill is very much welcomed. It will represent a sea change in reducing harm caused by tobacco, which is still our biggest killer. Significant numbers of people continue to smoke and are still addicted to smoking. The product itself is not only extremely dangerous but extremely addictive at the same time. We welcome these measures to address that.
Q
David Fothergill: The engagement has been really positive and constructive. We have faith in the Bill and that it has the right intention, the right measures and the right provisions. Our concern is around the funding, the timing and the pipeline of trading standards. The key thing for us is that it is an empowering Bill; it empowers local authorities. If you tried to legislate for every single local authority to implement it in the same way, we would run into some quite difficult conversations and difficult times; it would make enforcement more difficult. Allowing local councils to do what is right for them is the route to go.
People who sit on licensing committees have local understanding. I can give you an example. Should we ban the sale of tobacco within 100 metres of a school? That would be quite easy to do in an urban area, but I look after villages. If you do that, they have lost their only shop. People would not be able to go to that shop to buy legally. So you have got to have local knowledge. It is the right Bill, but we need to make sure that it is an empowering Bill for local authorities to implement in their local communities.
Q
David Fothergill: It is very much about keeping our feet on the ground. Let us be honest: trading standards are under a lot of pressure and have been cut over the last 10 years. Trading standards have responsibility for enforcing over 300 pieces of legislation, so there is a lot of pressure on trading standards; but I think that by working with retailers and building the relationship locally and ensuring that we use enforcement as the final tool, we can work very well in our local areas.
Q
Professor Tracy Daszkiewicz: It is a really useful question. It is about looking at it through multiple lenses. So there is the enforcement element of it, but there are also the elements that go behind that. If you take hospitals as an example in terms of having NHS smoke-free sites, enforcement is part of that, but it is also about having cessation services in place. If you have people going in for elective surgery, for example, you have got a period of time where you can put in a smoking cessation intervention. It is a “waiting well” method, if you like, so that people go in for surgery in a way that makes for the best possible outcomes, and have an opportunity to either get towards a quit or at least not go in smoking. That enables patients not to be going outside and using cigarettes and so on, which enables that smoke-free site and also creates better outcomes for our patients. So, we do need to think about that.
There has to be a common-sense approach. We know that vaping is a tool towards quitting smoking; we recognise that is part of the process. Where we can get people off tobacco smoking, that is crucial, particularly around health and wellbeing. The open spaces element and the public spaces element is a part that we have really focused on in Wales. The learning from that is still going on; it is not the end of the road. We are learning all the time, adapting to new evidence and making the changes that we need to make to enforce that more consistently, but in a fair way for our population.
Q
David Fothergill: We would like to see a licensing scheme that is very aligned with the alcohol licensing scheme, although there clearly cannot be a single scheme. The four provisions within the alcohol licensing scheme brought in by the Licensing Act 2003 were preventing crime and disorder, ensuring public safety, preventing public nuisance and protecting children from harm. If we can build those provisions into this legislation for the licensing of the sale of tobacco and vapes, that will give us enough to work on. I would also say that the flexibility we need at a local level remains critical.
Q
David Fothergill: I will take the fines element first and then talk about the cost of licensing for those retailers. A fine of £200 is quite a low figure. I think it was £100 previously, so it has been increased. If you pay within 10 days, it goes from £200 to £100. If you sell 40 vapes in one day, you have paid your fine. Some retailers—very few, because the vast majority are scrupulous—will take the view that they could sell more vapes to under-age people and those they should not be selling to, and pay that £100 fine within 10 days. So yes, we view it as too low. We would like to see a review brought in within a year to see whether it should be increased.
If we can align the cost of licensing fees with alcohol licensing, that would enable us to find a way to reduce the burden, because the vast majority of people who are selling alcohol are also selling tobacco. We need to work with our businesses to reduce the cost of applying for those licences, which is why we need the consultation period over the next few months, before we bring in legislation, to ensure that we have worked with our retailers, the public and our communities in order to deliver a scheme that actually works.
Q
Alison Challenger: We are ultimately trying to reduce the harm caused by smoking—that is the big killer, and we really would not want to lose sight of that. The Bill also brings in elements around the second-hand smoke agenda. It is important to recognise that there are many vulnerable people who would potentially be harmed by breathing in second-hand smoke, so we welcome the fact that the Bill includes that element. As for whether it will increase vaping, it is really hard to know at the moment how that will work out. Potentially more people might switch to vaping, but ultimately, the Bill brings in a progressive approach to taking out smoking tobacco, which is to be welcomed.
Q
Alison Challenger: I do not have the actual figure, but it is significant. One of the early benefits of the Bill going through will be the impact on children, particularly around asthma. Obviously, second-hand smoke will be exacerbating some of those respiratory illnesses, particularly for children. There is a considerable burden on the NHS as a result of breathing in second-hand smoke. We must also consider those who have cardiovascular disease and those who have existing respiratory illness. It is not always evident that somebody is vulnerable, so it is really important that the measures in the Bill serve to protect those who are vulnerable from inhaling second- hand smoke.
Q
Alison Challenger: We are very mindful of that. Some of the statistics we give around smoking prevalence are an average smoking prevalence for often quite large geographical areas. For my own area in west Sussex, our local survey suggests there is a variance of 4.3% in our most affluent area compared with 16% in our least affluent area. Those are still averages. We also know that in households in the most deprived part of our area, 40% of children are exposed to cigarette smoking from a parent or carer. That is through our own survey.
The point I am trying to make is that there is very much a health gradient, and in those who are most disadvantaged and living in our most disadvantaged areas, we see both higher rates of smoking and more children exposed to that smoking. Those children are more likely to take up smoking if they have been exposed to it.
Q
David Fothergill: We have discussed this outside the room, and I think the area we would be most concerned about is illegal sales online. Our local teams could not get into those, and therefore we might need more national resources to break into how people are bringing illegal substances into the UK.
Q
Professor Tracy Daszkiewicz: That is exactly the focus: reducing health inequalities and ensuring we get good health equity across all of our populations. When we look at preventable premature mortality, we know that smoking is a huge driver around that. We need to think about this across the life course. If we can stop the harms that second hand smoke causes to children, we can then think about deprivation across the life course and people who are dying early from preventable harms, with smoking being one of the risk factors.
We need to focus really narrowly on that, because it is not just about life expectancy, but about the number of years we live in good health. In my patch across Gwent in Wales there is huge variance, with up to 14 years’ difference in healthy life years between the richest and the poorest parts of the population. It is about not only the health outcomes around that, but the economic part of it, in terms of work productivity and work days lost. When we think about the cost of the NHS, which we often do, that is the cost of healthcare, but if we look at the economic picture of employability, productivity and those kinds of things, it increases that sum tenfold. We need to think about this so that when we look at the inequalities associated with smoking, we do so through a social, cultural, economic and environmental lens, to ensure that we get the full cost impact. It is something that we need to be mindful of.
Alison Challenger: I wanted to make a point about household income. We know that cigarette smoking is incredibly expensive. If one or both parents smoke in a household with a low income, that will have a considerable impact on the family’s spending capability for other things. It is not a matter of choice, either; smoking is an addiction. Seven out of 10 smokers really do not want to smoke, but it is incredibly difficult because of the level of addiction. If one or both parents smoke in a family household, that has huge repercussions for the funding of all the other household commitments.
Q
David Fothergill: That is where local knowledge comes in. Taking that shop in the village, we would not say that it should not sell tobacco, but we would say that it should not be selling tobacco during these periods—for example, 8.30 am to 9.30 am, or 3.30 pm to 4.30 pm. Knowing the local communities and being able to put in local restrictions would help us to really have an impact. Clearly, in urban areas it would be very different.
When the Minister asked questions about England, Wales and Northern Ireland, I should have said that what we would really like to see—it is in the Scottish legislation—is verification, where people are required to verify their age. Challenge 25 seems to work really well with alcohol, and we would like to see that brought in. We understand that that is in the Scottish legislation, and we would like to see it brought in in England as well.
If there are no further questions from Members, I thank the witnesses for their evidence today, and we will move on to the next panel.
Examination of Witness
Professor Linda Bauld gave evidence.
We will now hear oral evidence from Professor Linda Bauld, who is a Bruce and John Usher professor of public health and co-head of the centre for population health sciences at the University of Edinburgh. Thank you for being flexible and appearing earlier in today’s session. For this panel we have until 3.10 pm. If Members want to refer to Professor Bauld’s contribution and evidence, it will appear further on in your packs.
Q
Professor Linda Bauld: Thank you for the question. The first thing I would say is that I very much welcome the legislation. I also welcome the fact that it was introduced by the previous Government and then brought back by the current Government. I welcome the cross-party support I have seen. The academic community has contributed a lot of evidence to inform this legislation.
What I meant by those remarks was based on the previous Bill. There were areas that could be strengthened, and that is what we have seen in the current proposals—new measures are being introduced, many of which will need to be consulted on, and there are powers that can be acted on. In those remarks, I was thinking more about the implementation of the legislation and the regulations that will be required. A lot of that will need to be consulted on, but we need to ensure that we strike the right balance between what I see as the two primary priorities in this legislation: protecting young people and preventing smoking uptake. We must also protect young people from the harms of vaping, while also recognising the needs of the 6 million smokers we still have in the UK, who we need to support to quit.
I think the proof will be in the pudding. As all Members know, a lot of action will need to be taken forward to ensure that we get it right at the regulation stage. Certain elements of that will need to progress at pace to make sure we seize the moment to get it right.
Q
Professor Linda Bauld: As you know yourself, it is one of the leading causes of premature morbidity and mortality for the mother if she continues to smoke during and after the pregnancy. It is also a major cause of complications in pregnancy and for the baby, in terms of low birth weight and even stillbirth, along with a variety of other complications. The consequences of low birth weight are manifold in the health outcomes for the baby and the child. Finally, as you have heard from other witnesses, if the mother continues to smoke, or if other members of the household are smoking, that child is exposed to second-hand smoke in the home and is also three times more likely to become a smoker themselves.
As I think we heard from the CMOs—it could have been other witnesses—one of the great promises of the legislation is this prevention piece for young mums and partners, even pre-conception. We know that if we prevent smoking uptake earlier, the parents of the future are far less likely to smoke. The levels of smoking we have in pregnancy now are at around 9% or 10%. They have reduced a lot, but we can drive them down even further. It is important to make the connection between the smoke-free generation measures in this Bill and reducing smoking in pregnancy.
Q
I had a look at the evidence for how good people are at establishing how old somebody is. We are often told, “Don’t try to guess someone’s age—you can get yourself into a lot of hot water by doing that.” The research I found online showed that we are remarkably not very good at establishing how old somebody is. We are quite good at establishing if someone is of a similar age to ourselves, but beyond that, it is not that easy. What information do you have on the research in that field?
Professor Linda Bauld: I will speak just to the Scottish scheme. As we have heard from the previous witnesses, Challenge 25 is quite easy to implement. It is widely used and highly effective. The benefit of Challenge 25 is that you have got people who are obviously a number of years older than the legal age of sale for the product they are buying, be it alcohol or another product, and it includes anybody who looks roughly around that age, so asking to check age verification is actually very effective. As the regulations in this Bill are taken forward across the four nations, ensuring that we have robust age verification as part of the scheme could be effective.
Q
Professor Linda Bauld: I think we also heard this from previous witnesses, but as the legislation comes into place, it is really not about 34-year-olds versus 35-year-olds; it is about acting on the age of sale gradually, so that we are de-normalising tobacco use and stopping the start at an earlier stage.
By the time we get to the difference between the 34-year-old and the 35-year-old, you will have far lower smoking rates than we do at the moment. The modelling for the legislation that was carried out by the University of Sheffield for the Department of Health and Social Care suggests, as I think Hazel Cheeseman said earlier, that by 2040 we will have reduced the smoking rate among those aged 14 to 30 to 0.4%—down from 0.6% by 2030—so I think you are going to see very low rates. To go back to Challenge 25, age verification is something that we can build in, and, irrespective of how old you are, actually seeing proof of age will support this.
Q
Professor Linda Bauld: Thank you for that question, Minister. I have been working in tobacco control for almost 30 years, and the impact has been phenomenal. If you look back to the late 1940s and 1950s, 80% of men smoked in the UK. We have driven that down gradually over the years. We started to measure it in about 1974, and the level of smoking in the UK is now about 12% or 13%—the second lowest in Europe. The reason that we have achieved that is in line with what is being proposed in this legislation. It is about using comprehensive measures and implementing them over the years to regulate what I often call the four p’s: the product, the place, the price and the promotion. You are taking action on potentially all of those—including price, with the levy that is coming in, or the tax on vapes.
We have made a lot of progress, but we are not there yet. I think what you will hear from my clinical colleagues later is that in line with keeping that firm focus on prevention, as you are doing in this Bill, we also need to keep the focus on cessation and particularly on marginalised groups, deprivation, mental health and so on. The key is comprehensive tobacco control. Keep doing it, and that is what the Bill is adding to.
Q
Professor Linda Bauld: If I can start with the second part of your question, in terms of not deterring adult smokers, we need to continue making the products available for smoking cessation. We are not banning vapes—that has happened in a number of other countries, as the CMO for England was saying—but we are recognising the things that make them appealing, attractive and affordable to young people, and taking action on those. It is fine for the adult smoker not to be able to see a wide array of advertised products on the shop front, on the billboard or at the point of sale, but to know they are there behind the counter and ask for them. I also do not think that the adult smoker who is trying to quit cares about gummy bears or Coca-Cola flavours—maybe they want some flavours, but not all of them. It is about striking a balance.
Finally, although we are not here to talk about the funding of smoking cessation services today—certainly in England, you have made previous announcements about that—it is important that in clinical settings and through stop smoking services we can give good information about vaping and other cessation aids, and support people to quit that way.
Q
Professor Linda Bauld: It is very ambitious on tobacco. We will be the first in the world—after unfortunate events in New Zealand, from my personal perspective—to introduce the smoke-free generation policy, and the world is looking at us. That is good. In terms of protecting people from vaping, the Bill has a proportionate set of measures, but if I come back to the answer that I gave to the shadow Minister, we really need to keep our eye on the regulations and—going back to the Minister’s questions—make sure that we are striking a balance. Given the evidence that we have for much stronger regulations on vaping, I think this strikes the right balance, but we need to make sure that we do that in a proportionate way. Finally, to go back to the comments from the previous set of witnesses, we also need to make sure that local areas have the flexibility around some of the measures to adapt them for their local circumstances.
Q
Professor Linda Bauld: Dr Ahmed, you know—as Sir Gregor Smith said earlier—that smoking rates in our most deprived communities in Scotland are about 26%, compared with 6% in the least deprived. That is a very big number, and we see that pattern across the UK.
The Bill will make a difference in several respects. First, on preventing smoking uptake by gradually raising the age of sale, the evidence that we have from studies done by my colleagues at University College London and elsewhere is that previous rises in the age of sale have not exacerbated inequalities but have had a benefit in terms of preventing uptake. We know from the evidence that we have that those measures should be useful and helpful, and should not exacerbate that. The other thing is that, to go back to my earlier answer to the shadow Minister, by preventing smoking uptake in the groups that are likely to be future parents who are already likely to smoke, which are highly concentrated in our most deprived communities, we are going to have an impact there.
I do not see any signs in the Bill, when I look across the measures, that we will be exacerbating inequalities with it. I think that we will probably have the biggest impact in the areas where we have the most smokers which, unfortunately, are our most deprived communities.
Q
Professor Linda Bauld: I do not have in front of me the cost to the NHS—other witnesses will probably have it at the tip of their tongue—but it is substantial. If you look at the number of admissions to hospital from smoking, there are over 500,000 every year in England, and we still have over 75,000 deaths. By reducing smoking prevalence, you are going to see very significant impacts and cost savings.
The other thing we know from our research, as previous witnesses have said, is the effect on productivity and workplace absence. As you all know from your constituencies, smoking is also driving some of the loss of people from the workforce in their 50s, early 60s or even younger that we have seen recently. I think that you will see cost savings and an impact on productivity.
The final thing that I would say on that, despite not having the figures in front of me, is that this is an area that causes such a burden to the NHS. One of the things that our CMOs did not make clear earlier, although they said it indirectly, is that if you look at non-communicable diseases in the UK, smoking is the only risk factor that is linked to all four of our NCDs—respiratory conditions, cancer, diabetes and heart disease. It is the only one that is directly linked to all of those. If you think about all of those diseases, and the burden of disease that Sir Gregor mentioned, of a 21% increase by 2040 in my own nation of Scotland, we are going to make an impact on that, and that will achieve cost savings for the NHS—and, importantly, for social care.
Q
Professor Linda Bauld: I think there are political aspects to that, which I will not comment on, but obviously the understanding was that it was a very comprehensive and ambitious set of measures that was introduced. Like this Bill, it was about not just the smoke-free generation but other measures as well, including, interestingly, on the density of retail outlets, which might be something for another day or another, potential future measure. A new Government came in and decided not to take it forward.
The learning that we need to take from that, from my understanding and from speaking to colleagues there, goes back to the CMOs’ evidence about the lobbying that is going to occur. The tobacco industry and partners around the industry are very powerful, so persuading colleagues that this is undermining choice and that it will be a burden in terms of regulation, cost to retailers and so on—those were the arguments that were used in New Zealand.
We need to keep a watchful eye, as we think ahead to the regulations and the next steps for the legislation, that we do not open that door too widely and allow those arguments to become too powerful. As you heard earlier, that industry is continually looking for new recruits to replenish those it loses through morbidity and mortality, and that will happen in the UK as well unless we get this right.
Q
Professor Linda Bauld: This is quite a comprehensive piece of legislation, with lots of different pieces, so I will give a couple of examples. One area we looked at was protecting more places from second-hand smoke, and the health benefits of that to people who are vulnerable—people with asthma, respiratory conditions and cardiovascular disease—are very immediate. When the smoking ban came in in England in 2007, I did a study looking at admissions to hospital from myocardial infarction after the legislation was introduced, and in the first year we saw substantial reductions in admissions to hospital for heart attacks. So I think some things will be quite quick.
In terms of the pregnancy question, if a woman is not smoking during pregnancy—some of the measures encourage that—the health benefits to the mum and the baby are immediate and long lasting. I also mentioned the modelling statistics on driving down prevalence, which is obviously going to take more time. There are then the regulations to protect young people from vaping, some of which will, I think, have quite a big effect if they prevent somebody from taking up vaping at all, and some will take a bit longer in terms of driving down the rates. It is a balance.
The final thing I would say is—this is my opportunity to make this point, as you would expect—please, let us make sure that we do the research. We must support the academic community to do the research to monitor how the Bill is implemented, so that we can provide evidence that what colleagues have put forward and decided to do actually makes a difference. Other countries will then be able to look at that evidence and make up their own minds.
Q
Secondly, linking to the economic argument you made earlier, you are right that deprivation is key. There is more smoking in deprived communities. I have asked all the witnesses this question. Is there a concern that because of the concurrency of people vaping and smoking, the people who are doing both will move to an economically cheaper option—that is, pick up smoking again because vapes might become more expensive because of other measures that are introduced? Has that concern been raised in academia?
Professor Linda Bauld: Let me start with the first part of your question. Those data come from the Action on Smoking and Health survey covering Great Britain, which was funded by Cancer Research UK and conducted by YouGov for ASH. Those harm perceptions are really concerning to me because we do not want people who have never smoked or young people to be vaping but, from the evidence I have seen, if more of those 6 million smokers could switch to vaping, we would see health benefits. I think those misconceptions are largely driven by the media and some of the myths—the really harmful stories that get the front page. We need to deal with that and make sure that health professionals and others are empowered to give accurate advice about vaping. We have got a distance to run on that, and anything that the Bill can do to assist that would be welcome.
On whether people who are dual using, which is a significant proportion of smokers, are more likely to switch to smoking if we take action on, for example, removing point-of-sale displays or take other measures on vaping, I am actually not sure about that. The key point is that we need to continue to make smoking more expensive than vaping and to make sure that we address the availability of tobacco in our environment and in different settings. If we can keep that balance to show that vaping is a good option for cessation and is more affordable than cessation, while we keep doing the research on it, I would be optimistic that we are not going to see masses of smokers who are currently vaping to cut down just switch back to smoking in its entirety—hopefully.
Q
Can I ask people to speak into the microphone if they can? We are often finding it difficult to pick things up, and the volume is on maximum as it is. Thanks.
Professor Linda Bauld: I think that the legislation, as currently put forward, is good. There are not areas where I would say that the research community—the colleagues I work with—would suggest that the right measures have not been put forward; I think they have been put forward. But I will come back to the point I made at the beginning: I think it is about the implementation, and making sure that we get that right.
Again, I would come back to the four F’s that I mentioned at the beginning. Just thinking about implementing this, I think there are things that need to be considered in how we sequence things. For example, in the last session, you heard from witnesses about the licensing scheme; we already have a register in Scotland that works pretty well, and we are going to move to a conditional register. As those licensing elements and so on have been consulted on, let us at least get retailers in England and Wales on a register, so that we know who is selling vapes and tobacco, until we move to that next step.
Thinking about the promotion aspects, and in-store promotion in particular, let me just give you one figure from a recent study conducted by my colleagues at the University of Stirling—the Cancer Research UK-funded vaper study. When they asked young people where they were seeing the promotion of vaping products, it was on shop fronts and in shops. At almost two thirds, that is the most common area where they see advertising promotion, and then on posters and billboards. There are also concerns about social media and so on. So, again, if you are thinking about what you might implement first, some of those in-store promotions are important. Then, on the product, I think that removing those promotional characteristics from the packaging and labelling is particularly important. Those are the kinds of things that I think need to be brought forward first, as well as thinking about really getting the regulation right.
The only other thing I would say is that, in terms of the different products in this Bill—and it is very flexible—let us not forget the categories that maybe you have not asked about yet. I think one colleague mentioned shisha, but there are also smokeless tobacco products, which are used in some of our communities in particular and which often get through the loopholes. I have done a number of studies on oral tobacco, which we know is very harmful and is linked to mouth cancers and head and neck cancers. So let us make sure that we just keep a focus on the range of tobacco products, even though the dominant product used is the cigarette.
Q
Professor Linda Bauld: That is an interesting question. My colleagues at UCL did a study that looked at what happened when they raised the age of sale from 16 to 18. I have to be honest with you: at the time, the tobacco control research community would not have pointed to that as the most ambitious measure that you could do; we did not think that changing the age by just two years would make an impact. But, from the data, it actually created 1.3 million more people who could not be sold cigarettes. We also know that, at the same time, due to the action on illicit tobacco, which is really important, the amount of illicit tobacco consumed fell by about 25%. So it is about those two things in partnership: tackling illicit, which of course is really important, and changing the age of sale.
The promise of the smoke-free generation is more ambitious, however. Rather than just raising the age of sale by a few years, we are gradually changing it over time. That protects future generations, because we do not have the big jump to being suddenly ineligible to be sold cigarettes. To go back to the evidence in the annexe to the legislation, which shows the modelling done by my colleagues for the Department of Health and Social Care, it looks pretty robust. I think that this will have a big impact over time. I hope that is helpful.
Q
Professor Linda Bauld: That is interesting. I think a similar question was asked earlier. I do not think that history bears that out. Often, a concern is that if we take action on one product, we displace youth use to other products. With action that we have taken on smoking over the years, we have not seen a dramatic increase in, for example, youth alcohol use or use of other legal products. There are still major issues with young people consuming alcohol but, actually, the number of young people drinking at harmful levels has reduced in recent years, at the same time as tobacco measures have been introduced over time.
I do not think that we will see a big displacement to other substances by introducing this set of measures, but we need to keep our eye on getting that balance right. In terms of the other products that we are concerned young people might use—obviously, there are illegal drugs, which we have separate legislation on, and we need to keep an eye on alcohol control for young people—all those things need to happen together. But I have not seen any evidence to suggest that taking this kind of action will cause some other public health issue that we need to be overly concerned about.
If there are no further questions, I thank the witness, Professor Bauld, for her contribution. We will move on to the sixth panel of witnesses.
Examination of Witnesses
Lord Michael Bichard and Wendy Martin gave evidence.
We will now hear oral evidence from Lord Michael Bichard, chair of National Trading Standards, and Wendy Martin, director of National Trading Standards. We have until 3.30 pm with this panel. As you can see, because both the earlier panels finished earlier than expected, we have a fair bit of extra time for these two witnesses, if they wish to use it or if Members wish to ask more questions.
Q
Lord Michael Bichard: Good afternoon. We will try to be provocative, so we can keep this going until half-past three. It is as long as a piece of string, in a way. If you compare the penalties to those in some other legislation, they are a bit low. On the other hand, trading standards can prosecute if we find, for example, that someone is a repeat offender, and then I think the fines are up to £2,500.
The only thing we thought might be possible would be to have a higher level of fine for a second offence. I think the first offence is a £90 fixed penalty, but you could have a couple of hundred for a second offence. But we enforce; we do not fix the fines—we just do what you tell us. It is not an unreasonable figure, although it certainly could go up, rather than down, and we could have something for a second offence. Also, we could take action through prosecution for someone who was constantly offending.
Wendy, do you have any thoughts—
Lord Michael Bichard: Sorry, I did not hear that. The sound is not—
Q
Wendy Martin: Lord Bichard has spoken about the rather varying levels of fines that do exist. The other point worth making is that the issuing of a fixed penalty notice is not automatic anyway. A lot of the work, especially around first offences, would be to try to support businesses with advice on how to comply with the law. It is not the case that, immediately you find something wrong, there will be a fixed penalty notice. There are a lot of drivers for compliance, especially with legitimate businesses that want to comply. As we said, prosecution is an option and you have the £200 fixed penalty, but for longer-term or egregious offences—definitely for repeat offences—prosecution through the magistrates’ court is likely to be an option.
Lord Michael Bichard: One of the problems with prosecution is that it costs money. Therefore, if you can train retailers not to offend, that is a better outcome than having to issue a fixed penalty. For local authorities in particular, with their resource situation being what it is, the last thing they want is more bureaucracy around fixed penalties, prosecutions and all the rest.
Q
Lord Michael Bichard: Do we welcome that? Yes, I do. It is our task to take a proportionate position. Some people make mistakes, and there is probably no point in even a fixed penalty notice if someone has just made a mistake. As Wendy has said, training is probably a better option. However, if someone is clearly determined to flout the law, you need to increase the penalties.
Q
Lord Michael Bichard: This is not complex legislation. One of the points we want to make on behalf of trading standards is that we are used to doing this sort of stuff. We are used to doing it for tobacco and illicit cigarettes. It is not complicated. The main issue is, as you say, age identification. People are increasingly used to having to provide some identity or proof of age for all sorts of things. In terms of training retailers, that is about it: if they have any doubts, they need to seek identity.
Q
Wendy Martin: No training exists at the moment, because the law is not in place yet, but you are quite right that Challenge 25 is the industry standard in terms of current age-restrictive products, no matter what they are. Certain industry organisations, such as the Association of Convenience Stores or the British Retail Consortium, put on a lot of training programmes for members. There has been Government-funded training in the past. The Chartered Trading Standards Institute hosts a site called the Business Companion, which has good, simple guidance and information that is designed specifically for small businesses and is easy to read and digest.
There needs to be a change of mindset around needing to ask for a date of birth, rather than asking, “Are you 18?” There does need to be information out there, as long as it is not complex. It is a case of reinforcing that, but I think those routes do exist via those websites, industry groups and pre-existing information that needs to be updated. There should be as much communication as possible with the public and businesses as the Bill goes through and gets Royal Assent about what to expect and what is required.
Lord Michael Bichard: Again, we want it to be proportionate, because small businesses cannot afford to spend a huge amount of time in training rooms. I do not think personally that this requires profound, long-term training. It is pretty simple stuff. A lot of it can be done informally.
Q
Lord Michael Bichard: I try to make it a principle of my life not to go around asking for more money from Government or the Treasury, so that would not be my first response. However, you have to look at this in context. Trading standards resources have been reduced by about 50% over the last decade, and staffing in local authority trading standards has gone down by about 30% to 50%, so we start from a very low base.
The suggestion that has been made is that trading standards should get £10 million to implement and enforce the legislation. That sounds like a not unreasonable figure, but the way in which it is distributed is quite important. If it is going to be done on a one-year rolling basis, that makes it difficult for local authorities to employ staff; you need some stability if you are going to employ staff. We think that, if it will be £10 million, it needs to be on a four-year cycle so we know that for four years we have that money and can employ the staff.
The other issue to be concerned about is that local authorities that I know—I am a local authority man originally—have been under huge pressure. There is always a temptation to take whatever money is there and use it on the highest priority. If this money is to go to tobacco and vaping, I am afraid that it probably needs to be ringfenced. I know there are some local authority former members here who will not agree with that—I do not normally agree with it, because I think local authorities should have the space to make their own decisions—but if you want this money to go to tobacco and vaping, it will probably need to be ringfenced.
I will make two final points. I know it sounds like a detail, but quite a lot of money has to go on storage and disposal. We think it is about 50p to £1 for every vape. That has to come out of the £10 million. Finally—this is really important—some investment has to be made at ports of entry. That is probably the most important intervention of all. We depend on UK Border Force in particular to give us the intelligence to enable us to target our efforts. We are already responsible for product safety at ports, so we rely on UK Border Force. That needs to be properly resourced because, as you will appreciate, it has a lot of other important priorities. If it is going to be effective at port level, we feel that about 20% of whatever money we get needs to be spent there.
I say that with some knowledge, because I visited a couple of ports before Christmas just to see how the product safety stuff was dealt with, and I was pretty shocked. I went to Southampton and Dover, and I must say that on occasions I felt that whether or not we were successful was pretty random. As I say, we were often not getting the intelligence from UK Border Force to enable us to target our resource, and I understand why. We only have a very small number of staff at these ports. We should not underestimate how important port entry is and some money has to go to that. That is a long answer to your question: £10 million sounds like a lot, but if you put in storage, disposal and ports, that makes it look rather less generous, and it probably has to be ringfenced and done on a four-year basis if it is going to have an impact.
Thank you, that is a really helpful answer. We know that vapes are very difficult to dispose of and to recycle.
Q
Lord Michael Bichard: I think we do feel we will have the right powers, based on the fact that we are already doing some of this quite successfully. We seized something like 2 million vapes last year; we carried out 400,000 test purchases—which is how we check whether or not the legislation is being enforced—and we seized, I think, 19 million illegal cigarettes. So in a way, this is not new stuff for us; it is just bigger. We have the powers and we use them quite effectively. We know that HMRC thinks we are pretty effective in relation to tobacco. We like to think we are a good delivery agency.
Wendy Martin: There has been a lot of work in the development of the Bill and the associated Department for Environment Food and Rural Affairs legislation around the ban on single-use vaping products with officials, so we have worked together with them to try to get this to a good place in terms of enforcement powers.
Q
Lord Michael Bichard: No. Our experience of the illicit tobacco market is that it has reduced rather than increased, despite the additional regulation, the price rise and all the rest of it, so we do not think that is a serious issue. We think that there are a number of myths around illicit tobacco and illicit vapes that do not stand up to close scrutiny. So no, we do not think that is a serious problem.
Q
Lord Michael Bichard: Yes, I think we feel that. You might also consider an increase for second offenders before you move to prosecution. I do not think anyone wants to move to prosecution, because it is such a time-intensive process. I know we have limited time, but one thing we have not talked about is retailers. We also ought to be concerned about the online market—or rather, you should be concerned, as we are. It is a difficulty for us and for local authorities, because no single local authority thinks it should be responsible for enforcing legislation in an online marketplace.
We have a solution to that, which is that we have a lead authority that we think could deal with this and avoid the problem with individual local authorities. I think that will become an increasingly important element of the vape marketplace.
Q
Lord Michael Bichard: It seems to me that it is now such a part of life that it is not as big a problem as it was; I think it is a problem that will diminish.
Wendy Martin: Certainly the retail violence is of concern and has been well publicised. It is clearly a policing issue rather than a trading standards issue. I guess it needs activity to make sure that everyone understands what is being done and why it is being done, and to make sure that there is a policing response, if possible, where there are issues. I know that local authorities work through community safety partnerships and things like that in local areas if there are particular incidents. Again, it is not specifically a trading standards response, but local authorities and local police forces will work together to do their best to address these things, because nobody wants anyone to be threatened with violence.
Q
Lord Michael Bichard: We think it does. You have to look at the package, because you do not just have age regulation or display and promotion regulation; you also have the proposal for licensing—which, by the way, we do not see trading standards being equipped to do; that is a local authority business and, as a former local authority man, I would have to say “with the resources”, because there is always a danger that you give local authorities more power but you do not give them the money.
You have regulation, you have licensing and you have registration of products. If you put all that together, I think it is quite a powerful package, but it does need to be backed up with the resources, because it is delivering it that really matters. We are all used to legislation that sounds great and never gets delivered.
Wendy Martin: I agree; we think the balance is there, hopefully with good communication to businesses. Again, in a similar way, this is not going to be entirely new territory—certainly for those businesses that are already involved in the sale of alcohol and tobacco in particular—in understanding where to go for support and the kind of controls that are in place. Certainly, if the changes are made to the product registration scheme, which should then make it more effective for businesses to be able to check that a product they are stocking is legal and compliant—if the package is right, as Michael said—it should not be too complex for businesses to comply with it.
Q
Secondly, in the United States, you can have products with up to 60 mg-worth of nicotine; that is a standard product in the United States. In the UK, it is 20 mg, or significantly less. Is there an awareness within trading standards of just how much we are potentially out of kilter with some of the key markets that we are aligned to? Our limit is significantly lower than those of other major economies, so do you think that we might therefore have a problem with products perhaps coming in from other sources that are not the same as tobacco? Is that a concern for your Department?
Lord Michael Bichard: I will pass that one to Wendy, if it is not unfair. On the first point, you are right that we think that that is going to make regulation enforcement easier but I will have to leave the second question to Wendy, I am afraid.
Wendy Martin: Just to reinforce Michael’s point around the digital stamps, I am not close to this myself, but I know that trading standards colleagues who are operational experts in this field are working in response to the various HMRC consultations about the implementation of excise and tax stamps, and those sorts of things. I know those conversations are happening, and I think the view is that that kind of simple identification is really important for trading standards.
In terms of the 60 mg versus 20 mg, I am afraid I do not have any detailed knowledge of that personally, but I would certainly anticipate that those kinds of challenges and issues would be built into the guidance and information being put to officers and any planned training programmes once we know the final form of the Bill, the excise duty and all the other changes coming over the next few years as the Bill and other legislation progress. I am sorry that I do not have a detailed answer.
Lord Michael Bichard: But we can get it for you.
Q
Lord Michael Bichard: I do not want to sound complacent, because I am not. But this is something we are used to doing, so we do not see that as a major issue or a major problem. That is what we do.
Q
Lord Michael Bichard: No, the point I was making was about enforcement.
Wendy Martin: To add to that, as part of the programme that DHSC has been funding for the last 18 months, we tested out a number of issues, and one was online under-age sales. I think we tested 312 purchases, and there was a 10% failure rate. That was significantly lower than premises-based sales. There was a lot in the platform’s corporate website design to try to ask the right questions and kick purchasers out. It is very much about who does it and who takes responsibility, rather than a major problem in itself.
We also work quite closely with the Advertising Standards Authority, and it does a lot around broadcast and published media, and website compliance and claims. That is quite a well-established mechanism for enforcement. It is about the structure of enforcement, as you have rightly identified.
Lord Michael Bichard: It is probably worth pointing out—it does not relate to the online point—that I said earlier that last year we carried out 4,000 test purchases, and 26% of those were failures. Compared to the 10% online, it is significantly higher. This is a very practical point, but some of the other changes that are going to happen will make it easier for us to do test purchasing. At the present moment, we can only use children or young people, so we have issues of safeguarding and we can only do it at certain times of the day. It should become easier, in that sense, for us to enforce the legislation.
Q
Lord Michael Bichard: It will be enforced in the same way we enforce it for tobacco and other things. This is not new. Trading standards officers employed by local authorities are constantly visiting premises, and they will therefore deal with any offences that are being committed. They also have their own local intelligence networks. We cannot afford, because we do not have enough staff, to just have a random system where we pop in every now and then. We depend on people giving us intelligence. Some of those people are members of the public, and some are from other agencies. We try to target what we do. When you visit a shop—there are something like 60,000 outlets—you can see whether the current legislation, or future legislation, is being implemented. We can take action against the retailer if it is not.
Q
Lord Michael Bichard: Absolutely. I was going to say that if you are making a case for trading standards to have more resources, I am absolutely with you. I think that trading standards does an amazing job with limited resources. One borough in London now has no trading standards officers, and that is a great worry. We are there to protect consumers in all sorts of ways, but we are also there to try to establish a fair marketplace, so we are working on behalf of legitimate businesses. A lot of retailers want to support us in dealing with bad practice among their competitors. Yes, we need more resources.
Wendy Martin: Clearly, the responsibility is on businesses to comply with the law, first and foremost, and the hope would be that the vast majority of those outlets do so, because they are either part of bigger businesses with corporate structures to ensure compliance, or part of trading associations where that training and information is available. Generally, most people want to do the right thing. What that means is that the additional resources are necessary and can be focused on those sectors where there is intelligence from consumers, enforcers and other businesses—businesses will complain, and rightly so, about competitors who are flouting the law. That enables targeting, rather than feeling the need to try to inspect 60,000 or 70,000 premises. That would not work, and it does not need to work like that.
Lord Michael Bichard: Local trading standards officers know the problem retailers, where the problems are. I started my career doing prosecutions for trading standards, so I know a bit about how they work on the ground. They know where to target their efforts. I should also point out that there is a committed workforce here. Recently, we did a survey of the workforce, and 80% of them supported the legislation. It always helps.
One final quick question from Jim Dickson, before we have to go on to the next panel.
Q
Lord Michael Bichard: I cannot see that it would not be useful, but it is not something that has come across my desk.
Wendy Martin: Mine neither, but intelligence-led enforcement means the more that intelligence is available, the better one is able to target. I do not know exactly what tobacco companies collect, but generally any intelligence is useful.
I thank both panellists for their evidence. We will move on to the next panel.
Examination of Witness
Inga Becker-Hansen gave evidence.
We will now hear oral evidence from Inga Becker-Hansen, who is policy adviser for retail products at the British Retail Consortium. For this panel we have until 3.50 pm.
Q
Inga Becker-Hansen: Good afternoon, and thank you for the opportunity to speak. The question was about age verification, I think—sorry, it is a bit quiet for me here.
Yes; what are the challenges in implementing the new regulations?
Inga Becker-Hansen: One of the key challenges of age verification is this idea of the rolling age for the smoke-free generation. At this point it is quite identifiable, with those under the regulation being 15, but in 30 years’ time if you have someone who is 45 versus 44 from the date of January 2009, it may lead to ID for each sale of a given product, if that makes sense. This will eventually lead to potential issues. Points of sale can be a flashpoint for violence and abuse against retail and shop workers, so it is a real concern for retailers that that could be an issue in the future in terms of the smoke-free generation and the ageing of that generation.
We would also like to highlight that a digital ID could possibly make things easier. The Department for Business and Trade is promoting the use of digital ID for alcohol consumption. That could potentially be included as a means of age verification to make the process easier for the average consumer and member of the public.
Q
Inga Becker-Hansen: Specifically for under 30 or 40 years old, I do not think we have anything. I imagine that with the Bill something would be implemented.
Could I ask everybody to speak louder, please? The microphones are not very good at picking up the sound.
Inga Becker-Hansen: Okay, no problem. In terms of age verification for product sale, our members have lots of experience of the sale of tobacco and alcohol products. They have till prompts looking at the date of birth of the customer in the store. There are also badges, posters and mystery shoppers to ensure that they are compliant. Challenge 25 has been implemented since 2009, and our retailers are very compliant with it. There are due diligence procedures that are agreed with primary authorities. I imagine that in terms of identifying sales for people under 30 or 40, it would be a matter for retailers to discuss with their primary authority to identify the best route for that in store.
Q
Inga Becker-Hansen: In terms of the licensing scheme for smaller retailers, it is more about the administrative burden that there will be, and the cost of that. Smaller retailers may not have as much capacity with regard to the licensing scheme. It is quite difficult to comment on it at this point, because we do not know the full detail. If the licensing scheme were to bundle alcohol and vapes and tobacco, or if they are separate or together—those are all the kinds of questions your smaller retailers will have to take on board with regard to the licensing schemes and what they can and cannot provide for their customers.
It will affect revenue for smaller retailers, so it is something to bear in mind. There will be increased bureaucracy and increased costs. We would welcome the opportunity to discuss and contribute to the design of the scheme, but we do not know the full detail, so it is quite difficult to comment on how it will or will not affect smaller retailers specifically.
Q
Inga Becker-Hansen: Retailers are quite comfortable with the licensing scheme for tobacco at this point. That is something we are used to as a whole. One aspect of it is the fact that your larger retailers, for example, who have multiple premises do not have to worry about individual licenses for those individual premises. That is something we are quite concerned about with the licensing scheme, and what that could mean. If individual licenses had to be applied for, that could lead to divergence across a retail brand, and that affects your overall public retail image for customers.
We would also like to highlight that if the licensing scheme were to follow something such as the tobacco licensing scheme—the idea that licensing authorities could approve or deny certain applications—that could affect long-standing, established, compliant retailers, and that could lead to a loss of revenue for them. We appreciate the need for the legislation. We appreciate the need for a level playing field, and that is what we would encourage through the Bill.
Q
Inga Becker-Hansen: Currently, retailers are used to the idea of over the age of 18, simply because of tobacco and alcohol sales. The identification of January 2009 is more difficult, in terms of the rolling age and how that will look in the future. Currently, it is quite identifiable. I would say that January 2009 is more difficult for retailers to handle in the future per se.
Q
Inga Becker-Hansen: Yes, currently that is true. However, in the future, if somebody walks into a store and they are 45 or 43, I would not be able to tell that at face value.
Q
Inga Becker-Hansen: From their ID, you would. What I am trying to say is that it raises the thing of eventually becoming “no ID, no sale”, which is a concept that retailers would have to follow. But it would also mean that consumer-wise, you would require a consumer-facing public awareness campaign to identify and illustrate to the general public that it is “no ID, no sale”, if that is the angle that the Government are focusing on.
Q
Inga Becker-Hansen: Ideally, with a cohesive guideline illustrating to retailers how to implement the legislation. We would also encourage alignment across the regulations in terms of new regulations coming through, such as secondary legislation on the licensing scheme, and consultations on any secondary legislation so that both larger and smaller retailers may contribute their ideas. Ideally, there would be constant communication with industry to understand how these changes are made, as well as a public awareness campaign so that the public is aware of the changes, which would hopefully reduce any potential violence against or abuse of retail workers.
Q
Inga Becker-Hansen: We would like to see a licensing scheme as a level playing field where small, independent and larger retailers are viewed on the same level. Again, we would encourage the multi-stores to require only one licence rather than looking at individual premises licences, because that will make things more difficult.
In terms of the tobacco scheme, ideally things would be grouped together so that there is less administrative burden and therefore less cost for retailers, so that, if the aim for the Government is to transfer from the idea of selling tobacco to people to selling vapes because of the health benefits, that transition is made easier for retailers. Adding on an additional licensing scheme with additional costs and a separate administrative system makes it more difficult for retailers to handle those things at the same time, particularly smaller retailers and independents.
Q
Inga Becker-Hansen: It is a bit difficult for me to give you specific details, but in initial response my thinking would be that it would be a discussion between retailers and their primary authority and how that is handled, bearing in mind smaller retailers versus larger retailers. I am happy to follow up in writing and give evidence that way, but I cannot give specific details currently.
Q
Inga Becker-Hansen: Again, I cannot give a conclusive answer at this point, but if you have different shops under one retailer that have different licensing schemes, it devalues customer confidence in the products they are selling across the country, if that makes sense.
Q
Inga Becker-Hansen: Okay.
Q
Inga Becker-Hansen: If you have certain branches of a certain brand selling alcohol in one shop, and then in another shop, they are selling alcohol and vapes, when you are going to purchase your product, you will think, “Okay, I will just pop to the shop”, but they may not have exactly what you need. But if you see it as a national product per se for the brand, then you have confidence in going into the retailer.
Q
Inga Becker-Hansen: Precisely. But then it should be up to the business or the retailer to decide that strategy for themselves rather than it being implemented.
Q
Inga Becker-Hansen: It is difficult for the BRC to comment on that, given that we are not public health experts or behavioural economics experts. I would therefore ask that you confirm that with public health experts, rather than the BRC.
Q
Inga Becker-Hansen: Some of the challenges with the restrictions on advertising will be at the point of sale of products for some retailers. There is also a query from retailers about how recycling schemes for vapes can be implemented if they cannot be advertised, and about how the Bill and the Government can support recycling initiatives alongside the reduction in advertising of vapes. Retailers appreciate the need to restrict advertising. Again, there is this idea of creating a level playing field among all retailers, rather than focusing on specific ones.
Q
Inga Becker-Hansen: Again, I do not have specific details, so I cannot comment. I am happy to follow up in writing.
Q
Inga Becker-Hansen: I think the key would be guidance for retailers on implementation and how the measures will be carried out. Again, there is the idea of encouraging a consumer-facing public awareness campaign that highlights the new restrictions and the safeguards for shop and retail workers so that, when the new regulations go through, the public are aware of the changes.
In any new secondary legislation, we would encourage alignment within the regulations themselves and across the devolved nations so that it is clear and consistent.
We can squeeze one more in if anybody wants to ask a question. I thank the witness for giving evidence.
Examination of Witness
Matthew Shanks gave evidence.
We will now hear oral evidence from Matthew Shanks, who is the chair of the Secondary Headteacher Reference Group and chief executive of the Education South West multi-academy trust. For this panel, we have until 4.10 pm.
Q
Matthew Shanks: That is quite a large question, but I can answer it from an anecdotal point of view and from talking to colleagues around the country.
Vaping is a bigger problem than smoking within schools. Children who would not contemplate smoking—sporty children, dancers and so on—engage in vaping because they see it as harmless. It is easily accessible. It is very difficult to detect in schools in a way that cigarette smoking is not. It is seen as very fashionable in terms of the way it is advertised and promoted. I am not saying that this is happening in every school, every day, but we can report instances of children going out of lessons to vape in toilets or various places. Vaping is difficult to catch, because there is no smell, unless they use bubblegum, grapefruit or other such flavours. It is having a huge impact on discipline within schools—on ensuring that children are in lessons, or are in school in the morning on time, and not off-site at lunch time looking for places to vape and so on.
Q
It is difficult to prove what is in vapes. Again, there are instances of vapes containing illegal substances, but that is difficult to prove, because of their small size and where they can be secreted or hidden. There is evidence out there of drugs being contained in vapes—snus or Spice in the vapes—being quite addictive. Any kind of addiction leads to misbehaviour, particularly if you put that into secondary schools or among older children in primary schools.
Q
Matthew Shanks: To speak frankly, those vapes are not marketed at 40-year-old people who are trying to give up smoking. I do not think that vaping is marketed at people who are giving up smoking—it is not a cessation tool: it is a tool to encourage young people to engage in something else. I have talked before about this—it is almost the gateway from chewing gum to the next stage. Half a mile down the road, if you walk towards Trafalgar Square, a shop on the right-hand side—I passed it walking in—is full of colourfully arranged vapes, which do not look harmful; it looks like a sweet shop.
Marketing and selling a vape that looks like a mini pen drive or a highlighter is only done so it can be secreted and make it difficult to catch students with them. We have had instances where part of the vape can be slipped into a bra, so we cannot search and find it. As I was saying, it is difficult to know what is in the vapes or whether people are actually vaping, which leads to confrontation between teachers, children and parents.
More recently, one of the things we have found is that, although they are still fashionable, we have seen a lack of fashionableness around the single-use vapes, because of the impact on the environment and the hope that they will be banned. There is far more reluctance—with arguments caused—among children and parents not wanting to give up larger vapes, because they have paid for them, and that therefore brings parents into conflict with teachers when they want to claim back their children’s vapes. Sometimes those vapes are their parents’ vapes or, sometimes, vapes that they have spent a lot of money on. My view and that of colleagues that I am representing is that vapes are not being advertised to help people to cease smoking; they are being advertised to encourage people to take up a habit.
Q
Matthew Shanks: At the moment, there is a vacuum around an understanding of what vaping is and what it can and cannot do. I cannot talk to the health aspects, because I am not a health expert, but it is something that is not clear. Because it is not clear, that is enabling children to engage in it and parents to encourage children to engage in it. There are instances of parents giving it as a reward because it is not a cigarette and they therefore see it as being “safe”. I think the Bill will help with that.
What is really important is the messaging and the education around the harm that vaping can do to young people and to adults as well. We need to bring it back to the original reason why vaping came about in the first place, which, as far as I was concerned, was about ceasing smoking. Lots of my friends took up vaping to cease smoking. They do not vape any more or smoke, but lots of children vape who would never contemplate smoking.
Q
Matthew Shanks: Children are very clever, and they will find a way round. On the other hand, far be it from me to sit here as a teacher and talk about funding, but vape detectors would cost money. Smoke detectors are in schools anyway, so it is far simpler. I think children will find a way around it. We saw a real decrease in cigarette smoking with the advertising and marketing. I have been teaching for 30 years, and we saw a decrease in that, but you cannot win an argument at the moment with parents or children talking about the dangers of vaping. That is the hardest thing.
Q
Matthew Shanks: Yes—very much so.
Q
Matthew Shanks: I think it will, but for some it will not unless it has the education behind it as well. I also think it is too easy for children to purchase vapes. It is all very nice to think of shopkeepers not allowing children to buy vapes or tobacco if they are under age. I am not denigrating them, but we have instances, for example, of a year 9 child who had a loyalty card for a vape shop. She is 13 years of age—she did not look 18—yet she is being sold that at the local shop. You go in and talk to the local shop and they say that no, of course they have not sold it to her, and then there is conflict there. We need to look at the legality of it and sterner punishment, for want of a better word, for people who are found to be selling.
The drop box online purchasing industry also needs to be looked at. I do not know how, but again, we know that people purchase vapes from those places. The education side is for parents, because parents and older brothers and sisters think it is safe and will therefore give them a vape. The Bill will help, but there are other things that could help as well.
Q
Matthew Shanks: Packaging and flavouring is really important. As I said before, it is set out as if it were sweets and bubblegum. Why would you need these different flavours? Why are they making something more attractive that is meant to help you stop doing something, so that if you do not like one flavour, you can try lots of them, and collect the different coloured vapes, or build them up into towers? Addressing all those things would help. Linking vaping with smoking, in terms of not being able to purchase it as you go up the age range, would also help.
Vape-free zones are really important. People are vaping indoors. I have seen it today in London on the tube, in pubs and other places—I have not been in a pub today, by the way; that was over the Christmas period, but people are vaping in pubs in the way they used to with cigarette smoke. Again, it is not seen as something dangerous.
If you put all that out there and then put children into the mix and they are looking up and seeing the colourful packaging, the flavouring and so on, why would they not do this?
Q
Matthew Shanks: Yes. My question would be: why would we not?
Looking at the number of Members who wish to ask questions and the amount of time that we have left, I ask Members to be short in their questions and the panellist to be short in his answers.
Q
Matthew Shanks: I would say yes to the second point, but I would aim the campaign at everybody, because we also need to educate parents to get them to understand. On the first point, I think people who want to find ways of rewarding people to get them to join things that are not appropriate will find something, and vapes are something that is being used at the moment. I am not saying that this Bill will stop that happening, because people will always find ways, but it will certainly help the majority of people to see that vaping is not something they should engage with.
Q
Matthew Shanks: Yes, I think the online area is hugely influential for children. It is where they spend a lot of their time—a huge amount of their time—so it would be really good if this Bill could look at that as well. I do not receive any online marketing adverts for vaping, but I am not 13 years old. I bet if I was, I would, so I think that is an element to look at.
Q
Matthew Shanks: I think the appearance and location of vape shops are important, so there could be better regulation around that. We have talked already about sponsorship bans. We have talked about raising the age of sale for vapes. I think vape packages should have the same kind of warnings that cigarette packages have on them. I really think so, because at the moment, they do not—and why would they not, if it is a cessation? “You are going to stop that, but you could still get this, so actually, we want to stop that.” Ultimately, that is what we should be aiming for.
I think the young people parenting support provisions are engaged in that, because as I have said, parents see this as a way of enticing children back into school or helping them or taking away an argument. You have to appreciate that I am not criticising parents, because they have a tricky job to get them back in. They see this as something safe and think they are caring for their child, so if we make it clear that actually it is not, that will be really important.
I have talked about vape detectors being useful in schools, but would it not be good if actually these things were banned? Then they could not be there. From that point of view, I think it is important.
Q
Matthew Shanks: Yes, but not on its own. It would help, but people will find a way to get something if they want it—we know that. The price hike without the education might increase other instances of unpleasantness between people, such as bullying, bribing, theft and so on. It has to come alongside education. The whole message needs to be that vaping is not something for children to engage in. It is something to help people to stop smoking. That is my view and the view of educators.
Q
Matthew Shanks: It is not that they are not an issue—
I meant that I was pretty surprised that they are such a predominant issue. I would have presumed that disposable vapes were the predominant issue.
Matthew Shanks: Oh yes, they are a huge issue.
Q
Matthew Shanks: The reason disposable, single-use vapes are more popular is that there is less to carry, so it is easier to secrete, hide and get rid of. Refillable vapes are fiddly to fill up, for a start. That is something that is not appealing, if you do not have that speed—I am conjecturing here around it. However, the flavours and colours are certainly something that influences and impacts children using vapes. As I say, I think the size of the single-use, disposable vapes is an issue. We have said, for example, that single-use vapes are banned anywhere on site, which means that parents cannot bring them in as well. What we have then seen in some of our schools is more children bringing in their parents’ vapes, and when you catch them with those, that brings conflict in. I was not trying to imply that people were not still using them, we just cannot necessarily know.
Q
Matthew Shanks: At the moment I would take anything that is not coloured and does not make it look like it is candy, to be honest, in the American version. They are like sweets, and when you walk in to shops, they are in your face with the way they are placed. They are not behind a screen shutter. Yes, the health benefits are not known in the same way, but I would like to see a move towards that for packaging. I would welcome anything that tells children that this is not something that is safe or recreational or a reward, and it will not help them to have a better life or to study better within school because it relaxes them—all those things.
Q
Matthew Shanks: No, with the refillable ones it is the way that the flavours are displayed, as well. It is not just the disposable vapes; it is all vaping. You can go into a shop with a refillable and buy four different flavours in four different colours to refill at a different time, and you all have a different toke of a different type of flavouring. That is exciting and different, because it is a reward and it is pleasant and it can help you to be calm.
I thank Matthew Shanks for his evidence today. It has been very interesting and stimulating for those of us who do not know much about vapes. I am sure we will take a lot of what he said into consideration in our deliberations.
Examination of Witness
Dr Laura Squire OBE gave evidence.
Now that things have settled a bit, I welcome Dr Laura Squire OBE, from whom we will now hear evidence. She is chief healthcare quality and access officer for the Medicines and Healthcare products Regulatory Agency. For this panel, we have until 4.30 pm, which is obviously 20 minutes.
Q
Dr Laura Squire: Thank you very much for that question—I welcome the chance to answer it. As you say, we are a healthcare products regulatory agency. That is what we are about. When a medical product comes to us, it has a medical purpose. For example, it might be something that is prescribed to help someone deal with issues of nicotine withdrawal and to get them off a product. That would be licensed as a medicine because the active ingredient in it is a medicine. The Medical Devices Regulations 2002 sometimes come into that too.
In order to give a licence to a product such as that, the manufacturer that has produced it will need to give us a dossier that has clinical and quality evidence in it—all sorts of things that go through a detailed assessment by our very skilled assessors, some of whom are medics and some of whom are skilled in pharmacy and also look at quality.
It is important to say that when we license any medical product, we do not say, “This product is safe.” We consider the risks and benefits of the product, and if the benefits outweigh the risks, we will give it a licence. We always say that medicines are not safe things, so if you do not need them for the benefits, do not take them.
The approach that we take on consumer products is very different. That is not an assessment process; it is a notification scheme that we undertake under the Tobacco and Related Products Regulations 2016, whereas before I was talking about the Human Medicines Regulations 2012 and the Medical Devices Regulations. Under the Tobacco and Related Products Regulations, we basically have a notification scheme. The manufacturer of a consumer e-cigarette would have to come to us and show that the product has the 20 mg, and that the refill container has no more than 10 ml, and then there are some limited labelling requirements. But we do not inspect or test that product; it is a data check to see whether those things are true, and then it goes on to the register. It is a very simple notification scheme, which is very helpful in terms of having a single record of what is out there on the market, but it is nowhere near the sort of assessment that we would do if it were a prescribed product that was proven to help people stop smoking.
The other role, once any product within our remit is on the market, is post-market surveillance. We have something called the yellow card scheme—people may have heard much more about it during the pandemic—whereby anybody can report a problem with a product. That covers consumer vapes, medical e-cigarettes and other nicotine-containing products that we might license.
We examine all the reports that we get, and if there is a signal that there is a problem, we sometimes issue a safety communication. We did that a couple of years ago when there was some evidence of lung damage. We have that role, and we often co-operate with other organisations where there is a need for enforcement. We heard from trading standards earlier, which does that. The roles are very different.
Q
Dr Laura Squire: I do not have any evidence of that, but it does worry me. We are an organisation that is about healthcare products, medicines, medical devices and blood products—that is our business—and it concerns me that people might think that vapes are safe. When I talk about risk-benefit, what I mean is that vapes are safer than tobacco; I do not think that anyone disagrees with that. However, vapes are not safer than nothing—and we do not actually know how unsafe vapes are, because there is a need for much longer-term study and understanding of the damage that they could cause.
My feeling is that, yes, there is potentially a misleading position with an organisation like ours, which is basically about healthcare products, running this scheme.
Q
Dr Laura Squire: I think we heard earlier about the different elements you need to make something work—licensing, regulations and registration—and I agree with that. I think it was also mentioned that registration is important to allow compliant businesses to check that the product that they have is compliant.
The significant problem with the notification scheme at the moment is that there is not an easy way to take something off the register once it is already on it. That is a problem, because if people are checking the current register, there might be something on it that we would quite like to take off but cannot.
There are powers to take things off the shelves, so if there was a recall issue, that could be dealt with. However, the main problem, or the primary thing in the Bill that I think needs to change, is having powers to take things off the register. Obviously, we must consult on the regulations themselves, but we welcome that change.
Q
Dr Laura Squire: I think somebody talked earlier about the package; the Bill is more than the notification scheme, and I think the whole thing works together to make a much safer environment. I was particularly pleased to see that there is a requirement to carry out studies and a requirement to carry out testing. We are sometimes asked about testing. Testing at the point of registration is one thing, but you need to know that the product remains compliant.
Obviously, there must be consultation about exactly what will go into the regulations, but I would expect that there would be an awful lot more linked to the other requirements of the Bill, and that will make it tighter. I think that would be an improvement, because at the moment the Bill is very light-touch.
Q
Dr Laura Squire: For a medicines licence?
Q
Dr Laura Squire: That is a difficult one. We had one product that was given a medicines licence in 2015, but it has never been marketed. We continue to try to encourage people to come forward to get medicines licences. However, the reality is that there is such a huge discrepancy between what you can do with a consumer product if you are a manufacturer, in order to get it out there and get it on the market, and what you would have to do to get a licence for it as a medicine—and that is quite right.
What this scheme does is to make it more demanding to be a manufacturer of a consumer product and put more requirement on it. To a certain extent, that reduces the differential between the two, which is welcome. We really continue to encourage people to come forward and talk to us about licensing products. One of the things that will be interesting is the impact this will have on the narrative out there—which was talked about by the previous witness—that vapes are safe. This will perhaps change that narrative and make people realise. All I can say is that we stand ready for more applications for medical licences. We put out some detailed guidance in 2022 to try to encourage manufacturers to do this, and we actually have one coming through the pipeline at the moment. So it will be interesting to see but hard to predict.
Q
Dr Laura Squire: With the current notification scheme, we have the resource that we need to do that. As the registration scheme becomes more detailed and demanding, and as there is more in it, I would expect that to require more resource. That is something that we need to continue talking to the Department of Health about as it develops the policy, and we will do that.
Also, as part of that, the impact on us will depend on not only what is in the regulation but who does it. I know that there are conversations about where it is best done, and there are registrations for other consumer products that already exist, so there are conversations happening with the Office of Product Safety and Standards. It is important to learn from those sorts of schemes that are already happening. Where that goes is a policy decision for the Department of Health and Social Care, and we will continue to work with it. I think it would also involve being clear about what resources we might need if we carry on and need more. At the moment, we have what we need to do what we need to do under the current law.
Q
Dr Laura Squire: They would do if it was a licensed product.
Q
Dr Laura Squire: There are not, which is why that is the way we would prefer to do it. Again, if we licensed these consumer products as a medicine, there are very strict requirements on labelling and on what needs to be given to the patient to explain what the product is and its risks. That is not there with these consumer cigarettes. It is going to get stricter under the new rules, but my preference would be that we give people more information.
Q
Dr Laura Squire: It depends on what happens with the actual regulations. At the moment, we do not have powers to test consumer e-cigarettes—that power sits with trading standards. Again, if we license something as a medicine, we go into absolute detail about what is in it. At the moment, it depends on what is in the regulations that come round. We do not do testing at the moment, and it would be important to think about the point at which any testing is done. If it is done at the point where something goes on to the register, that is fine and it tells you that the sample we saw at that point was compliant. But what happens later down the track? I think the role that trading standards has in doing that testing is really important, because it can do it post-market at any point. The question really is about the role of the MHRA—a medicines and healthcare products agency. Is it getting deeper into these consumer products where the risk is not outweighed by the benefits? That is an uncomfortable position for a medicines regulator.
Q
Dr Laura Squire: I do not have a view on whether a vape should be a medicinal product. I have a view on the role of the Medicines and Healthcare products Regulatory Agency in regulating products that are not medical products, which is a little confusing at the moment. As I said, when something is a medical product, as with any medicine, you would not take it if you were not ill, because the benefits are not outweighed by the risks. That is really my point. I am pleased to see the strengthening in this area. There are conversations that are still to happen, as the consultation goes through and we understand exactly what the new registration scheme will involve, as to the best people to do this, to give the right message out to the public.
Are there any more questions to this panellist? If not, I thank Dr Squire on behalf of the Committee. I am sure that a lot of your evidence will be taken into consideration.
Examination of Witnesses
Professor Steve Turner and Professor Sanjay Agrawal gave evidence.
For this panel we have Professor Steve Turner, the president of the Royal College of Paediatrics and Child Health, and Professor Sanjay Agrawal, the special adviser on tobacco at the Royal College of Physicians. We have until 4.50 pm for this panel.
Q
Professor Steve Turner: I will answer that question. Thank you for accommodating me; I have flown a long way. I thank Professor Bauld for reshuffling the order of the panels. I am passionate about this issue, and I am grateful to be able to contribute.
Vaping is harmful for children, and the evidence is accumulating. Vapes contain nicotine, which is harmful to us as human beings. You have heard previously from Matthew Shanks of the Secondary Headteacher Reference Group about the impact of vaping on children’s education. There are evidences of children coming to harm from vaping devices bursting into flames. There is a lot of talk about something called popcorn lung, which fortunately is very rare, but it is very serious and can affect children who vape. Collectively, there is already a substantial burden of evidence that vaping is harmful for children.
Q
Professor Steve Turner: The Royal College has 24,000 paediatricians in the UK and overseas, so we are a substantial college. We strongly support the Bill as it is. We believe that it provides the right protection for the most vulnerable members of our society—our children, who are our future—and that it is proportionate. We think the Bill as it stands addresses all the concerns that you just raised, and others.
Q
Professor Sanjay Agrawal: The majority of adults who vape have smoked, so they are using vapes to quit smoking. The amount of research that looks at populations who have never smoked, who have only vaped, is actually quite small—the longitudinal studies are still not there. We know from shorter-term studies that vaping can lead to things like coughing and throat irritation, but it is important to consider the alternative, which is continued smoking.
I estimate that, in the roughly 30 years since I qualified and started professional practice, about 3 million people in the UK have died from smoking tobacco. The intensive care unit in which I work and the lung cancer clinics that I do are full of people who have come to harm from accrued smoking. There should be no doubt that smoking combusted tobacco is the key thing that we want to prevent future generations being subjected to. There are still 6 million smokers in the UK, and we need to help as many of them as we can to stop smoking. Vaping is one means by which they can stop smoking, and that is really important.
Q
Professor Sanjay Agrawal: There are a few things to unpack there. First, a lot of people who smoke and who want to give up use vapes because they have tried other products and have not been able to give up, be that nicotine replacement therapy or tablet pharmacotherapy. One thing those people want to get away from is the taste of tobacco, and having flavours allows them to do that. Actually, other NRT products, such as gums and lozenges, also have fruit flavours—it is not just vapes. Flavours are an integral part of helping people to get away from smoking.
Equally, as we know, flavours attract young people to smoking, so it is really important that we limit the number of them. However, the flavour descriptors are perhaps more important: I think we need to make them bland. The Bill, as it stands, provides powers to restrict all sorts of elements related to vaping, such as the number of flavours, the descriptors, the packaging, the appeal and the advertising. Having bland descriptors and eliminating flavours that we know are popular among children would be really helpful.
Q
Professor Sanjay Agrawal: First, there is good survey evidence of what is popular among adult smokers who are using vapes to try to quit, so that is one helpful factor. Then there are flavourings that are potentially associated with harm. Cinnamaldehyde has been associated with harm, so that would be one, for example, that you would remove.
Q
Professor Sanjay Agrawal: No.
Q
Professor Steve Turner: Smoking is bad whether you are an active smoker or a passive smoker. Sadly, there are lots of children who still actively smoke, but there are many hundreds of thousands of children who are exposed to second-hand smoke in the home. There is undeniable evidence that that exposure is harmful. I do respiratory paediatrics. Asthma admissions are very common and are clearly associated with exposures.
We can look at natural experiments. For example, in Scotland we had the “Take it right outside” campaign, which was a smoke-free homes initiative. After that, there was a reduction in the number of children coming into hospital. When we brought in the ban on smoking in cars in Scotland, there was another reduction. On that whole-population basis, there is a lot of evidence of benefit to the population, particularly children, from smoking interventions. There are also benefits to the birth weight of children.
There is no doubt that there is a huge amount of harm from second-hand smoke, and anything that reduces the population’s exposure to second-hand smoke will benefit the whole population. As we heard earlier from Matthew, the headteacher, it is part of a package, and it is part of education as well. Smoking continues to be something that children should not do. Children should never vape. Children should never smoke. They continue to do so, and anything that we as a responsible society can do to stop that is to everybody’s benefit.
Q
Professor Steve Turner: Children are very susceptible and can be easily influenced, and they are learning all the time. If they see that it is okay to watch your child’s football match and smoke, or to smoke outside a pub, they will very quickly adapt and think that that is a social norm. There is a powerful social norm exercise there about what we as a society expect is normal, and approving smoking outside hospitals seems to be such a bad, conflicting message. To me, that argument in itself is very powerful.
There were a number of people back in the early noughties who felt that the smoke-free legislation might not have much benefit on pregnancy—why on earth would that reduce low birth weight and premature delivery? Well, it did. That was probably the snowballing effect of stopping smoking in pubs, for example—I think the whole of society changed its attitude and behaviour around smoking. So, going back to the original question, I think that putting restrictions in public spaces will change that social norm to everybody’s benefit.
Q
Professor Steve Turner: That is a really good question. I think that the balance in this Bill—between supporting the 6 million smokers to quit and not engaging children in nicotine addiction—is the right balance. Going back to what I was saying earlier, getting the message across to young people is a multifaceted intervention that requires education as well as legislation. It is a really difficult balance, but I do believe that the Bill, as it is, has that balance just right.
Q
Professor Steve Turner: The impact on the whole of society of second-hand smoking in children is complex, but there are various pieces of the jigsaw. First of all, children come to the clinic, are admitted to hospital, come to the emergency department, or go and see the GP, so there is that healthcare side. If any of you have children, however, when your child is off school, that has implications for you as a family; there are some difficult discussions over breakfast about who is going to work and who is not. Therefore, there are a number of different impacts on us as a society, economically and to the NHS from second-hand smoking.
I am not clever enough to put a number on it, but it is a lot bigger than I think people know. I do know that £46 billion is the number cited as the direct health cost to the NHS of smoking—it is almost too big to consider—but I suspect that the wider societal cost will probably be a magnitude greater than that.
Q
Professor Steve Turner: The children who are exposed to second-hand smoke in the home are over-represented among children with respiratory symptoms. Parents do not want their children to smoke, so they feel torn. They are conflicted: they are addicted to nicotine, but they do not want their children to smoke, and having a smoke-free generation will address that almost impossible parental conflict.
Q
Professor Steve Turner: I support the Bill as it stands. I think that the onus has to be on the vendor not to sell, not on criminalising the customer or the child.
Q
I am particularly thinking about vaping here, given that I think there is pretty unanimous agreement on the tobacco side. Therefore, just on vaping, is there any more that you think the Bill could do, not necessarily in terms of vaping as a cessation tool to support the transition from smoking, but in terms of preventing people—obviously children, but even just adults—from beginning that journey and vaping in the first place?
Professor Sanjay Agrawal: From my standpoint, there are the online harms—for example, through social media, gaming and music videos. It is a wild west out there—regarding both tobacco and vapes, actually—and there are lots of depictions that lure people in. There is a lot of advertising and promotion of both tobacco and vaping products. I think that that online and social media area is the one area that we could do much more with. That would strengthen the Bill further.
Q
Professor Sanjay Agrawal: I have not yet had the chance to say this, but first, I think the Bill is really well balanced. It is bold and world leading; all nicotine products and non-nicotine containing vapes are part of it. The people who put this together should be congratulated, but we also have to be aware that industry never sleeps. It will try to adapt to regulation and legislation, and we need to be wary of that and make sure that we use the powers in the Bill in the future, depending on how industry responds.
For example, with disposable vapes, which are due to be banned later this year, I am sure that there will be a lot of companies right now changing their products to make them look as though they are not disposable vapes when, to all intents and purposes, they are. There will be lots of adaptation by industry that we must be wary about. The Bill provides those future powers for us to adapt to industry.
Q
Professor Steve Turner: Touching on what I have said before, there are communities, invariably the poorer communities, in something called the tobacco map. If you look at the areas where tobacco use is greatest, it maps totally on top of deprivation. We have an opportunity to break that generational social norm of, “It’s okay to smoke.” The people who come to the greatest harm from cigarette smoking and nicotine addiction are invariably the poorest. What is proposed here will be a good step towards narrowing the divide we see in this country in health outcomes, which is totally determined by poverty.
Professor Sanjay Agrawal: We estimate that around 350 children a day start to smoke. A lot of those will be from the most deprived communities. In addition, smoking in the UK brings around a quarter of a million families into poverty, and those families have children. The Bill will go a long way to not only reducing the health harms to individuals, but reducing poverty and hopefully smoking-related deprivation.
To answer one of the questions earlier about the cost of smoking to the NHS, it is estimated that it costs secondary care about £1 billion a year. With primary care in addition, that is a total cost of £2.6 billion to the NHS, around £20 billion a year to social care, and about £50 billion a year in lost productivity. That is the overall cost of smoking to our society, whether at the level of the individual, poverty, deprivation, social care or workforce productivity, and that is why the Bill is so important.
Q
Professor Sanjay Agrawal: These additional measures warn people away from smoking—those who might be looking at the packaging or the individual cigarette. Remember, an individual cigarette—every time someone takes out a cigarette—is an advertisement for cigarettes. Lots of times, children are sold cigarettes on a per-cigarette basis, and they have never actually seen the packet; they have only seen the cigarettes. Therefore, having on-cigarette warnings is another measure that we can introduce to warn people off the harms of smoking. It would be great to see that.
I was incorrect; we have until 5 o’clock, rather than 4.50 pm, which is now. Do we have any more questions from Members? No. In that case, I thank Professor Turner and Professor Agrawal for giving evidence, which I am sure will be useful to the Committee in its deliberations. The next panellist happens to be the Minister. Instead of asking questions, he will come under fire from his own Committee.
Examination of Witness
Andrew Gwynne MP gave evidence.
For the record, our final witness is Andrew Gwynne MP, Parliamentary Under-Secretary of State for Public Health and Prevention at the Department of Health and Social Care. We have until 5.20 pm.
Q
Andrew Gwynne: Thank you for that question. I was not actually on the Bill Committee when the previous iteration of this measure went through Parliament, because I was the shadow Social Care Minister—I had been bumped away from public health, only to return to it in government.
The starting point is a recognition that the previous Government brought forward a Tobacco and Vapes Bill, which was incredibly foresighted of them. I thank those—including you—who supported that proposed legislation. We have to be mindful of the fact that the first thing we are seeking to do is to make the United Kingdom smoke-free, and smoke-free as soon as possible. As we heard from the chief medical officers from the various nations that make up the United Kingdom, tobacco is a killer. Our first target has to be driving down the instances of smoking and, as a consequence, of tobacco-related death and illness, and the harms caused by second-hand smoking. That is why the measures in so far as tobacco is concerned are far weightier than the measures in respect of vaping.
The other thing I would like to say in answer to your question—this is an important point; we are concerned about nicotine addiction—is that we need to get the balance right. We recognise that vaping is an important smoking cessation tool—as the CMO said, not all countries share that point of view, but in the United Kingdom we see it as an important part of the package to help people to quit smoking. There has been a very successful scheme in this country, the Swap to Stop initiative, and that is an important part of this.
We are really concerned about the scourge of child and youth vaping, however, and that is why we think that the measures in the Bill are proportionate, because we are tackling a specific issue: stopping children taking up vaping and trying to dissuade adults who have never smoked from taking up vaping. As the CMOs have said, vaping is better than smoking, but not vaping and not smoking is the best option of all.
This is a proportionate measure. As you know, we are seeking quite far-ranging powers, and that is to ensure that, across the four nations, we can react as industry reacts to these changes so that this Bill will be future-proof. If we were overly prescriptive, we would then have to come back to Parliament with further primary legislation. While we are not seeking to be nicotine free at this moment in time, there will be powers in the Bill that allow, at some stage in the future, the Governments that make up the United Kingdom to consult to go further. The aim now is to stop smoking, to get to our smoke-free targets and to crack down on childhood vaping.
Q
My other question is about advertising. You will be aware that I put forward an amendment to the Conservative Bill to try to restrict advertising, because I think it is important to try to restrict advertising to children. How will health professionals who are promoting vaping as an alternative to smoking specifically in a medical setting, not necessarily on the tube or the side of a bus, be protected from being criminalised?
Andrew Gwynne: This is an area in which this Bill really does build on the previous Government’s iteration of the Bill. I want to take the politics out of it and thank Members such as yourself who really pushed this last time round. We are able to do this because it was a commitment of the Labour party in the 2024 manifesto that we would ban the advertising of vapes and the promotion of vapes in sponsorship. There is 75% support for an advertising ban on vapes.
In terms of being able to promote vapes as a quit aid, of course, you will have read in part 6 of the Bill that it is only an offence if advertising is done in the course of business. That excludes the promotion of vapes as a quit aid. That is something that hopefully you will welcome.
Q
Andrew Gwynne: Oh, you will get me on my hobby horse, having mentioned bongs. All tobacco products will be covered by the measures in this Bill. Shisha is covered. Shisha is a harmful product, as are other tobacco products. In respect of paraphernalia, I have raised with officials and colleagues in the Home Office what I see as a potential issue: if this Bill becomes law, as I hope it will, and there is further consultation on the packaging and display of vapes, we could end up with a situation where vapes, like cigarettes and other tobacco products, are hidden behind cabinets in plain packages, but those same newsagents have bongs in the window. I am assured by my officials that bongs and grinders can also be used for the consumption of tobacco, and therefore will fall within the scope of the measures in this Bill in that they will not be able to be displayed.
Q
Andrew Gwynne: Well, we cannot easily do so. The powers in the Bill mean that we have a statutory duty to consult. As we have already heard, Wales already covers the areas that we wish to consult on in respect of England. Scotland, Northern Ireland and Wales will have their own consultations. But as far as England is concerned, the Government have been very clear that, should this Bill pass, we will consult on implementing smoke-free areas outdoors around children’s playgrounds and schools and outside hospitals.
Given the media interest and speculation over the summer as to outdoor areas to which the Government might extend the outdoor restrictions, including hospitality, it would not be possible for any Government to just wake up one day and decide they were going to extend these measures to x, y and z and for nobody to notice. It would be on the front cover of every newspaper and all over X, Facebook, Bluesky and other social media. People would be very aware of a Government’s intentions to extend outdoor smoking and we would be under a statutory duty to consult and to pursue secondary legislation, which is ultimately subject to a vote of the House.
Q
Andrew Gwynne: That is a really important question. It is why, at every opportunity today, I have been asking those with an interest in public health in Wales what lessons we can learn. We want to get this right. The reality is that alongside the package of enforcement we will bring forward—the registration; the licensing scheme; the fixed penalty notices—we have to approach this with a degree of proportionality, particularly to ensure that there is as good a compliance with the regulations as possible.
Most people are law-abiding citizens, and we saw with the indoor smoking ban introduced in 2006-07 that most people complied from day one. I really expect that most people will comply in respect of children’s playgrounds, schools and hospitals. I would hope that the enforcement agencies use a degree of discretion and proportionality at the outset to ensure that those not complying understand that they are potentially breaking the law and should stop doing what they are doing.
We have about 15 minutes left, and five Members wish to ask questions. Could they do that briefly, and could we have brief answers too?
Q
Andrew Gwynne: The short answer to both those questions is yes. We have committed to an investment across HMRC, trading standards and Border Force of £100 billion over the next five years to enforce these measures—sorry, it is £100 million. The Treasury will be having a fit; I am getting my billions and millions wrong. I wish it was £100 billion.
As far as public health campaigns are concerned, just this week we committed £70 million for smoking cessation. For this new year, I have signed off a concerted public health campaign for smoking cessation on social and broadcast media. As this Bill progresses and becomes law, there will be a huge public health publicity campaign so that everybody is aware of our Smokefree 2030 target ambitions.
Q
Secondly, could you make a wider comment on the historical context of the Bill? In 2006, it was a Scottish Labour Government in the Scottish Parliament who set in train some of the processes that we are trying to finish today. Over those 14 to 15 years, we have seen many positive short-term and long-term public health outcomes. What do you think will be history’s judgment on this portion of that journey?
Could you make the answer shorter than the question?
Andrew Gwynne: Those are two very good questions. This Bill is a landmark piece of legislation. I think it will be the biggest advance in public health for a generation. It will be a truly historic thing. What a wonderful thing to say that, in the near future, no child born after 1 January 2009 will ever legally be able to be sold tobacco. That leads me on to your first point: tobacco is a killer. It kills about 80,000 people in this country a year. It is responsible for a quarter of all cancers. It puts enormous pressure on our NHS and our economy.
The death rate for somebody in a more deprived part of our country is more than two times higher as a consequence of smoking. There is no reason beyond smoking why the life chances of somebody living and growing up in Richmond are so much better than those of somebody growing up and living in Blackpool. It is because the smoking prevalence for somebody growing up in Richmond is about 4.6%, whereas for somebody living in Blackpool it is over 20%. This will save lives. This will narrow health inequalities. That is what all of us, irrespective of our parties, were brought here to do.
Q
Andrew Gwynne: We wanted to have a proportionate approach. We recognise the difficulty that the hospitality sector has gone through and is in. We listened to the voices of concern. I cannot speak for ministerial colleagues in Scotland, Wales and Northern Ireland, but, as far as England is concerned, we decided that we wanted to target outdoor smoke-free places to areas where children and the most vulnerable people are likely to be. That leads to the logical conclusion that we should target the outside of hospitals, where a lot of vulnerable people go through the doors, outside schools and outside children’s playgrounds.
Q
Andrew Gwynne: It is. The four nations that make up our United Kingdom have gone at different speeds and to different depths in terms of tobacco control over recent years. Zubir was absolutely right to point out that it was the Scottish Labour Government that first introduced the indoor smoking ban, and we followed suit soon after, but it is really important that the four nations stand together on this, not least because some of this does require a four-nation approach in legislative terms. It also means that we can meet this ambition together, and that we are all in this together, because, for me, a health inequality in parts of Greater Manchester is just as important as a health inequality in Glasgow, Cardiff or Belfast.
We need to tackle these inequalities, because they are a scourge on our society. That is why a four-nation approach, alongside the permissive nature of this Bill, means that the four nations can go forward together, but also diverge on the basis of extending consultations and so on. That is why we have the support of the devolved nations and the Ministers, who come from different political persuasions across Northern Ireland, Wales and Scotland; we are all in one, as far as this Bill is concerned, and we have shaped it together.
Q
Andrew Gwynne: That is really important, and I want all Members to understand that a key aspect of reaching our smoke-free ambition is to drive down the prevalence of current smokers. That means a real investment in smoking cessation, a close eye on what is happening on the ground, and using the flexibilities in the Bill, should they be needed, to ensure that we reach that smoke-free ambition.
We announced £70 million of stop smoking funding this week, which has been weighted towards the areas with highest deprivation and smoking prevalence, so that we can try to drive down those inequalities. Obviously, future years funding is subject to the usual processes of the spending review, but let me make it clear that it is a priority of this Government to invest in stop-smoking services. We will ensure that local authorities and the public health functions of the country have the resources needed to reach a point where we are smoke free.
Q
Andrew Gwynne: That is an interesting question. First, there has been really close engagement between the UK Government and the devolved nations. We have the full support of Mike Nesbitt, the Northern Ireland Health Minister, who has helped shape the Bill, as have his officials. The UK Government and the Northern Ireland Executive are in close dialogue with colleagues in the Republic of Ireland to ensure that we discuss at length and in detail the cross-border issues. We will continue to engage with the Republic of Ireland to ensure that the Bill works. Only time will tell whether the Republic of Ireland will decide to follow suit, but the Bill will be a game changer and other countries will want to follow the United Kingdom’s lead.
In the short time we have left I cannot allow any more questions.
Ordered, That further consideration be now adjourned. —(Taiwo Owatemi.)