Tobacco and Vapes Bill (Second sitting)

(Limited Text - Ministerial Extracts only)

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[The Chair]

Andrew Gwynne wishes to move an amendment to the programme motion.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I beg to move a manuscript amendment:

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—

[The Chair]

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.

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[Dr Beccy Cooper (Worthing West) (Lab)]

Q Thank you for coming to give evidence this afternoon. As we have two of my fellow public health colleagues giving evidence, could I ask what the general response to the Bill has been from the public health community? Are there any significant suggestions from the public health community of areas that we should consider further?

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.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

Q I thank the LGA for the support and engagement that we have had in drawing up the measures. Do you think that the Bill gives local authorities the right tools in relation smoking and vaping? How can we best work with colleagues in local government to get this right and ensure that it is workable on the ground?

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.

[Andrew Gwynne]

Q Of course local government has been at the forefront of enforcing existing tobacco measures. What lessons can we learn from the experience of local government in terms of enforcement to date?

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.

[Andrew Gwynne]

Q Professor Daszkiewicz—I hope I have pronounced that right—we heard earlier from the chief medical officer of Wales and from representatives of Action on Smoking and Health Wales about the extension of outdoor smoke-free spaces in Wales. What can we learn from the experiences of Wales in extending to schools, hospitals and children’s playgrounds?

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.

[Andrew Gwynne]

Q The measures in the Bill include the introduction of a licensing scheme for England, for Wales and for Northern Ireland. Scotland already has its own arrangements, which the Bill will seek to extend. What would you like to see from a licensing scheme?

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.

[Tristan Osborne (Chatham and Aylesford) (Lab)]

Q My first question is on the enforcement element. We have had some correspondence and feedback that the £200 level is too low. I wonder whether councils or the Local Government Association have a view on the appropriate level. Conversely, if the level were too high, it would potentially damage high streets by loss of trade and shops closing because of fear. Is there a worry in the local government community that we could see high street shops closing as a result of enforcement? Again, those are some of the comments coming out of the correspondence we have received.

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.

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[Dr Johnson]

Q The last time I was asked for ID —when I was trying to buy a bottle of champagne, an orchid and a punnet of strawberries in a major supermarket—I was 38, so it would seem we are not very good at working out how old people are, or some people are not. We are going to ask people to decide not just if someone is younger than 25, but potentially if they are younger than 45 or 35. Is that going to be difficult for people to do?

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.

[Andrew Gwynne]

Q Welcome, Professor Bauld. What impact have tobacco control measures had on smoking rates over time? What impact do you expect this Bill to have?

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.

[Andrew Gwynne]

Q In an earlier answer that you gave to the shadow Minister, you talked about the two priorities of preventing new smoking and tackling youth vaping, alongside supporting the 6 million to quit. The Bill seeks to reduce youth vaping. How do you think we best achieve that while not deterring adult smokers from quitting?

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.

[Liz Jarvis (Eastleigh) (LD)]

Q Do you think the Bill goes far enough to protect children and young people from the harmful effects of tobacco and vaping?

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.

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[Sadik Al-Hassan]

Q We have spoken a bit about the gradual change and about that preventing uptake, but how does the gradual change in the age of sale affect the impact on tobacco and vaping behaviour, compared with increasing the age of sale in one go? That is based on comments we have heard about the difficulty in asking people’s ages at 34 or 35—I think most people have no problem knowing I am old enough for most things nowadays.

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.

[The Lord Commissioner of His Majesty’s Treasury (Taiwo Owatemi)]

Q We have spoken briefly about this. Are you concerned that introducing a generational ban on cigarettes might cause other forms of tobacco use to increase among younger generations?

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.

[The Chair]

I call Jim Dickson.

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[Dr Johnson]

Thank you, that is a really helpful answer. We know that vapes are very difficult to dispose of and to recycle.

[Andrew Gwynne]

Q I have a very similar question to the shadow Minister’s. She asked whether you are confident that trading standards will have the resources to enforce the measures in this Bill. My question is: are you confident that trading standards will have the right powers to enforce the measures in this Bill?

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.

[Andrew Gwynne]

Q One of the issues that came up on Second Reading and in the previous iteration of this Bill is that some people question whether moving to a smoke-free generation policy risks a growth in the black market and illicit trade. Does that accord with your experience of the illicit tobacco market and previous tobacco control measures?

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.

[Andrew Gwynne]

Q Finally from me, in the previous iteration of this Bill, the fixed penalty notices were to be set at £100. There was criticism and concern from trading standards representatives, who advocated for increasing the value of the fixed penalty notice. Notwithstanding your answer to the shadow Minister’s question, do you think that doubling the fixed penalty notice to £200 strikes a better balance?

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.

[Sarah Bool (South Northamptonshire) (Con)]

Q To build on a point my hon. Friend the Member for Sleaford and North Hykeham made a moment ago, the Scottish Grocers’ Federation has indicated in some of the information it sent to us that, in its latest crime report, the most prevalent cause of threatening behaviour in stores is the refusal of sale and asking for proof of age. I am concerned about that rise in retail crime and what more can be done. I know that the education piece is needed, but is any thought being given to how we can further prevent some of these problems?

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.

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[The Chair]

I call the Minister.

[Andrew Gwynne]

Q Welcome to the Committee. Can you outline the lessons from the introduction of previous tobacco control policies, for example on age of sale change, which we can consider as we introduce the measures in the Bill?

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.

[Andrew Gwynne]

Q On proof of age and identification, which do you think is more complex? Is it having to work out, on a daily basis, whether somebody is over the age of 18 from their date of birth, or is it just being able to see that they were born after 1 January 2009?

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.

[Andrew Gwynne]

Q I am not sure whether you understood the question that I was asking. If I have a piece of ID that shows clearly that I was born after 1 January 2009, that is very simple to understand. If I say I was born on 4 June 1974, it is obvious that I am over 18, but if it was 2004 rather than 1974, you would have to calculate in your head what my age is.

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.

[Andrew Gwynne]

Q From their ID, you would.

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.

[Andrew Gwynne]

Q How can Government best support retailers to implement the changes in the Bill?

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.

[Andrew Gwynne]

Q I can assure you that there will be consultation with the sector. What would you want to see from a licensing scheme? Are there any lessons from supporting the implementation of alcohol licensing, for example?

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.

[Sadik Al-Hassan]

Q We talked a little bit about the new licensing scheme’s impact on retailers, and you have talked about a level playing field. You say that large companies should have one licence across multiple branches. How does that balance the risk that these measures will disproportionately impact small and independent retailers, which will have to apply for a licence for every individual premises?

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.

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[Dr Johnson]

Q Will this Bill help with that?

Matthew Shanks: Yes—very much so.

[Andrew Gwynne]

Q The shadow Minister is absolutely right to mention highlighter pens. You mentioned pen drives. There are examples of vapes that look like mobile phones. There are examples of vapes that are concealed within the hood strings of hoodies, so kids sucking on their hood strings are often vaping. It is clear that the industry is being very malicious in its approach to marketing vapes, which is why the Bill introduces a ban on advertising and sponsorship. Do you think that will have a material impact on dissuading children and young people from vaping?

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.

[Andrew Gwynne]

Q In terms of other measures in the Bill, advertising and sponsorship is one side of it, but another aspect will be bringing in regulations on flavours and packaging, subject to the Bill receiving Royal Assent. Do you think that will have an impact on youth vaping?

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?

[Andrew Gwynne]

Q Clearly, smoking rates have declined considerably in children and young people and, indeed, the wider population, but do you see the progressive age of sale for smoking as being another important tool to help to create a healthier generation of children and young people?

Matthew Shanks: Yes. My question would be: why would we not?

[The Chair]

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.

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[Dr Johnson]

Q You have explained that they are very different roles: in one, there is a level of safety that is checked; in the other, the manufacturers just notify that they are following the basic level of rules. When a customer buys a product, do you think that the suggestion that it is MHRA-approved leads the customer to believe that there is some evidence that it has been medically checked in some way by some higher competent authority, when that actually has not happened? In fact, would it be better for some other organisation to do this work, or for there to be a different name when the lower-level process has taken place?

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.

[Andrew Gwynne]

Q Welcome to the Committee, Dr Squire. I will ask two questions specifically about the notification scheme, which you very helpfully outlined to the Committee in your response to the shadow Minister. First, what do you think are the most pressing issues with the current notification scheme that you would like to see addressed in a new registration scheme?

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.

[Andrew Gwynne]

Q What do you see as the main differences between the current notification scheme and the scheme that the Bill creates powers to establish?

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.

[Taiwo Owatemi]

Q What effect do you think the Bill will have on the number of vaping products that the MHRA will have to approve through its licensing route?

Dr Laura Squire: For a medicines licence?

[Taiwo Owatemi]

Q Yes, for medicine licensing.

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.

[Taiwo Owatemi]

Q May I ask one more question? What is the MHRA’s capacity to handle the increased workload that the new legislation will require?

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.

[Sadik Al-Hassan]

Q When we give a new medicine to somebody, we give them advice and explain what it is and what it is safe to do with it. When people get vapes, do they get the right level of information and advice about what that product actually is and about the risks?

Dr Laura Squire: They would do if it was a licensed product.

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[Dr Johnson]

Q Okay, but you do not have specific evidence that compares flavours. Say the popular flavours are cherry and raspberry—you do not have anything that says which is safer.

Professor Sanjay Agrawal: No.

[Andrew Gwynne]

Q Welcome to the Committee, and I thank you both for your time. In answer to the shadow Minister, you have outlined some of the early impacts of vaping that we are seeing in patients. But I am interested in smoking—tobacco is a killer. Following on from the evidence this morning from the CMOs from across the UK, what impacts of smoking do you see in your patients—I include second-hand smoking in that analysis—and what difference do you think the measures in the Bill will make?

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.

[Andrew Gwynne]

Q The extension of smoke-free legislation to outdoor settings is of course subject to consultation, but in England we have made it very clear that we will be consulting on children’s playgrounds, schools and hospitals. Some have argued that the current public health test, which is in the 2006-07 legislation, should be applied going forward. Given that children’s playgrounds would almost certainly not meet that threshold, what is your argument in terms of protecting children from the harms of second-hand smoke?

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.

[Andrew Gwynne]

Q The Bill seeks to reduce youth vaping. How do you think we can best achieve that while not deterring adult smokers from quitting?

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.

[Dr Chambers]

Q Thank you for coming all the way down from Aberdeen; I worked there for a few years, so I know it is a long way. We have been trying to ask some panellists approximately what this issue is costing the NHS. As a consultant, in your clinic, doing respiratory paediatrics, what proportion of your patients are in some way involved with smoking or second-hand smoking?

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.

--- Later in debate ---

[The Chair]

Last, but certainly not least, I call Taiwo Owatemi.

[Taiwo Owatemi]

Q Following up on Alex’s question, what engagement has there been with the Irish Government in regard to the differences between what is happening in Ireland and Northern Ireland? Do you think that will lead to changes in Ireland, in terms of moving in a positive direction?

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.

[The Chair]

In the short time we have left I cannot allow any more questions.

Ordered, That further consideration be now adjourned. —(Taiwo Owatemi.)