NHS

Caroline Johnson Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

I most certainly do, and it is a pleasure to hear that my hon. Friend, who is such a great campaigner in his constituency, has that as a clear target for his area to represent his constituents. On the recruitment of general practitioners, we have set out, through our long-term workforce plan, our ambitions—and, importantly, the plans underlying those ambitions—to ensure that we recruit even more doctors, nurses, midwives, dentists, and so on, to build the NHS of the future. My hon. Friend might want to share this fact with his constituents: since 2010, there are more than 41,000 more doctors in our NHS in England and more than 73,000 more nurses. Those are figures to be proud of.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I associate myself with the good wishes that have been sent to you this morning, Madam Deputy Speaker.

Prevention is, of course, better than cure, so will my right hon. Friend confirm that she is doing all that she can to ensure that the Government’s world-leading Tobacco and Vapes Bill is passed during the wash-up? She knows of my concern about children’s exposure to vaping. If the Bill will not be passed through wash-up, will she confirm that a Conservative Government would act quickly, once re-elected, to protect our children from deadly nicotine addictions?

[Victoria Atkins]

I am very grateful to my hon. Friend, who, of course, brings her professional expertise into the Chamber. On the Bill, she will appreciate that we are at a very delicate stage, which I am not allowed to say anything about at the Dispatch Box, but she should be confident of my commitment, and that of the Prime Minister, to this important legislation and to a smoke-free generation.

Tobacco and Vapes Bill (Fifth sitting)

Caroline Johnson Excerpts

Committee stage
Thursday 9th May 2024 Public Bill Committees

[Preet Kaur Gill]

Right. However, that brings me to my second point. The Bill provides a number of powers for the Secretary of State to make secondary legislation, particularly on vapes. It is therefore important that we think carefully about how to achieve the objective of stopping young people from getting addicted to nicotine in the first place. Whoever the Government are after the next election, they will likely inherit those regulations, and some of them can be deceptively tricky to get right.

I want to ensure that whoever the next Government are, they have the powers they need to get a grip on this issue given that so recently this Government have not done so—when one in three vapes on the market is illicit, when youth vaping has trebled in two years, and when gaping loopholes in the law have undermined enforcement and put children at risk.

Vaping is a valuable stop-smoking tool, but those trends are a serious concern. There are areas where the Bill can be strengthened, and I hope the Minister will listen closely to our arguments. The Bill is an opportunity to think about not just the public health challenge as it manifests today, but the challenge we will face in 10 years’ time. That is what a real agenda on prevention must do.

When the last Labour Government took office, one in four people in the country was a smoker. Every pub we walked into was clouded with the fumes, and one in 10 of our 11 to 15-year-olds smoked. When we banned smoking in public spaces and raised the age of sale to 18, we were met with a lot of opposition. Some of the charges put to us were like the ones we heard on Second Reading: that the law would be unenforceable, that it was an attack on working people and their culture, that it would fuel the illicit market, and so on. None of them held up.

Today the idea that children should be allowed to smoke or that non-smokers should have to tolerate deadly second-hand smoke is unthinkable. No one would think of making those arguments now. Just as the opponents of that legislation were wrong then, they are wrong now. Since 2007, the number of people who smoke has been cut by almost a third. The percentage of 15-year-olds who smoke regularly has dropped from 20% to 3%, and our understanding of second-hand smoke has grown. There has been a culture shift around where it is acceptable to smoke. Even at home, people go outside to smoke instead of smoking in front of their children. The year after the smoking ban came into effect, there were 1,200 fewer hospital admissions for heart attacks according to The BMJ.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Could the hon. Lady tell me about the consumption of nicotine among people once the Government had brought in the smoking ban in public places? Was there a reduction in nicotine consumption among the people who continued to smoke because of the restrictions on where they could do so?

[Preet Kaur Gill]

I have just said that after the smoking ban came into effect, there were 1,200 fewer hospital admissions for heart attacks. We saw a drop in people smoking—the data from The BMJ is already out there. By working towards a smoke-free future by progressively raising the age of sale, I hope that this Parliament can leave a similar legacy.

I turn to clause 1 and its equivalents for the devolved nations—probably the most important clauses in the Bill. Clause 1 of course changes the age of sale for tobacco products from 18 to a set date of 1 January 2009, meaning that anyone born on or after that date will never be able to legally buy cigarettes. It will progressively raise the age of sale by one year every year, so that the generation who are 15 now will—we hope—never smoke.

When the shadow Secretary of State, my hon. Friend the Member for Ilford North (Wes Streeting), proposed the measure in January 2023, it was because we know that it will take fresh, radical thinking on public health to take the pressure off the NHS and get our ambition for a smoke-free future back on track. The rationale for the progressive approach, compared with what some MPs have argued for in raising the age of sale to 21, is that it is a radical but realistic way of phasing out tobacco over time. It means that no one loses a right they already have, but it does not limit its ambition to young people —there is no safe age to smoke.

I hope that a lead-in time of three years will be enough for us to get support to those under-18s who already smoke, so they are not affected by the time the legislation comes in. Will the Minister say whether she is planning a targeted campaign to ensure that we reach those young people, perhaps by working through schools? Almost two thirds of long-term smokers began smoking before they were 18. University College London has calculated that every day around 350 young adults aged 18 to 25 start smoking regularly, risking being trapped in a lifetime of addiction and premature death. The vast majority of smokers and ex-smokers—85%—regret ever starting in the first place, but it is infamously difficult to quit. Stopping people from starting is the single best way of saving them from a lifetime of potentially deadly addiction.

I reject the suggestion that the legislation will be uniquely difficult to implement or enforce. Labour raised the age of sale in 2007, and that is well understood and widely enforced.

Shopkeepers are already used to enforcing age of sale legislation, and we have initiatives like Challenge 25, so it would not be until 2034 that we enter the uncharted territory of routinely checking the age of customers who look 26 years old. I would expect by then that we would already be beginning to see a considerable reduction in the number of people still smoking under that age, but even then, arguably this legislation makes implementation easier: instead of having to ask for someone’s ID to compare their birth date against the current date, which involves doing maths in one’s head, it will be as simple as checking against one static date every time. I do not want to insult the intelligence of anyone working in retail, but that has formed part of the arguments of some of the Bill’s opponents, so I really want to call that out.

As for the right to feel protected and confident in their jobs, there is no doubt that violence against shop workers has risen in recent years, but that is why we in the Opposition have long campaigned for violence against shop workers to be a separate criminal offence. As with much recent legislation, I am glad that the Government have seen sense and followed Labour’s lead on that, too.

I know that some libertarian Conservative MPs have a philosophical objection to this legislation—the Business and Trade Secretary is one—but let us be honest: if we had known the social, public health and economic harms of smoking that we now know, would we not have legislated in similar terms long ago? Let us be clear: addiction is not freedom. The impact of second-hand smoke on the children of smokers is not freedom. It is certainly no freedom if, as is the case for two thirds of long-term smokers, one’s life is cut short as a result of smoking. It should be a source of pride if, from having the highest smoking rates in the world, we can successfully introduce genuinely world-leading legislation to phase out tobacco for good.

I want to make some brief remarks on other clauses. I have no substantial concerns about clause 2. For the Bill to work, it cannot be possible for adults over the legal age to buy tobacco on behalf of others who cannot buy it. It is obviously right that the clause avoids criminalising children by specifying that it applies to over-18s in its alignment with the commencement date in 2027. I see no issue with that.

I do, however, have questions about implementation. We have spoken a lot about physical retailers but less about online retailers. This is undoubtedly an enforcement challenge and I wonder what the Minister can say on that. In response to the consultation, the Government said that they were exploring how to enhance online age verification so that young people under the legal age cannot buy age-restricted products online. What progress have the Government made since the consultation response was published in February?

On clause 37, I want to pick up on the specifics of the Scottish age verification policy. Will the Minister explain the Government’s view on introducing additional requirements for retailers to establish an age-of-sale policy in the rest of the United Kingdom, in addition to the requirements in clause 1? I understand that the Bill would require the existing Challenge 25 policy to stay in effect in Scotland with legal force until the end of 2033, at which point over-25s will be within the legislation’s scope and then 1 January 2009 would take precedence again.

Finally, on clause 41, we support the amendment to Scottish regulations to include herbal cigarettes. Herbal cigarettes may not include tobacco or nicotine, but they are still harmful to health. Their smoke still contains cancer-causing chemicals, tar and carbon monoxide, similar to a tobacco cigarette. I am glad to see an alignment of approach across the UK nations on the point that no smoking product should be left out of the Bill’s scope. We also have no problem with the inclusion of clauses 48 and 49 to change tobacco control laws in Northern Ireland to align with the approach that we have discussed.

I reiterate that the Opposition support these clauses and we will reject attempts to amend them that would water them down. I would be grateful if the Minister responded to my questions.

--- Later in debate ---

[Dame Andrea Leadsom]

I appreciate the clear cross-party support for the measures in the Bill. I understand that hon. Members will have views on ways to amend or strengthen it, but I urge the Committee to appreciate how little time we have. As we heard clearly from last week’s evidence sessions—from the chief medical officers from all parts of the United Kingdom and from so many medical professionals—this is a very good Bill, so let us not make the perfect the enemy of the good. Let us get this through.

I very much appreciate the welcome of all colleagues, and I assure them all that I will take away any suggestions and requests and come back with clear answers. Where something is relatively simple to do, we will seek to do that, but equally, as Members will appreciate, it is not always possible to accept every suggestion, no matter how well-meaning—and I absolutely accept that, in this Bill, it is always well-meaning.

I will answer the points that hon. Members specifically raised. The hon. Member for Birmingham, Edgbaston asked about how we will encourage young people to quit smoking at an early stage. She will be aware that there are lots of measures to try to help people to stop, including the financial incentives that we are providing, particularly for those expecting a baby and their partners. There are also the quit aids to help people to swap to stop—to move to vapes, which I think we all recognise can be a useful quit aid. They are not harmless, but are less harmful than smoking cigarettes.

We are working at pace with online retailers on how to support them to ensure age verification, and I hope that we will be able to say more about that. The issue of duty-free sales is a tricky one, as my hon. Friend the Member for Harrow East will appreciate, because we do not want to put the burden of legality on the purchaser. The idea is that it should be illegal to sell, and, of course, we have jurisdiction only in the United Kingdom, but I take his points on board and will come back to him on that.

The hon. Member for York Central is right that we need to do everything we can to stop advertising. There are already very strict rules around advertising, and smoking and vaping are severely restricted when it comes to advertising to children. But I think—I hope that the hon. Lady will agree—that the vaping measures, including the powers to limit packaging, flavours and in locations in stores, will do a lot to reduce the appeal to children, which I know we are all incredibly concerned about.

[Dr Johnson]

I say, first, that I fully support this Bill and what it intends to do. Having worked in respiratory medicine in my very first job as a doctor, I saw far too many people suffering from and dying of respiratory illness, and suffering through the final years of their life due to respiratory illness caused by smoking. I think this is excellent legislation.

My right hon. Friend talked about advertising being quite restricted, but, with vaping, we see sports teams—rugby teams and football teams—using vaping brands as adverts for children. These are not recreational substances, or should not be recreational substances. They are supposed to be quit aids and do not need advertising where children can see them.

[Dame Andrea Leadsom]

My hon. Friend makes an extremely good point. She will be interested to know that I have recently written to the Advertising Standards Authority to ask about how well it considers enforcement to be working, and what more it can do to enforce the already strict regulations. I am happy to share its response, when it comes, with all members of the Committee.

--- Later in debate ---

[Dr Johnson]

I welcome clause 3. It is sensible that we protect children from having easy access to products that we have decided should be age-restricted, and it is clearly sensible that tobacco products be age-restricted —that is part of the purpose of the whole Bill. However, clause 3 does not extend to vaping products or other nicotine products. We know that the use of such products is becoming increasingly prevalent among children.

As the Minister knows, I have tabled new clause 16, which would create the same offence for nicotine-containing products or vaping products to be sold in vending machines because they are age-restricted. It is not usual to have age-restricted products in vending machines and it is my view that children would quickly find a way round machines that are supposed to check their age. Will the Minister look at that sympathetically?

[Dame Andrea Leadsom]

The purpose of clause 3, as with a lot of the clauses that we will debate in line-by-line consideration of the Bill, is to tidy up the statute book for the whole tobacco regime, both to align all four nations and to make sure there is a clear understanding of the law where it relates to tobacco, tobacco products and vaping. The fundamental purpose is to tidy up the statute book by restating it with clarity at this critical time.

My hon. Friend the Member for Sleaford and North Hykeham made a point about vaping and vending machines. As she will be aware, the Government are taking powers in the Bill to look at issues such as location of sale, packaging and flavours. It was felt that it was important to have further consultation under those powers to look at issues such as whether vaping products should be sold in vending machines. It will be debated at a future time under those regulations. The key point is that we have clarity in the Bill.

[Dr Johnson]

I thank the Minister for that information. She talks about location of sale. I understood location of sale to refer to a geographical location, rather than a method of sale, such as through vending machines. Could she be clearer on that point?

[Dame Andrea Leadsom]

I will get back to my hon. Friend on that point, which is a good one. This clause and many others are intended to tidy up the statute book, rather than to introduce new subjects that would be more appropriately considered somewhere else.

--- Later in debate ---

[Preet Kaur Gill]

First, I want to make some general points about these first vaping-related clauses of the Bill. We agree fundamentally with the Government in their efforts to find a balance by phasing out tobacco use and cracking down on youth vaping while being careful not to undermine the proven success of vaping as a stop-smoking aid. There is no doubt, however, that the rise in youth vaping is a serious concern.

My main question about the Government’s response is “What took them so long?” Labour proposed measures more than two years ago to stop vapes being branded and marketed to appeal to children, but that was blocked by the Government. I am glad that the Government have listened to us. I hope that they will continue to do so as we debate the Bill; I firmly believe that some of its provisions can still be strengthened.

I am pleased by the inclusion of clause 7. Coupled with clause 34, which defines a vaping product in a way that includes non-nicotine vapes, it will tackle a substantial loophole that we have been calling on the Government to close for a long time. Youth vaping is a serious and growing issue. In 2021, Labour voted for an amendment to the Health and Care Bill to crack down on the marketing of vapes to children. Since then, according to the most recent survey by Action on Smoking and Health, the number of children aged 11 to 17 who are vaping regularly has more than trebled. That is more than 140,000 British children. Meanwhile, one in five children have now tried vaping. In clause 7, a couple of issues therefore intertwine.

I think most people would be surprised to learn that it is legal to sell non-nicotine vapes to children, which could so obviously be designed as a gateway to addiction to the real thing, as the Minister mentioned. It is doubly concerning when we think about the illicit vapes that end up on British shelves. Testing by Inter Scientific, from which we heard last week, has found that a considerable percentage of seized vaping products that it tested contained nicotine, even when they were marketed as 0%.

That is highly concerning. It means that for the past several years, we may have seen a spate of accidental addictions among children. According to survey data from ASH, 9.5% of vapers aged 11 to 17 exclusively puff on so-called 0% nicotine vapes. Analysis of that and of data from the Office for National Statistics suggests that at least 40,000 child vapers could have been exposed to nicotine-containing vapes without their consent, becoming accidentally addicted by illegal products masquerading as nicotine-free that, under existing regulations, they are allowed to buy. That is an important testament to why not just regulation, but effective enforcement— especially over the illicit market—is vital to the success of the Bill.

The two-tier system of regulation for nicotine and non-nicotine vapes is not robust. The exclusion of non-nicotine vapes from the Tobacco and Related Products Regulations 2016 is important for a few reasons. Primarily, it is confusing and more difficult to enforce the rules on the ground if it is not clear which products contain nicotine and which do not. As 0% nicotine vapes are out of the scope of the current regulations, they do not need to be notified through the Medicines and Healthcare products Regulatory Agency process, on which trading standards officers often rely to identify illicit products. I raised that point with the Minister in a debate in January and am keen to seek clarity. Does the Minister think that all producers should have to notify vape products, regardless of nicotine content, to the MHRA?

I note that clause 71 provides the power to extend the notification process to non-nicotine vapes, but the Government have not, to my knowledge, explicitly expressed a view on the matter. Will the Minister do so now? In theory, including non-nicotine vapes in the notification process should allow for a complete database of products. Currently, it is difficult to identify which products are legal or illegal, which really undermines enforcement action.

As we heard in evidence, the impact of vaping products on the developing bodies of children has the potential to be very harmful. It is vital that we take every step to make sure that our systems of regulation and enforcement are as robust as possible to stop a new generation of products hooking our children on nicotine and harming their long-term health. We absolutely support the clause, and I am keen to hear the Government’s view on the issues that I have raised.

I have no substantial comments to make about clause 8. It is a common-sense reapplication of the principles of clause 2, which we have debated and which I support.

Clause 9 will finally address a loophole that I regret to say the Opposition raised in an amendment to the Health and Care Bill in 2021; I am glad that it is now receiving the Government’s attention. Our 2021 amendment would have prohibited the free distribution or sale of any consumer nicotine product to anyone under 18, while allowing the sale or distribution of nicotine replacement therapy licensed for use by under-18s. The then Minister rejected the amendment. To quote my hon. Friend the Member for City of Durham:

“There was no evidence of a serious problem, but the Minister sympathised with the argument for preventive action.”—[Official Report, 22 November 2021; Vol. 704, c. 56.]

Two and a half years later, it is clear what a widespread issue this has become. It goes without saying that Opposition support clause 9, which will close the loophole, as well as clause 44, which will introduce powers for the Scottish Government to extend the existing powers to regulate the free distribution of vapes and other nicotine products such as pouches, as mentioned by the Minister. Likewise, clause 51 will mean that age of sale restrictions can be extended to non-nicotine vaping products.

Finally, clause 53 relates to the free distribution of vapes and nicotine products in Northern Ireland, whether or not they contain nicotine. As I have discussed, I am very concerned that that has presented a loophole that has undermined enforcement, so I support a consistent approach across the United Kingdom. May I ask the Minister to set out what the words “in the course of business” will mean in practice when it comes to the free distribution of harmful products, given that we would expect any person caught out by the provision to argue that there is no “business” in giving away something for free? Of course, we know that that is not true in the case of addictive products, but I will be grateful if the Minister can reassure me that the clause will do in practice what it needs to do. Can she also please reassure me that it will not prohibit under-18s from accessing nicotine replacement therapies?

I reiterate that the Opposition support these clauses, but I am very interested in the Minister’s views on how the Bill should affect the notification process for vapes.

[Dr Johnson]

I welcome the clauses. I have been very concerned about the number of children who are taking up vaping and about its effects. We have heard in evidence, both in the Health and Social Care Committee and last week in this Committee, about the dangers of vaping for children who have never smoked. The chief medical officer has made it extremely clear that for someone who smokes, vaping may be better for them, but that someone who does not smoke should not vape. These measures will help to reduce the number of children who have access to such products, which is good. They will also close the loopholes for free samples and non-nicotine vapes, which can provide a gateway to such awful addiction.

We have also heard how nicotine in general is not just very addictive but harmful to children’s developing brains, and how getting them hooked early makes it more difficult for them to quit in the long term. We have heard about how children in schools are struggling to concentrate when leaving lessons to consume nicotine, which is having an impact on their education and wellbeing. We have heard from health experts about small particles going into children’s lungs, without our knowing what the long-term effects of that might be. I welcome any clause that will help to reduce the number of children vaping.

I do have one question. The cross-heading before clause 7 is “Vaping and nicotine products”, but clause 7 only makes it an offence to sell a vaping product to a person under the age of 18, rather than also making it an offence to sell all other nicotine products, although the capacity to do so is set out later in clause 9. I am just wondering why the Minister is taking a power to restrict nicotine product sales but is not actually doing so. We are starting to see that children at school are using nicotine pouches that are available in all sorts of different flavours. I can see nicotine pouches becoming the next way for the industry to try to hook children on nicotine. Has the Minister considered getting ahead of the game by saying that nicotine products cannot be sold to children at all?

[Kirsten Oswald]

Is the hon. Lady reflecting, as I am, on the comments that we heard in evidence about the link between professional footballers and some of these products? There is an obvious interest and attraction in these kinds of products for the very young people we are concerned might take up vaping.

[Dr Johnson]

Yes. Sportspeople, as we know, are very influential on young people. To promote products that are potentially harmful to children is morally wrong, in my view. They need to be careful to think about the effects that they may be having on children.

My question to the Minister is whether she will consider extending clause 7 outright to include nicotine products for children. We need to support children who are smokers or vapers and wish to quit, but those children can get nicotine replacement products from their GP on prescription. There is no need for those products to be sold to children.

Tobacco and Vapes Bill (Sixth sitting)

Caroline Johnson Excerpts

Committee stage
Thursday 9th May 2024 Public Bill Committees

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

We support clause 10 as a tidying provision that ensures that the additional restrictions on the sale and free distribution of vaping products to under-18s can be extended to other nicotine products in England that have the potential to cause similar harms. It provides that the measures in clauses 7 to 9 can be extended to emerging products such as nicotine pouches, and clause 43 makes similar provisions for Scotland.

It is clearly not right that addictive nicotine products can be sold and freely distributed to children. Awareness of the products is growing, and legislation needs to keep up. According to research by Action on Smoking and Health, awareness and usage of nicotine pouches is higher among younger adults, and just over 5% of 18 to 24-year-olds have tried one. As with vapes, the marketing of nicotine pouches is likely to be attractive to children and young people, with similar branding to sweets and soft drinks. At present, a loophole means that it is not illegal to sell them to children, so I support the measures to close it.

Will the Minister set out her intentions with regard to the use of the new powers, and what conversations she has had with devolved nations on the issue? Will she also explain the Government’s view on the potential harms from the use of nicotine pouches? Does she believe that these products could have value as a stop-smoking aid, like vaping? What merit does she see in including the products in regulations similar to the tobacco-related products regulations for vapes? If she intends to introduce regulations on nicotine pouches, can she set out her intended timescale for that?

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I support clause 10. We heard compelling evidence from Professor Gilmore last week about the tactics the industry uses to try to get young people addicted to nicotine, so that it can continue to profit from their buying the products for the rest of their lives. We also heard from Professor Gilmore about emerging evidence showing that exposure to nicotine at a young age, particularly as a teenager, can rewire the brain, making it more difficult to quit. I therefore welcome the powers in clause 10 that allow the Government to be flexible and respond to changing techniques in the market in order to stop children becoming addicted to nicotine, but why do we not just make it illegal to sell nicotine of any kind to children?

[Rachael Maskell (York Central) (Lab/Co-op)]

I appreciate being called to speak to clause 10, which is a very important part of the Bill. As we have heard many times already, the industry will look at every possible mechanism to try to bring about a new generation of people who are addicted to nicotine and make it harder for them to quit. That goes not just for people under 18 but for those in later adolescence and adulthood.

My concern is with products already on the market that are being taken up quite readily. Next week, the Health and Social Care Committee will look at the public health measures being taken in Sweden. We will see how nicotine pouches—snus, as they are referred to there—are being used as an alternative to smoking, really quite extensively.

[Dr Johnson]

Does the hon. Lady agree that nicotine pouches are starting to be marketed to young people in a similar way to vapes, with an increasing amount of flavours, a relatively inexpensive price per unit and horrifyingly high levels of nicotine?

--- Later in debate ---

[Rachael Maskell]

I am grateful to the hon. Member for that, and I agree that we want to be able to adapt as soon as the market does, but right now the industry is promoting nicotine pouches and we must ensure that we take the earliest opportunity to bring them into the scope of legislation, so that the industry does not just think, “Well, we’ve got six months now to promote our product.” Given the way the industry is behaving, this is a bit like a game of cat and mouse, and we need to do whatever we can to ensure that we are ahead of the curve, whether that is through primary or secondary legislation.

I ask the Minister to ensure that the regulations are brought forward expeditiously and that the first set—we may need further sets; I appreciate what the hon. Member for Harrow East says—is introduced in the shortest time possible. Can she tell the Committee what the timescale will be for that, so that we know how quickly these other products will be brought within the scope of the Bill, ensuring that young people are protected?

[Dr Johnson]

I agree with the hon. Lady and with my hon. Friend the Member for Harrow East. Clause 10 applies to clauses 7, 8 and 9, giving the Government flexibility on all three. As the hon. Lady said, it is great to have the flexibility to bring in regulations to amend clauses 8 and 9, but on clause 7, can she think of any good reason why we would want to be able to sell nicotine products to under-18s?

[Rachael Maskell]

The hon. Lady is following up on a theme that I probed at earlier stages of the Bill, notably on Second Reading. I believe that we need to look at stringent measures, so that people do not have their choices restricted by the addiction that they adopt. It is really important that young people today, or anyone else who engages with these products, do not get addicted at an early stage. We have to look at the issue of the impact of addiction in that wider realm, as we are doing on the Health and Social Care Committee, which is looking at products that are addictive and harmful to health in connection with the public health measures that we are scrutinising.

The hon. Member for Sleaford and North Hykeham makes an important point, and at a later stage of the legislative process I hope to examine how we address the drug nicotine and its harmful impacts on young people and more widely. Addiction has been utilised by people who exploit the lives of others for their own profit, and we need to ensure that they do not get the opportunity again with children, young people or adults. They plague those who live in the greatest deprivation in our country, driving them to more harmful addiction. I therefore welcome the legislation, but I believe that we can go further. Given the industry’s activities right at this moment in trying to find new ways around legislation before it is even on the statute book, the Committee needs to be wise about ensuring that it does not get that opportunity.

--- Later in debate ---

[Dame Andrea Leadsom]

The hon. Lady is absolutely right; they vary from 2 mg to 150 mg per pouch. I imagine that that variation would make it hard to provide a complete comparison, but she is quite right that education will be a big part of the implementation.

[Dr Johnson]

I think that most parents in my constituency would be horrified to think that nicotine pouches are available for sale to children. I appreciate that the Bill takes the power to ban nicotine products other than vaping products at a later date, but I would grateful if the Minister could explain why we should not ban the sale of nicotine to under-18s full stop. I do not understand why and in what circumstances anyone would ever wish under-18s to have nicotine sold to them.

--- Later in debate ---

[Dame Andrea Leadsom]

All I can say to the hon. Lady is that she has heard me, and I am determined to bring that forward as soon as possible. There are good reasons for not putting the provision on the face of the Bill, which are to do with future-proofing. I can only give her my absolute assurance that, as soon as humanly possible, I will bring the regulations forward for consultation where necessary and for implementation where not.

[Dr Johnson]

I am grateful for the Minister’s answer, but I am still a bit confused. I can see the point she makes about the industry and the need to remain flexible; that is really important and why we support clause 10 —particularly in relation to sections 8 and 9, which are about the purchase of products on behalf of children. I welcome the fact that later in the Bill we will see restrictions on the appeal of the packaging of vaping and tobacco products, which will help to make them less attractive to children.

However, I still do not understand why any product containing nicotine would need to be available to children and why that would not be on the face of the Bill. If we were to specify nicotine pouches in the Bill, I see that that could be got around by calling them “nicotine gum” or something else, but if it said, “Nicotine—full stop—cannot be sold to under-18s,” that would be difficult to work around, because no nicotine product could be sold to under-18s. I expect that if I did a survey of parents in my constituency, most would presume that that was already the law.

[Dame Andrea Leadsom]

My hon. Friend makes a good point, which I will take away and reflect on. We have obviously already aired the discussion about the benefit of taking powers as opposed to putting something in primary legislation, but she makes a good point and I will come back to her.

--- Later in debate ---

[Rachael Maskell]

If I might be so bold, I think the Minister is making life slightly complicated for herself. We know the impact that taking smoking products out of the line of sight of people who go into shops or supermarkets has had. Putting them in closed cabinets has very much had the effect that we would want. People do not see the products, but they have to request them; they are not on display for people to just glance an eye over. They are simply not there in the line of sight.

If the same legislation applied to all vaping and nicotine products, that would make things simpler for shopkeepers and supermarkets. They already have the shelving and the shutters; it is not as if they would have to make a financial investment in new shelving. They would not have to do anything different—just pick up the vapes and put them into a contained, enclosed space. I do not see any reason why that could not be in primary legislation, because it would be so simple, and I believe the expectation of the public is already there.

I walked down a street in York just the other day, and almost every shop had their little vape display. Putting them behind the counter, behind screens, behind shutters, would be the simplest method of dealing with that. We know it is effective for smoking. There is no reason why tobacco products should be dealt with at a different standard than vaping products when people go to purchase them, and we would get the effect of “out of sight, out of mind”. We know how much the industry spends on packaging to draw the eye to products, and how powerful that is. Putting them out of sight would have the required effect of reducing people’s thinking about those products.

Simplifying and bringing the legislation into line, for shopkeepers, the public and for us as legislators would meet the public expectation that this is what will happen. I do not think we need separate legislation to deal with vapes one way and smoking products another. Let us just pool it together, make it simple and say that this is about protecting the public. I do not think anyone will bat an eyelid.

[Dr Johnson]

I rise in support of clause 11 on restricting the display of vaping and nicotine products. I have been horrified to see that after the Government, with good intentions, made it difficult for children to see sweets at the counter, to reduce pester power and help protect them from obesity, the sweets were in many cases replaced by vapes. The Government are doing exactly the right thing in taking the powers to look at displays. As has been mentioned, the ability and flexibility of doing so through regulations means that we can move swiftly when the industry seeks to get round the latest rules. I think that is great.

I have two examples for the Minister. Would they be covered by paragraph (1)(c)? The first is a mini-mart in Grantham. The entire shop window is covered in pictures of things such as Kinder chocolate, Haribos, fruit and very large-size vape devices in bright colours. I was in WH Smith in Nottingham last weekend; this is a shop that sells children’s books, children’s toys, sweets and children’s stationery, yet at the till there is a very large video display of vape adverts immediately behind the shopkeeper’s head. Will these two types of advertising and display be covered by the regulations?

[Dame Andrea Leadsom]

Again, I appreciate the sentiments expressed and associate myself with all of them. The hon. Member for York Central requested that we put in primary legislation that vapes must be behind the counter. It is clear from the impact assessment and the consultation that that is the intention. However, as my hon. Friend the Member for Sleaford and North Hykeham points out, the reason for taking the powers is that doing so allows us to stay ahead of the next place they might be sold, for instance outside the shop, on a bus or outside a school—we can imagine all sorts of other ideas. It is important to have the regulations to get ahead of other ideas, rather than saying, “They shall be behind the counter.” That is why we are taking regulatory powers right across the Bill, so that answer holds for all the areas in which we are taking powers: we are taking them to stay ahead of an industry that has shown itself to be very imaginative and brutal in its determination to addict children. We need to stay one step ahead, and that is the plan.

--- Later in debate ---

[Dame Andrea Leadsom]

My hon. Friend highlights exactly the challenge, which is the balance between helping adults to stop smoking, where turning to vapes can be the most successful tool in the toolkit, and preventing children from ever taking up and becoming addicted to nicotine.

[Dr Johnson]

I have a question, but I appreciate that the Minister may not know the answer. Adults who wish to stop smoking have many smoking services that they can go to for advice, such as their GP or pharmacist. Other mechanisms of giving up smoking, such as Nicorette gum and nicotine patches, are available, but they are nowhere near as widely advertised as vapes. Does the Minister think that smokers are unaware of them?

[Dame Andrea Leadsom]

That is a very tricky question to answer. I certainly think that stop-smoking services are fully aware of all the different alternatives that an individual can take up. There is of course the question raised in previous discussions, which nobody has raised today, about whether there should be a prescription-only vape. Many people would say, “No, I want the convenience of buying a vape. I don’t want to have to go and get a prescription, argue why I need it, and so on. I’d rather just buy one.” There is a genuine issue of convenience and accessibility, but my hon. Friend is absolutely right that it is vital that stop-smoking services set out the whole array of different choices to help adult smokers to quit, and that will include vapes. The evidence is that vapes are particularly successful in helping adults to quit smoking.

[Dr Johnson]

My point was about that balance between protecting children and making adult smokers aware that they can use vapes to quit or to change their habit to one that may be safer for them. There seems to be a reluctance to apply stringent methods that would protect children in order to protect adults. My point on advertising was really about whether adults are any less aware of gums and patches because they are not as floridly advertised as vapes. Do we really need to be as sensitive in protecting adults, or should we prioritise the protection of our children?

[Dame Andrea Leadsom]

Intellectually and morally, I completely agree that we need to protect children, and that is the priority. I think the Bill will do exactly that. We are taking the powers to restrict the flavours, the location and the accessibility, and we are massively ramping up enforcement. All of the measures that we are taking are exactly designed to strike the right balance between helping adults to quit smoking and protecting children.

I want to address one other point raised by the hon. Member for Birmingham, Edgbaston on vending machines, and I think the hon. Member for East Renfrewshire also raised it. There will be powers taken in the Bill to limit the use of vending machines for vapes. At the moment, the evidence is that it is not a real problem; vapes do not tend to be sold in vending machines. We need to take the powers, as I have already said, so that we can stay ahead of whatever approach is taken next by the tobacco industry.

[Dr Johnson]

May I push on that point? Does that mean that the Government will accept new clause 16—the vending machine clause?

[Dame Andrea Leadsom]

We are not at that point yet. We will come to those amendments and new clauses as and when.

Question put and agreed to.

Clause 11 accordingly ordered to stand part of the Bill.

Clause 12

Restricted premises orders

Question proposed, That the clause stand part of the Bill.

--- Later in debate ---

[Dame Andrea Leadsom]

I am grateful to the hon. Member for Birmingham, Edgbaston for bringing this discussion to the Committee, and I fully appreciate the sentiment behind the amendment. I completely understand why it is attractive to raise the fixed penalty notice and make it more material to the individual, but I urge hon. Members to take into account the fact that local trading standards take a proportionate approach to tobacco and vape enforcement. The Bill proposes fixed penalty notices of £100 to enable trading standards to take swifter action by issuing on-the-spot fines, rather than needing to go through lengthy court processes. Littering, parking or under-age alcohol sales attract on-the-spot fines. The proposal in the Bill is for £100, or £50 if it is paid within two weeks. That avoids people thinking, “I can’t pay this, so you’ll have to pursue me through the courts.” That creates an incentive for these issues never to come to court, and it can clog up court time and so on. I fully appreciate the hon. Lady’s point, but this is about practicality.

I find it slightly odd that the hon. Lady says £100 is affordable but £200 is not. I would be shocked to get a £100 on-the-spot fine, and I am sure she would, too. Most retail workers would find a £100 fine to be quite devastating vis-à-vis their daily cost of living. I fully understand the sentiment behind the amendment, but £100 is in line with the precedent set by penalties for comparable offences. The fixed penalty notice for under-age alcohol sales is £90. If the penalty were raised to £200, as the amendment suggests, trading standards could issue higher on-the-spot fines, but how many of us have that kind of money on us? It would push a person into severe difficulty. As we have discussed, there is a very swift escalation—it is a “two strikes and you are out” policy—and there is the ability to take the business to task, too, so I think the current penalty is actually quite stringent.

[Dr Johnson]

The Minister will not be surprised to hear that I think we must always consider the most stringent possible fine for selling these things to kids. Will she confirm that, in the event that someone is selling age-restricted tobacco and vaping products to children, the shop worker, who is unlikely to be on a particularly high income, could receive an on-the-spot £100 fine, which they would have to pay immediately; and that the shop premises can be taken to court, and if necessary, enforcement can result in the shop not being able to sell these products at all? In addition, under clause 1 an individual can be taken to court for selling these products and can get a level 4 fine. There is a whole range of options, from on-the-spot fines, which may be relatively low and can be used if the trading standards officer wants to quickly remind someone not to make such mistakes in future, to much more severe penalties for those who are more persistent or deliberate.

[Dame Andrea Leadsom]

My hon. Friend is exactly right, and I will run through the levels of fines for the benefit of hon. Members.

--- Later in debate ---

[Dr Johnson]

Will the Minister give way?

[Dame Andrea Leadsom]

I will make progress, if that is all right—I will give way before I finish. I just want to ensure that hon. Members are aware of the facts.

Clause 25 states that funds received from fixed penalty notices issued in relation to the offences in the Bill will be retained by local authorities and must be used in connection with their functions under the Bill. That means that if trading standards issue a fixed penalty notice, the local authority will retain the funds from the fixed penalty notice, and those funds must be used by the local authority to support the enforcement of tobacco and vape legislation. That allows local authorities to cover the enforcement costs of issuing fixed penalty notices, and to reinvest any remaining funds in enforcement regimes.

Clause 26 provides the Secretary of State for Health and Social Care and Welsh Ministers with the power to change the amount of a fixed penalty notice and the percentage discount for early payment as set out in clause 24. The power provides flexibility for Ministers to adapt the amounts specified and will future-proof fixed penalty notices, ensuring that they remain an appropriate and proportionate enforcement tool to deter offenders.

[Dr Johnson]

I thank the Minister for giving way. The purpose of the penalties is presumably to punish those who have deliberately acted against the rules, and to be a deterrent against those who consider doing so. I am satisfied that the Minister has thought very carefully —I know she has—about the level at which the fines should be set. She has come up with £100, but can she reassure me that the Government will monitor to see whether that is sufficient and, if it is not, that they will increase it accordingly using the regulations provided for under the Bill? Secondly, when an individual is deciding to break the rules and to sell an age-restricted tobacco product to a child, could they know whether they would be dealt with under the fixed penalty notice or under clause 1, which carries a much bigger and more deterring fine?

[Dame Andrea Leadsom]

I can give my hon. Friend the reassurance that she seeks. With regards to the issuing of fines and whether the shopkeeper would know, it will be for trading standards to have the total range of enforcement tools that are available to them, including being able to impose a fine of up to £2,500 upon conviction in a magistrates court, as well as the other, potentially unlimited fines that we have discussed—for breach of a restricted premises order—or, indeed, this on-the-spot fine, which hon. Members will appreciate is a much faster way to provide swift and immediate punishment of offenders. Its escalation has already been set out—two offences in two years leads to the restricted premises or sale order.

Tobacco and Vapes Bill (Third sitting)

Caroline Johnson Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Trudy Harrison]

Q Thank you both for powerfully and poignantly outlining the preventable impacts of smoking-related disease and illness on adults. I want to ask about pregnant women. In Cumbria, 12.3% of women at the point of giving birth say that they are smoking. Given the evidence-based proof, why is that still the case? I am left asking why we have we left it so long to have these conversations and bring the Bill forward.

I would like to understand the power of addiction to be able to make the point that this is a pro-choice Bill. It will give women more choice against that addiction that they are enduring at the most important point of their lives, when they are unable to make that choice for themselves.

Kate Brintworth: I absolutely agree with you. As I have said, pregnant women go to extraordinary lengths to protect themselves and their babies. They change what they eat and drink and how they behave in myriad ways to ensure that they are doing the right thing, yet it has proven very difficult to shift the figures you describe—I think nationally it is a little over 7% of women who are still smoking. That is a poignant demonstrator of just how difficult it is and how addictive nicotine is, when all women want to do is the right thing for their children. That is why all the chief nursing and midwifery officers across the four countries are united in support of the Bill, as our medical colleagues are, because we see the damage wrought across families and generations. We are 100% behind it.

Professor Sir Stephen Powis: It is important to re-emphasise the point made repeatedly by the chief medical officer for England: smoking and nicotine addiction takes away choice. When you are addicted, you do not have the choice to simply stop doing something. It is an addiction. It is a set of products that removes choice, and in removing that choice, people are killed.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Q I want to ask you about vaping, particularly among children and pregnant women. First, to Kate, are you aware of any research into which chemicals from vaping may be transported from the mother’s blood through the placenta and into the baby, and whether that has any effect, or is the research too early to be able to tell us that information? For Professor Stephen Powis, could you tell me what research NHS England is supporting into the effects of vaping on children?

Kate Brintworth: The information that we have so far suggests, as it does across all areas of healthcare, that vaping is safer than smoking. What we do not have is the long-term data that we have on smoking to give us the confidence to describe the harms clearly. That is something that we need to keep observing and understanding so that we can give people the best-quality information.

Professor Sir Stephen Powis: NHS England is not a primary funder of research but we are an evidence-based organisation, as I described earlier, particularly on the use of vaping for smoking cessation. We are very keen that the evidence base, particularly on vaping, is expanded. We would support research in terms of calling for it to be undertaken but also in terms of supporting the NHS as a delivery mechanism for the context in which that research is done.

We very much want to support further research because, as you know as a paediatrician, this is an area where the evidence base is emerging but there is more to do. It is not as complete as the evidence base for smoking. It is really important, even with the passage of this Bill, that that evidence base grows and that we in the NHS support the generation of further evidence where we can.

[The Chair]

Thank you. That is a good point at which to say that this session has ended and to thank our witnesses for all the information they have provided.

Examination of Witnesses

Professor Kamila Hawthorne and Professor Steve Turner gave evidence.

--- Later in debate ---

[The Chair]

I call Dr Caroline Johnson.

[Dr Johnson]

As a declaration of interest, I am an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health.

[The Chair]

Thank you. I call Preet Kaur Gill.

--- Later in debate ---

[The Chair]

I call Dr Caroline Johnson—you have all been so kind to one another, we are now ahead of time.

[Dr Johnson]

Q Professor Turner, Dr Helen Stewart from the Royal College of Paediatrics and Child Health gave evidence last summer to the Health and Social Care Committee, of which I am a member. She talked about some of the passive effects of vaping on children, such as in the toilets on school premises, where many children had been vaping in an enclosed environment, and children with asthma and other lung conditions were frightened to go into those toilets because their conditions were triggered by being in the presence of second-hand vaping.

Do children breathe in second-hand chemicals when they are proximal to adults vaping, or in an enclosed environment? If they do, what effect does that have on children’s lungs? Would you, or the royal college, support a ban on vaping in public places in a similar way that we currently ban smoking?

Professor Turner: I think that vaping in schools and school toilets is a big problem. First, it means that fire engines come out and that disrupts school. As you say, there are some children whose asthma will get set off by exposure to vapes, for example. So I think that it is a big problem, and you have already heard from schools. We are still not sure what components of the exhaled second-hand vape, if you will, are causing symptoms, but, as you described, that happens.

On your third question about banning vaping in public spaces, I would not have an opinion on that. If they are being used by people who are nicotine-addicted to help to come off their nicotine addictions, I would not be unhappy with that. Most of the second-hand vape is water vapour, but if you walk behind somebody who is vaping, you can tell what the taste is, so there are chemicals in there. I think that banning them in public spaces, at this point in time, is something that I would not have a strong opinion on.

Professor Hawthorne: I think we are on a journey, over the years, towards stopping smoking as a nation, so this Bill looks like a great step forward. I think that it is a landmark suggestion, and now that New Zealand has backtracked, I think we will be ahead of the game.

Professor Turner: And we have a proud record of doing this, from a legislative point of view.

Professor Hawthorne: Also, to some extent, sometimes, when you make a big step—which this is—you then might want to stop and wait, consolidate, check and gather more data before you make the next step.

[The Chair]

If there are no further questions, I thank the witnesses for their evidence. That brings the morning’s session to an end. The Committee will meet again at 2 pm this afternoon, here in the Boothroyd Room, to continue taking oral evidence.

Ordered, That further consideration be now adjourned.—(Aaron Bell.)

Tobacco and Vapes Bill (Second sitting)

Caroline Johnson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Kirsten Oswald (East Renfrewshire) (SNP)]

Q We heard in an evidence session earlier about the challenges in schools, with children vaping in increasing numbers. There is an impact on their education because of their becoming addicted, and that causes challenges in their interactions with the learning process. Do you think that the measures in the Bill are sufficient to deal with that growing problem? Do you have a view on whether we have a handle on the quantum of that problem, and are the measures on advertising sufficient to try to remedy that?

Greg Fell: Yes, in part, in terms of the measures in the Bill. I would treat vapes like I would treat cigarettes in terms of colours and marketing, with plain packs out of sight behind the counter and strongly enforced. I would take care, though: we use and want to continue to use vapes as a route out of smoking cigarettes, so getting the balance right remains important, but I would be quite aggressive about the regulation and the deterrent.

Education in schools by itself will not be sufficient. It might or might not be effective, but it will not be sufficient. Action on Smoking and Health has co-produced with a number of local authorities a range of resource packs for parents, teachers and others, which are fairly widely used, but they are not sufficient by themselves to stop the rise in young people vaping, so we need strong regulation with the enforcement of that to boot.

Cllr Fothergill: It is not part of this Bill, but it is part of LGA policy that we would like to see a ban on disposable vapes. There are 5 million sold every week, with the vast majority sold to younger people. The vast majority are thrown away. Those that are thrown away responsibly finish up in one of our recycling lorries where the lithium batteries cause major problems with fires. It is not part of this legislation, but we think that that needs to be tackled separately; I think it will be.

Greg Fell: One point that I just remembered on the resource pack that has been widely circulated to headteachers and schools: a line was taken in that to tell the truth—not to over-egg the pudding but to tell the truth and say what we do and do not know, because in my experience scaring kids usually switches them on to something rather than turning them off something. In the pack, we have also told the truth about the methods and tactics that the tobacco industry has used to get kids hooked on vapes, and that as a rule makes kids pretty angry. It certainly makes parents pretty angry when they realise what has happened.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Q If I may, Mr Fell, I will bring you back to the issue of passive vaping. You talked about there not being so much evidence on the harms of passive vaping compared with passive smoking, which is correct. Of course, smoking has been around much longer for the effects to be understood. However, there are papers, published in reliable journals such as The BMJ, saying that those people—in particular, young adults who do not smoke or vape—who are exposed to passive vaping do get an increase in bronchial symptoms.

Greg Fell: Agreed.

[Dr Johnson]

Q There are effects. One reason why a former Government brought in the ban on smoking in enclosed public spaces was so that people would not be forced to experience such a risk, either at work or socially, which was one that they did not want to take. Would you, as a director of public health, support a ban in enclosed spaces for vaping, too?

Greg Fell: Possibly. I would need to go back to the science and have a really careful look at it. There is the danger of unintended consequences and turning people away from vaping as a route out of smoking. Outdoors it is not a thing; indoors—for me, it is a carefully balanced thing and I would want to go back to read the science. It is a while since I have read it, to be fair.

[Dr Johnson]

Q If someone cannot smoke in a pub, why would not being able to vape in a pub make them smoke?

Greg Fell: I am thinking of my logic now, and would agree. What I would not want is for somebody to not switch from smoking tobacco to vaping because they fear they would not be able to vape in a pub. That would be the unintended consequence I would try to avoid.

[The Chair]

David, do you want to add anything?

Cllr Fothergill: I have nothing to add.

--- Later in debate ---

[Preet Kaur Gill]

Q Is there anything you want to say on the age-of-sale verification process?

Adrian Simpson: In the large retail sector, we have worked on things such as Challenge 25 for many years, so we are used to challenging consumers buying products. One thing that we would like to make clear is that this can be a very controversial issue. We know that challenging consumers for proof of age leads to violence and aggression against shop workers. We think it would be beneficial if a long period were given for these regulations to come into effect, to give retailers the chance to educate their staff on these issues and to educate consumers.

[Dr Johnson]

Q I want to ask you about the licensing regime. You have to have a licence to sell alcohol and tobacco, and some have suggested that you should have to have a licence to sell nicotine full stop because it is an addictive substance. That would mean that you would need to have a licence to sell vapes, partly as a way of making them less accessible to children in the places that they may be sold. Would you support that?

Adrian Simpson: It is not an issue that we have discussed at any length in the British Retail Consortium. We are aware, of course, that there are parts of the UK where licensing is required for certain tobacco products. We are well used to the alcohol licensing that has been going on for many years. Unfortunately, I cannot comment on whether the whole sector would be in support of that. We would perhaps need to see how a potential licensing system would operate before we gave our full support to it.

[Dame Andrea Leadsom]

Q Thank you so much for being here. You will be aware that, in putting together legislation, huge effort is made to be balanced and not excessive and to make it doable and achievable, nowhere more so than for those who are trying to enforce it.

May I press you a bit further on the point that Preet made about whether the fines are sufficient? You have said that it is a bit complicated and will require some lead-in time—which is obviously provided, with the 2027 date—to give appropriate training to shop staff. The quantum of the fine was intended to enable on-the-spot fines, rather than having lengthy litigation because the person who incurs the fine does not have the cash and needs to go away, may or may not pay it, may or may not have to be pursued, may or may not have to go to court, and so on. Understanding that there are different views on all sides, is the balance just about right or, if you could have put your own wish list together, are there things that you would have done differently?

Adrian Simpson: We would have liked to see more education provided to retailers who might have broken the rules. A fine can be life-changing for someone who is given one, so we like to see whether there might be a way around that; perhaps the shop worker could be educated first, rather than going straight to a fine, if at all possible. We would like to see that balance of education before strict enforcement, if possible. That would be our wish.

--- Later in debate ---

[The Chair]

Colleagues, we might be voting fairly soon, so short questions, please, and concise answers.

[Dr Johnson]

Q My question follows on from that of my colleague. Lincolnshire police measured what was in vapes confiscated from children in my constituency. They found chemicals like diethylene glycol diacetate, antifreeze, Steol-M, poster varnish and others. As I understand it, when they look at a vape in a box, one of the challenges for enforcers is being able to tell whether it is a real, legitimate vape that contains what it is supposed to contain or a fake vape that contains a whole load of nonsense and potentially harmful chemicals. How could the legislation help you with that?

Secondly, someone showed me on packets of cigarettes recently that there is a scannable code, and trading standards have a special scanner that they can scan that with. Would that sort of thing help on so-called legitimate vapes?

Kate Pike: Potentially. The track-and-trace legislation on tobacco that enables us to scan a packet of tobacco and find out if it is where it should be—it is tracked all the way through the system—could potentially work on vapes. It would be very complicated to bring in—well, not complicated; it would be a big exercise to bring in track and trace for vapes, but it is potentially something. As you know, there is a consultation out at the moment for vapes to become an excise product, so it could possibly be that we introduce track and trace alongside that for vapes.

If you look at a vape and you look at the packaging, there are lots of red flags that tell us if it is illegal. We can usually tell by the packaging alone. We are doing some market surveillance work at the moment for vapes that look as if they should be compliant; they are notified to the MHRA, to check the ingredients. So far, touch wood, we are not finding too many issues in those nominally compliant vapes. But there are so many illegal vapes out there. It is actually quite easy to see that they are illegal, when you see them. We do know how to identify them at the moment, but obviously it could become more difficult. We will just have to make sure that the new regulations are still enforceable when they come in. For example, if there is a ban on types of flavour, we would want that to be really clear. We do not want to have to go round sniffing or tasting. It needs to be clear by the description, rather than just some sort of guess along the lines of, “Is that strawberry bakewell-flavoured?” It would be very difficult for us to manage that.

[Kirsten Oswald]

Q I do not know if others have had this experience, but I am aware that I am increasingly being advertised at online by products that, although I am not really sure what they are, are certainly connected or proximate to tobacco or vapes. That leads me to wonder whether there are any tobacco, vaping or other connected or related products that are not covered by this Bill, which you think perhaps should be.

Kate Pike: I think the Bill is really good at closing some of those loopholes. It will include an age restriction on 0% nicotine vapes, for example. There are other nicotine products, such as the little nicotine pouches. The popular term is, I think, snus, but we know that snus is already banned in this country. The enabling regulations to put a regulatory framework around products like that will be really helpful. These industries are very innovative, so we just need to make sure that we are keeping up with our regulation. I think that the enabling regulation powers will enable us to keep up with new products, but it is continually little steps, and regulation chasing after innovation. We would like it to be the other way round, really.

--- Later in debate ---

[Mary Glindon]

I would just like to say that vaping is 95% safer than smoking.

[Dr Johnson]

Q I proposed a ten-minute rule Bill to ban disposable vapes last February, so I am delighted to see that the Government have brought in an statutory instrument to do exactly that. I am disappointed, but not surprised, to hear you say that industry is doing its best to circumnavigate the regulations before they are even brought in.

I have two questions. First, how do we ensure that the regulations are flexible enough for us to be able to stay ahead of such measures? Secondly, could you say a bit about the effect on wildlife? My hon. Friend the Member for Penrith and The Border (Dr Hudson) has talked about puppies picking these things up in their mouths and the danger they can pose if the puppies bite into them. Could you talk a bit more about the danger that they pose to wildlife when they are thrown away?

Laura Young: Of course. On the regulations, I think that we have to think creatively and innovatively about some of the workarounds that might be being used. We are already seeing charging ports just being popped on the bottom. Of course, that might mean that the battery can be recharged a few extra times, but if it cannot be refilled with the solution, it is still, in practice, a single-use item and will have to be thrown away eventually.

The issue is about ensuring that we look at the builds and make sure that they are modular and that the circular-economy principles that we want to achieve are set in stone. I think that that means working as best as possible with the retailers and the manufacturers—although that will be really difficult—and looking to other initiatives, whether that is single-use plastics bans or treaties on plastic, one of which has just come to an end globally, to see what we can do.

I will tell you a story about the wildlife. A wildlife photographer, a birdwatcher, was taking some images of a marine bird doing a very normal activity, which was picking up a shellfish—what looked like a razorfish—and dropping it from a height to smash it open to get some delicious dinner. But after this young gull had failed multiple times, this photographer realised that, unfortunately, what it was actually picking up and dropping was a disposable vape. We are seeing not only domestic animals, such as cats and dogs and things that we love as pets, getting hold of disposable vapes and potentially breaking them open, but actual wildlife being impacted—picking them up, thinking they are shells on the beach, and trying to eat what is inside them.

That is just from the very short time that we have been paying attention and looking out for this, and from keen birdwatchers capturing it, so we know that there will be extensive wildlife impacts. We are only now scrambling around to try to find more evidence, but we know that it is already happening, and that that is just one example. The photographs are on Twitter, if anyone did want to go and find them. It is sad, but it is definitely the reality of what we are seeing.

[Mary Kelly Foy]

Q Just a very quick question: would you agree that this is symptomatic of the throwaway society that we live in? We have disposable vapes, plastic toys with happy meals and toasters—all small appliances that do not last long enough. They are all thrown away and are damaging the environment. I know that, in Durham, all sorts of electronic devices are thrown in the river, and that is interfering with wildlife.

Tobacco and Vapes Bill (First sitting)

Caroline Johnson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[The Chair]

That is more of a boast than a declaration of interest.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I am an NHS consultant paediatrician, and a member of the Royal College of Paediatrics and Child Health.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)]

I am a practising psychologist, and I also chair the all-party parliamentary health group.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

Q Public health messaging is most effective when it is simple. Should the restrictions on vaping being advertised on football shirts, for instance, be in line with those on tobacco advertising, and should there be similar restrictions on where people can vape as there are for smoking?

[Dr Johnson]

I want to ask about the passive effect of vaping. We know that if you are proximal to someone vaping you can smell the blueberry flavour, or whatever it is. Do you have any evidence on the passive health effects of vapes?

[The Chair]

Could we start with Michelle Mitchell, please?

Michelle Mitchell: I think Deborah is going to pick up on vaping.

Deborah Arnott: Actually, I think that question is best put to Professor Ann McNeill, who you are seeing this afternoon. It is a really technical question and needs to be answered by a scientist. In principle, though, as Michelle has pointed out, what cigarette smoke has in it—tar, nicotine and carbon monoxide—is much more harmful than any passive effect from vaping. It may be unpleasant, with the flavours, but that is something else.

--- Later in debate ---

[The Chair]

I call Dr Caroline Johnson, and this will be the final question.

[Dr Johnson]

Q In the Health Committee, of which I am a member, we heard evidence that some schoolchildren with lung diseases, such as asthma, were not able to visit school toilets during the day because the overwhelming smell of people vaping in there was triggering their asthma. Have you heard anything about that? Do you have any evidence about asthma in children or adults being triggered by vaping?

Sarah Sleet: We have heard anecdotally that people have had issues with being around vaping, but there is not any robust evidence as to whether it genuinely triggers asthma for some of those people. It is an area we want to look into a bit further, but I would say that here is a clear case of where the law is that children should not be vaping. We need to ensure that enforcement is in place, as far as possible, to prevent that from happening.

[Dr Johnson]

Q Is that an absence of evidence, or does evidence exist but is inconclusive?

Sarah Sleet: I am not aware of any serious evidence that has been gathered around this at this stage. It probably needs to be looked at.

[The Chair]

I thank the two witnesses for being not only concise, which enabled us to get through all the questions, but informative. I am sure we have benefited from the evidence you have given.

Examination of Witnesses

Matthew Shanks and Patrick Roach gave evidence.

--- Later in debate ---

[The Chair]

A very brief final question from Dr Caroline Johnson. We have to finish at 10 past 11, so I ask the witnesses to bear that in mind.

[Dr Johnson]

Q I want to ask about flavourings because we have heard that flavourings may encourage some adults to switch. We know that where adults stop smoking using vapes, flavourings might prolong their addiction to vapes, and we know that flavourings entice children to vape. Some people say that we need to keep the flavours for the adults; some people say no flavours because they entice children. To govern is to choose, so which do you think is the most important—supporting adults to stop smoking or protecting children from starting vaping?

Matthew Shanks: A simple question to finish with—thank you! I think you can have both, because I would. If you look at the way cigarettes are marketed—behind a shelf with the pictures of the damage they cause—that is different from the way vapes are marketed, with their colourful packaging and excellent flavours that appeal to children. If you change the way they are marketed, you could have both, because you could still help adults with the flavourings but not make them appealing to children.

Patrick Roach: A simple answer: protect children from harm.

[The Chair]

I thank the witnesses for giving us a very particular perspective that we have not previously heard about on how all this impacts on teaching and the education sector in general. We are grateful for that, and I am sure the Committee found it helpful.

Examination of witness

Paul Farmer gave evidence.

Tobacco and Vapes Bill

Caroline Johnson Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Elizabeth Truss]

My hon. Friend makes absolutely the right point. There are double standards in this debate. My view is that it is absolutely right that we protect the under-18s from these potential dangers before they have full decision-making capability, but we should allow adults to exercise that freedom. It seems to me that the medical establishment, the national health service and others working in the health industry have unfortunately been captured by this gender ideology, which is preventing them from seeing the truth of what is happening. That is why the Cass report is welcome. If only the hon. Member for Ilford North (Wes Streeting) had shown the same level of interest in dealing with the issue of young people and puberty blockers that he has shown in pursuing his crusade against smoking—he was not saying this a few years ago.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

As my right hon. Friend will know, I was in the Chamber on that Friday listening to the filibustering, and was unable to contribute to the important debate on puberty blockers. I support her Bill and am grateful for the Cass report.

In reality, there are some products that are banned for adults—things such as cocaine and heroin—so society as a whole has made a choice that some products must be banned for adults as well as children. It is about where we draw the line. My right hon. Friend said that people should be able to do whatever they want as adults, but in fact unless we want to liberalise laws on drugs and allow people to have heroin, cocaine and everything else—perhaps she does—a line has to be drawn somewhere, and it is just a case of where.

[Elizabeth Truss]

I certainly do not support the liberalisation of those drugs. We know that people who become addicted to heroin and cocaine are a huge danger to other people and to their families; it destroys society. That is not the level of danger that tobacco poses, so those are very different scenarios.

I will come to my conclusion, because I know that a lot of people want to speak in the debate. What I ask is that Members do not just follow the instructions of the health lobby. We have heard about what the chief medical officer says. I know from being a Government Minister that there are often schemes pushed by officials and civil servants because, fundamentally, there is a belief that government knows best. I want Members of Parliament to think not just about what happens if we ban smoking for people who are over the age of 18, but about the implications for shopkeepers who have to identify whether people are the right age. Will it mean that people have to carry ID into shops with them into their 40s? What are the practical implications? It is a very dangerous precedent to start saying that some adults can have the freedom to smoke and some cannot. That is a fundamental problem. It is fundamentally unconservative, it is unliberal and I will not be supporting the Bill.

--- Later in debate ---

[Kirsten Oswald (East Renfrewshire) (SNP)]

I am pleased to speak here today in favour of the Bill, part 2 of which specifically relates to Scotland, because smoking is the leading cause of preventable death in both Scotland and the UK. We know that, so we are surely duty bound to act and prevent harms. To be clear from the outset, I want us to help people to stop smoking. Smoking cessation, as well as preventing future harm, requires our action.

Dr Ian Walker, executive director of policy at Cancer Research UK, has correctly pointed out that nothing will have a bigger impact on reducing the number of preventable deaths in the UK then ending smoking. I will not go into detail about the terrible reality of the health impacts of smoking. We have heard about them already today, particularly powerfully from those who have worked directly in the medical environment. We have seen significant successes where we have acted on smoking in the past. I remember when the ban on smoking in indoor public spaces came into effect in Scotland, a first in the UK. It was a bit controversial, but not for long. It has undoubtedly hugely improved our environment and, importantly, our health outcomes. We have seen an important decrease in the numbers of smokers, but let us be real—there are still far too many lives being destroyed by smoking.

I am very glad that Scotland has been in front of the curve on these issues, whether that be with the indoor ban, the overhaul of tobacco sale and display, the ambitious goal of a smoke-free Scotland by 2034 or an issue that I have often spoken about here, the consultation on disposable vapes. The direction of travel is welcome. The SNP welcomes the collaborative step towards creating a smoke-free generation. It is not just us—the public are looking for action too. Action on Smoking and Health tells us that the largest poll of public opinion conducted to date—over 13,000 adults were polled—found 69% in support, including over half of all current smokers.

I watched with some despair—a little bit like I watched some of the proceedings in the House today—media interviews this morning where the right hon. Member for South West Norfolk (Elizabeth Truss) said some of the things she repeated here in the Chamber. She said:

“I don’t know why this legislation is being brought forward”.

I would have thought that was pretty obvious really, but let me help her with that: it is to stop people dying. She then said, as she has again during the debate, that this is “unconservative” legislation. To be fair, I know absolutely nothing about being a Conservative and I am very much OK with that, but what a bizarre statement. Surely regardless of our varying political views, we can look at the health impacts of smoking and say they is not the future we want, and not the damage, harm and heartbreak we want for future generations.

Let us be clear that any arguments put forward about personal choice or personal freedom make no sense at all when we are talking about children and a highly addictive substance. Smoking is not a free choice; it is an addiction. Nicotine is a horribly addictive substance. That is why this is a positive and necessary move, and one widely welcomed, including by Asthma and Lung UK. That organisation points to the significant harm to future generations if we do not act now, and highlights the enormous cost to the NHS if we do not take this preventative action when we have the opportunity to do so.

Scottish Government Public Health Minister Jenni Minto MSP has welcomed the Bill, pointing out that Scotland has been a world leader on a range of tobacco control measures. While there has been a steady reduction in the proportion of people smoking, we know it still damages lives and kills more than 8,000 people a year in Scotland. If we do not act, we know perfectly well what the impact of that inaction will be.

We also know that smoking causes and exacerbates health inequalities, which is exactly why we need to have a tobacco-free Scotland. Indeed, Mark Rowland, chief executive of the Mental Health Foundation, points out:

“Smoking harms disproportionally affect those with poor mental health and stopping smoking has been shown to be as effective as anti-depressants. The Tobacco and Vapes Bill is a once in a generation opportunity to prevent the known mental and physical harms that smoking causes and regulate commercial interests from undermining the health of future generations.”

Asthma and Lung UK notes that the harms of tobacco are not equally distributed. In fact, smoking is responsible for half of the difference in life expectancy between the richest and poorest in society. That generational nature of tobacco addiction means that children born today to parents who smoke are four times as likely to take up smoking themselves and to find it harder to quit. So the impact of smoking in terms of generational inequality and harm is clear and known, and we should aim to change that.

I am grateful to Asthma and Lung UK, and to the many other groups that sent me briefing materials. The breadth and range of organisations, including many medical and health groups, that have been in touch to urge me to support improvements in health and to stop future generations becoming addicted to tobacco, is very interesting and speaks to the wide spectrum of those determined to stop this harm, including, as we have heard, a majority of the public and retailers.

I would like to spend a little time talking about vapes, particularly disposable vapes. To nobody’s surprise, I am going to be positive in my support for any and all measures to arrest the tidal wave of children vaping, which should absolutely chill us all. The health impacts on children are terrifying, and that is only the ones we know about. My view is very firmly that all disposable vapes should be banned now, immediately. We should deal with the utmost urgency with the significant harms these devices are causing to our environment and to eye-watering numbers of children. Which of us can seriously say they are confident it is not their children? Members are deluding themselves if they believe that is the case.

[Dr Caroline Johnson]

As the hon. Lady knows, as we worked on this subject together, I brought forward a ten-minute rule Bill to ban disposable vapes last year. The measures in that Bill do not form part of the legislation today, because this is health legislation, but the banning of disposable vapes forms part of a statutory instrument that has been brought forward as environmental legislation. Does she welcome that?

[Kirsten Oswald]

I am grateful for the hon. Lady’s intervention. As she knows, it is important for us to look at disposable vapes in the round, including their devastating environmental effects as well as the terrible impacts they have on the health of our young people. Whichever angle we look from, these are devices of which we have no need and that we should get rid of as soon as possible, before they cause any more harm.

--- Later in debate ---

[Sir Jake Berry]

My hon. Friend is quite right. That is the legal position under the law in this country if we have capacity, no matter how bad the decisions we make. Constituents have contacted me about elderly relatives who are making poor financial decisions, but because they have capacity they are free to make those decisions, albeit bad ones in some cases.

[Dr Caroline Johnson]

Will my right hon. Friend give way?

[Sir Jake Berry]

I will not. I have given way once and want to stick to my time. I will not support the Bill, because I believe in freedom.

My second point is about mandate. The Prime Minister does not have a mandate to bring forward this legislation, and no Labour or Liberal Democrat MPs—in fact, no MPs in the House—have a mandate to vote for it, because it was not in our manifestos. We are just months away from a general election. If people believe that this measure is so important, they should put it in their manifestos. The Conservative party could put it in our manifesto and let people vote for it.

The powers that we have in this House of Commons are not ours; they are lent to us by our constituents between general elections. We are quite rightly getting to the point where we have to return those powers to our constituents and try to persuade them that we have done a good enough job to get them back. Before we start giving away their freedoms and liberties, let us at least give them the opportunity to have a say.

There is one addiction in this country that I am even more concerned about than the addiction to nicotine: the addiction of the Government to telling people what to do. I want to live in a free society where I am free to make both good and bad decisions. As people go through the Aye Lobby to support the Bill this evening—I shall be going through the No Lobby—I ask them to cast their mind back to the last time we were all washed through the Aye Lobby together on a wave of health and science and righteous hope to keep people safe, which was during the covid pandemic.

I am proud of furlough and all sorts of things, but I regret closing schools. It was the wrong thing to do, but I was washed along on that wave. I opposed some of the covid proposals. People should look back to that and think, “That was the last time we took people’s freedoms away from them. Did we always get it right?” In my view, the answer is no. We got lots of things right, but we also made lots of mistakes. As people march through the Lobby, they should think about whether in fact they urgently need to support the Bill or whether it should wait until after a general election—we may have a different Government then, if polls are to be believed—when the British public will have at least had the question put to them.

The addiction of our Government to telling us what to do goes beyond whether we should smoke. During covid, they determined who we could go to bed with, whether we could sit in the park and read a newspaper, and whether we could go to work. We are now told how we can heat our homes and whether we can drive an older diesel car in London. Unfortunately, we live in a country where those freedoms—those freedoms that are not free—are being eroded every single year of our lives. That is not something that I am comfortable with, and it is not something that I am prepared to support.

There are good bits to the Bill, but we cannot allow the fact that good bits of legislation have been annexed to this terrible legislation, which in my view will not work, to force us to support it. The Government could bring in the vaping measures on their own, and I would support them. I just do not support the creeping ban on tobacco. When people reach the age of 18 in a free society, they must be free to choose for themselves.

I will finish with this. If Members find themselves in the No Lobby tonight—I hope I will see a few colleagues in there—they should keep in their mind that freedom is the sure possession of those alone who have the courage to defend it. In my view, by voting no tonight, we defend the freedoms of our constituents and our country. It is the right thing to do, and I look forward to seeing as many colleagues in there as possible.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I rise in support of the Government’s Bill. One of the first speakers this afternoon was my hon. Friend the Member for Bosworth (Dr Evans), who talked about his first job in respiratory medicine. My first job as a doctor was in adult respiratory medicine, too, and I spent a lot of time looking after patients with chronic obstructive pulmonary disease, intermittent claudication and lung cancer, and that taught me that smoking causes not just premature death, but substantial, debilitating, miserable disability that can go on for many years. I therefore support the Government in doing all they can to reduce the number of smokers.

Some people have talked today about the freedom for an adult to choose to do what they want, but we already make changes to what adults can do. We already restrict their freedoms. For example, we tell adults that they must put a seatbelt on when they get in the car. They must wear a helmet when they ride a motorcycle. They cannot drink alcohol before they get in a car, and they cannot drive down the motorway at 150 mph. So we already make restrictions for people’s safety on that basis.

I do think that gradually increasing the age is inelegant, as my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health and Social Care Committee, put it, and will be challenging to enforce. But the alternative—to ban smoking outright—would be difficult, because it is an addictive substance. If we banned an addictive substance overnight, we would criminalise those already addicted. By doing it in advance and gradually increasing the age, we will instead not criminalise people for being addicted, because they will not get addicted in the first place, at least in principle.

I want to focus most of my remarks on vaping. I have been campaigning on vaping for some time, because I am concerned about the snowballing number of children who are addicted to it. Indeed, last year I introduced a ten-minute rule Bill to try to ban disposable vapes, which have been the most attractive vapes to children and cause the most environmental damage. At the time, 1.3 million vapes a week were being used—it is now up to 5 million. They are almost impossible to recycle in practice because the lithium batteries are difficult to recycle, and the nicotine gets soaked into the plastic, which makes that difficult to recycle as well.

I understand the need for adults to have something to help them stop smoking, but vapes are not just a stop-smoking device; we should look at them as an alternative addiction. Earlier in my campaigning, when I spoke to the industry, I said, “What is it with all these flavours?” I was told, “Well, the thing is, if someone tries to stop smoking using nicotine gum, they use the nicotine gum—or something—as a stop-smoking device. So they go from smoking, to gum, to nothing. If we give them vapes that taste of tobacco or are bland, they go from smoking, to vaping, to nothing. If we give them cherry cola-flavoured vapes, they go from smoking, to vaping cherry cola, to vaping mango and to vaping blueberry. They remain one of our customers and continue to use our product.” The industry is trying to create a new generation of addicts to make itself billions of pounds.

I can understand why the industry wants to make the money, but the way it is doing so is, in my view, immoral. In particular, its marketing of these things at children is immoral. A grown-up may wish to have a cherry cola-flavoured vape, but he or she does not need to have a unicorn milkshake-flavoured cherry vape shaped like SpongeBob SquarePants. That is why the flavours are important, and I welcome the Government’s measures to deal with flavours, colours, shapes and packaging.

What are the risks of vaping? As others have said, education is really important on that. For our children, in the short term, its powerful addiction causes problems with concentration, with some having to leave lessons because they cannot cope until the end of a double lesson without vaping. In some cases, as we have heard, it causes chest symptoms and can cause collapse. In the long term, the simple answer is that we just do not know.

A recent University College London study showed that DNA methylation—modification of DNA—occurs in people who vape. Does that show that vaping causes cancer? No, it does not. Time will tell us that, but it suggests at least that it might. That is why we must be extremely careful with our children. Adolescents will always experiment with substances because it is in the nature of adolescence to experiment with boundaries, but we need to ensure that we take as much care of them as we possibly can.

In particular, I welcome clause 10, which will allow the provisions to be extended to other nicotine products. The industry is making billions of pounds, and it will continue trying to flex to try to keep people addicted to nicotine. We can see that today. A search on the internet shows that Tesco is selling 20 nicotine pouches for £6.50. Those tiny pouches of up to 12 mg of nicotine—about 10 cigarettes-worth—are placed under a person’s gums and will release those 10 cigarettes of nicotine over an hour. They are sold in flavours called “Ice Cool”, Bergamot Wildberry”, “Mocha” and “Elderflower”. Does the House see a pattern here? That will be the next thing, and that is why I welcome the clause, which will allow the Government to reflect, if they want, on new forms of nicotine use.

I have some questions for the Minister. The Health Act 2006 prevents smoking in enclosed public spaces, on public transport and in certain other areas. Why has that not been extended to vaping? Also, as I was walking through Westminster the other day, I saw a big red Transport for London bus advertising vaping—something I have written to Sadiq Khan about. I wonder whether the Government plan to extend vaping regulations not just to what the package looks like but to the advertising itself.

[Kirsten Oswald]

Will the hon. Lady give way?

[Dr Johnson]

I will not, because I have only a minute left.

The hon. Member for York Central (Rachael Maskell) mentioned the advertising at Blackburn Rovers; again, sports advertising while children are watching is not helpful.

I have a final question for the Minister. Given that this is urgent, we are seeing so many children starting vaping and we want to stop people smoking as soon as possible, why are we waiting to bring in the regulations? Why not bring them in to affect children more quickly?

Cass Review

Caroline Johnson Excerpts

Monday 15th April 2024 Commons Chamber

[Victoria Atkins]

As I have said, we hope to expand it to Bristol later in the year, and there will be a further three or four sites across England. However—this is a really important part of the report—this is not just about specialist services but about giving clinicians the necessary confidence to look after children and young people who may well be presenting at their clinics or surgeries with this condition as one of a number of conditions. We want to give them back that confidence, and the comfort of knowing that they need not just go down the narrow pathway of specialist services. Of course that will be appropriate for many, but we want to treat the whole child rather than treating just this particular condition, as has happened in the past.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I must first declare my interest as a practising NHS consultant paediatrician whose practice sometimes involves caring for children with the condition we have been describing.

The Cass Review makes for sobering reading. This is an example of ideology being allowed to trump evidence and safeguarding. Let me give the Secretary of State a specific example. Individuals have thwarted the attempts of those working on the report to conduct research that would give them a better understanding of the outcomes for some children. I am pleased to hear that those people are now co-operating, but we should note the contents of a letter from John Stewart, the national director of specialised commissioning, which is appended to the report. He says that although NHS England wrote to the chief executives and medical directors of all NHS trusts, the research data was not released. One of the duties of doctors that are specified by the General Medical Council is to

“Engage with colleagues to maintain and improve the safety and quality of…care.”

May I ask the Secretary of State who exactly blocked that data, what investigations will be carried out to find out which individuals were responsible, and how they will individually be held accountable for their actions? How was it possible for them to do this in the first place, and what is she doing to ensure that data cannot be blocked in the same way in the future?

Illegal Vapes

Caroline Johnson Excerpts

Tuesday 16th January 2024 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I congratulate my hon. Friend the Member for Darlington (Peter Gibson) on securing this important debate.

Hon. Members will not be surprised by my presence or to hear my stance on this issue. For more than a year now I have championed the fight against youth vaping, an epidemic that is spreading like wildfire. These sleek, colourful contraptions, once touted merely as a smoking cessation tool, have become ubiquitous. They are not just in shops, but litter our streets and are hidden away in our children’s bedrooms and classrooms. According to a recent NASUWT survey, a staggering 85% of teachers reported vaping as an issue among their students. Teachers in my constituency have spoken of pupils struggling to concentrate because of their nicotine addiction and having to leave lessons for vape breaks—let us remember that these are not hardened junkies but schoolchildren.

I propose a number of solutions to this growing problem, including banning the sale of disposable vapes, removing them from public displays in shops and banning the bright colours and sweet flavours, which prolong the addictive effects and are so attractive to children. I welcome the Government’s work and commitments in this area, and I particularly thank the Minister for her commitment to stopping children vaping and her broader commitment to children and their health. However, we need to go further, and I would like the Government to extend the existing restrictions on cigarettes to vaping in public places to ensure that no one, least of all children, becomes an unwitting victim of second-hand vapour.

Coupled with that, we must impose tougher regulations on the advertising and marketing of vaping products. I have previously spoken out against the sponsoring of sports teams and the pervasive advertising that glamourises vapes. I would like to see these products taken off the side of Transport for London buses, off prominent displays in corner shops and away from sports stadiums. Instead, they should be put discreetly away behind the counter, as the medical type of smoking cessation device they are supposed to be.

Moving on to the specifics of today’s debate on illegal vapes, vapes can be illegal for one of two reasons. They are either illegally composed and perhaps have no self-extinguishing mechanism, excessive quantities of nicotine or more puffs than allowed. However, they may also contain harmful toxic chemicals. Last spring, Lincolnshire police took a selection of vapes from children and tested them. These are just some of the chemicals they found: diethylene glycol diacetate, aviptadil, 2-methoxyethyl acetate, poster varnish, Indian snakeroot and antifreeze. Those were all being inhaled by children using vapes in Sleaford.

The other way vapes can be illegal is that they can be sold illegally to children under the age of 18. Indeed, vapes can be illegal in both the ways I have mentioned. Newspapers locally are reporting an example of a police officer in Sleaford who recently stepped into a local shop to stop illegal vapes being sold to children. Those products were illegal not just because they were being sold to children, but because they contained much more than they ought to.

The next question is what we can do about this. We have talked about ways in which we can tackle the use of vapes. I welcome the vapes enforcement squad the Government put together with £3 million earlier this year, but we need more. There is no registration scheme for selling vapes, in the way there is for alcohol and tobacco. I would like to see a registration scheme for vapes, tied to alcohol and tobacco, specifically to disincentivise unscrupulous sellers. If they lose the vaping licence, they would also lose the alcohol and tobacco licence. I would also like to see an increase in on-the-spot fines, from £2,500 to £10,000, so that there is a significant disincentive to this behaviour. Let us face it, these people are making money out of this, and that is why they are doing it—they are making money out of selling illegal things to children that will harm them.

Another idea is an import tax. It has been proposed to me that one challenge facing Border Force is that vapes are not subject to excise. If they were subject to excise controls, Border Force would be able to intercept some of the illegal vapes. That is much more challenging because there is no excise duty on vapes. Also on the issue of tax, I am a Tory and would normally advocate cutting as many taxes as possible, but I think there is a place to put tax on vaping devices. Even with tax, they would still be potentially much cheaper relative to their nicotine content than cigarettes, making them a cheaper option for a genuine adult smoker who wishes to quit, but they would be more expensive for children, taking them out of the realms of pocket money.

In summary, this issue demands bold action, as it did when I first stood up to discuss it a year ago. I urge the Government and all hon. Members to join me in ensuring that vapes are used as a cessation device, as they are supposed to be. Only by toughening our response to a rogue industry can we protect our children from the suffocating grip of addiction.

--- Later in debate ---

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is an honour to serve under your chairmanship, Sir Mark. I thank the hon. Member for Darlington (Peter Gibson) for securing this important debate, and the many colleagues who have made excellent points, including my hon. Friend the Member for City of Durham (Mary Kelly Foy) who is a great campaigner on this issue.

Many Members have focused their remarks on the impact of vaping on children, and they are absolutely right to do so. The Opposition recognise the value of vapes as a stop-smoking tool. They have their place. The chief medical officer put it bluntly:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.

But the CMO has also been blunt about the epidemic rise in youth vaping in recent years. Nicotine addiction is in no one’s interest apart from the companies that profit from it. Certainly no child should be vaping. We do not even know some of the long-term risks of the ingredients used in vapes, and certainly not when inhaled by young people whose lungs and brains are still developing.

However, I am afraid to say that the Government have been asleep at the wheel. In 2021, as we have heard, Labour voted for an amendment to the Health and Care Act 2022 to crack down on the marketing of vapes to children. Since then, as Labour has found, the number of children aged 11 to 17 who are vaping regularly has more than trebled. That is more than 140,000 British children. Meanwhile, one in five children have now tried vaping. Does the Minister regret that her Government and MPs voted against the amendment in 2021?

The issue is that it is now 2024 and we still have no legislation in place. It is bad enough that so many children are using these products, but, as other Members have said, it is even worse when we consider how many products on the market are illegal in their own right. As the chief medical officer has warned, those products can contain dangerous chemicals such as lead and nickel. Some contain nicotine when claiming they do not, or harmful tetrahydrocannabinol chemicals found in cannabis. To be clear, in most cases that amounts to a failure in enforcing existing regulations, and it really is shocking.

Last year, Inter Scientific and the BBC conducted an analysis of vapes confiscated from schoolchildren, and found that the vast majority did not meet UK product regulations and were actually illegal. In a separate analysis of 300 products seized by various trading standards around the country, they found that 88% were non-compliant with UK regulations; 23% had a nicotine strength over the legal limit; 15% contained lead, which when inhaled can damage children’s central nervous system and brain development; 100% contained nickel; and 33% contained nicotine, despite being marketed at 0%, which absurdly means that they can be sold to children. Can the Minister tell us what she will do to crack down on the influx of illegal vapes so that dangerous products are not falling into the hands of our young children?

From speaking to experts in the industry, I have heard that there has been an influx of illegal vapes into the United Kingdom in recent years. One expert I consulted said they think that around 6 million illegal vape products have flooded the UK in the last 12 to 24 months. Can the Minister comment on why the UK seems to be targeted more than many other countries, and where she thinks these products are coming from? Until now, UK regulations have largely inoculated us from public health scares such as the spate of hospitalisations from popcorn lung in the United States, but does she share my concern that if we do not get a grip on illegal products flooding our markets, we could face something similar here? Lastly, can she comment on what she has learned from the Government’s consultation about the percentage of vapes circulating in the UK that are illegal under the 2016 regulations? If it is anything like the 88% found by Inter Scientific, we have a very big problem.

A glaring issue that many have identified is enforcement. As we all know, trading standards is stretched and Border Force is evidently not stopping the import of illegal vapes in sufficient numbers. However, the Government have not made their job easy. One issue is the confusing regulations. I know that the Government have said they will act to close the loophole that means that while it is illegal to sell vapes to children, it is fine to hand them out. We have heard less from the Government on the fact that it is also currently legal to sell nicotine-free vapes to under-18s, which is of serious concern. Labour has been vocal on this issue. As I have flagged, these 0%-nicotine vapes in fact often do contain nicotine or other harmful chemicals. Will the Minister confirm that the Government will take action to ban those vapes being sold to children? It strikes me as a blatant loophole that is giving unscrupulous companies scope to hook young children on their products as a gateway to addiction. These 0%-nicotine vapes are out of the scope of the regulations, meaning they do not need to be registered with the MHRA. Will the Minister now require all manufacturers to notify vape products regardless of nicotine content to the MHRA? This would allow for a complete database of products where currently it is not possible to say which products are legal or illegal, which really undermines enforcement action.

Speaking of the MHRA, we must also recognise that the relevant authorities are not always empowered to do what is needed to crack down on those breaking the rules. It strikes me as a serious shortcoming that as long as producers complete notification requirements with the regulator, their product is allowed to go on the UK market without being tested as a whole. The MHRA—the regulator—does not have powers to test products to determine whether they are even compliant with what producers claim are in them, nor to remove notifications once published.

The fact that under this Government children are using vapes with nicotine in them is pretty scandalous, given what we know about the lack of regulations. I say that because when the producer of Elf Bars was found to be selling products that had larger tank sizes than allowed, the regulations did not provide the MHRA with the power to remove the product from the market, as the product notifications said that it was compliant. That is farcical.

This matter is a huge concern not just for me, but for most Members across the House. Will the Minister say whether she is looking at this as part of the legislation? Will she consider allowing the MHRA to use notification fees for testing and enforcement and giving it the powers to remove notifications from publication and, if necessary, take products off the market? Likewise, does she believe that Border Force has the powers that it actually needs? Will the Minister finally tackle the issue of youth vaping, as we have heard about from many Members, by doing what Labour has called for for years and banning vapes from being branded and advertised to appeal to children? We have all seen the displays in our local off licences, with flavours like gummy bear and unicorn shake, looking like colourfully packaged pick ‘n’ mix products at pocket-money prices. These really do need to be banned.

[Dr Johnson]

The hon. Lady is making some very good points about the regulations that need to be brought in to protect children. I do not think anybody thinks that the colours and flavours are not there in some ways to attract children—how many adults are going to want a unicorn milkshake-flavoured vape, whatever that tastes like? On that point specifically, would the Labour party support legislation brought in by the Government to ban all but one colour and to severely restrict the flavours available?

[Preet Kaur Gill]

What has been marketed at children, definitely, is the different flavours. However, I appreciate that adults do choose different flavours as part of their whole smoking cessation, so we need to look at the evidence in the round once we are looking at the Bill. I would be keen to hear at what the Government say on that and to look at the evidence base. We need to look at the ingredients, the make-up of colours and how we get those flavours—it is about what those ingredients actually mean. We have to ensure that we have a proper evidence base on that issue.

[Dr Johnson]

I was talking to an industry representative about the issue of flavours in particular, and he told me that when a smoker decides to quit, they often start with a tobacco-flavoured vape. When their sense of smell and taste improves because they have stopped smoking, they then no longer like the taste of the tobacco vapes, so they move on to cherry cola or some other flavour. That actually can persist their addiction. The concern about removing the flavours is that instead of stopping using the vapes, people will continue—

[Sir Mark Hendrick (in the Chair)]

Order. Interventions are meant to be short. The hon. Lady has already spoken, and we still have the Minister to come. She requires 10 minutes at least, and it is now 5.19 pm. I suggest to the Opposition spokesperson that she makes an end to her speech fairly quickly.

NHS Winter Update

Caroline Johnson Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

I am so sorry, I do not know who the hon. Lady is referring to. On the Conservatives’ plans, at the 2022 autumn statement we announced up to £7.5 billion of additional funding—an historic increase—and we did not stop there. This summer, we announced an additional £600 million, which brings it up to £8.1 billion of additional funding over two years. That will support our care workforce, and the majority of the funding will end up in the pockets of the amazing people who provide care and support to the patients we are all concerned about.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I declare my interest as a member of the BMA and an NHS consultant who has worked during the industrial action. Let us make no mistake that these strikes are causing suffering to patients, both adults and children. The derogation process has not worked because, as the Secretary of State said, the BMA has not returned junior doctors to work when they have been asked to—where there has been a risk of dangerous harm to patients. The first duty of any Government is to protect their citizens, so when will the Secretary of State bring forward the minimum service levels to protect patients from these dangerous strikes?

[Victoria Atkins]

First, I sincerely thank my hon. Friend. I was in contact with her over the weekend when she had come off a very long shift in emergency care, looking after patients locally. I have nothing but admiration for her and the many, many other people who stepped in at short notice to cover urgent and emergency care in our NHS during the strikes. On minimum service levels, she will know that we have already introduced them for ambulance services—something that was opposed by the Labour party—but we have just closed the consultation on minimum service levels in hospitals and we are, of course, carefully analysing the responses. Again, the point that 40—four zero—patient safety mitigations were made by NHS leaders yet only two were granted by the BMA, is very, very worrying when it comes to how seriously the BMA is taking concerns about patient safety.