Tobacco and Vapes Bill

Lord Mawson Excerpts

Report stage
Tuesday 3rd March 2026 Lords Chamber

[Lord Mawson (CB)]

My Lords, I support the amendment from the noble Lord, Lord Young. Supporting a smoke-free society is the right direction of travel, in my view, but I also worry about contact with reality.

A road map should also include the potential unintended consequences of cannabis smoking in a smoke-free country, with real targets and interventions. Walk across London and other towns and cities and smell the cannabis smoking on every street corner. People are breaking the law, with the police doing virtually nothing about it.

Cannabis has profound long-term health implications in the young. Some of us have worked in this space and have to deal with them. What are the unintended consequences of the Bill for the uptake of cannabis smoking among the next generation? I ask the Minister: what work have the Government done on the unintended consequences of this policy, and what do they plan to do about the potential uptake and increase in cannabis smoking, and the increase in illicit dealing on our streets?

[Baroness Walmsley (LD)]

My Lords, I thank the noble Lord, Lord Young, for tabling Amendment 202, to which I have added my name. It would require the Government to publish, every five years, a road map to a smoke-free country: in other words, a plan for the event rather than a review after it.

There are two essential components to achieving a smoke-free country. The first is that no one should start smoking at all. I hope that the Bill will successfully achieve that over time; the Government have shown great ambition in this area. The second component is that all current smokers are supported to quit, so that everyone stops. On this second part, the Government have been a little quieter, until recently. We have heard about the recent success of targets met for the number of pregnant women smoking at the time of delivery: I think it has gone down by half. However, the rates for other groups remain stubbornly high and we are not seeing the same targeting interventions. We need to ensure that we have this type of focus, energy and commitment with other groups, where we know that smoking rates are higher. Plans for these groups could be located in the road map being proposed.

For example, mental health is a key priority area for the Liberal Democrats. There is a dual causal relationship between smoking and mental health: if you smoke, it increases your chances of developing mental health conditions and, if you already have a mental health condition, you are more likely to smoke. Nearly half of those with a serious mental illness in England smoke, alongside a quarter of people with depression or anxiety, compared with 11.6% of the general population. High rates of smoking in this population have a disastrous impact on physical health, particularly for those with a serious mental health illness who, on average, live 15 to 20 years less than someone without. It is estimated that smoking accounts for about two-thirds of this reduced life expectancy.

The pervasive false narrative that smoking somehow alleviates mental health symptoms urgently needs to be addressed, as it creates so many challenges when we are trying to support these smokers to quit. If the Government are going to publish a strategy, a dedicated section on how they will bring down smoking rates in this group would be extremely welcome and needed. I welcome the Government’s concession that vaping vending machines should be allowed in secure adult mental health settings; this should certainly help this population to quit.

Amendment 206, tabled by the noble Lord, Lord Lansley, would require the Government to publish a review of the Bill. I welcome government Amendment 205, which does something similar but with a lot less granularity. However, would the Minister give us a little more information about where the Government will get their evidence to underpin the review? Can she assure the House that that evidence will be independent and not influenced by any lobbying or so-called evidence put before the Government by big tobacco, or anybody else who would benefit from slowing down the elimination of smoking in the UK?

The intent of this review should be to support the legislation. As several noble Lords have said, the smoke-free generation is a novel policy and we need to demonstrate the impact and evaluate implementation to encourage other countries to follow. There are also many regulations on the way, along with those from other government departments, on nicotine products. A clear analysis of how these policies will work together would be very welcome.

However, the review must not be viewed as a sunset on the smoke-free generation, and I would welcome comments from the Minister on what, at this point, we know will not be in the Government’s review. For example, the Bill’s impact assessment notes that many of the health impacts of the rising age of sale will not be seen for 10 years, so we should be mindful that this part of the Bill is playing a very long game. There may be early data that we are on the right track and the review will perhaps be able to look at compliance, retailer feedback and all the other things that the noble Baroness, Lady Fox, mentioned. I feel that much of this falls into the scope of her Amendment 207.

Finally, Amendments 91, 120, 201 and 216, tabled by the noble Baroness, Lady Hoey, raise concerns about the Bill’s implementation in Northern Ireland. I have been reassured by the Government’s response to the TRIS process, which lays out in some detail their response to the concerns raised, but, as the noble Lord, Lord Forbes of Newcastle, mentioned, the legal opinion published in the Daily Mail was commissioned by the Tobacco Manufacturers’ Association. Without seeing it, I cannot really comment other than to say it is not surprising that the industry is laying the ground for future legal challenges. It is, as we know, highly litigious and wants to chill the appetite for tobacco control globally. It all goes to show, I suppose, that if you put two lawyers into a room, you get three opinions. There are, as we have heard from the Minister on other occasions, other legal opinions out there that say that the Bill is compatible, but I leave the noble Baroness to answer for those concerns. However, I support the Government to press on with this vital public health legislation, and to plan it and review it as required.

Terminally Ill Adults (End of Life) Bill

Lord Mawson Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.

[Lord Mawson (CB)]

My Lords, as the noble and learned Lord knows, I have spent a lot of my life working with people in housing estates in the East End of London. Research we did some years ago discovered that virtually every nation on earth is represented in the housing estates where I worked. I have spent a lot of my time, nearly 40 years, working with Bengali families. We know each other quite well, but do I really know what is going on in the minds of that community or with that single mother, trapped in a house, who does not speak English after all these years? The truth is that I do not. It is really difficult to know. In the same way, I find it difficult, as a Yorkshireman, to help southerners understand what is really going on in Yorkshire. Even though I have tried it many times, the quality of their fish and chips really does not cut it.

One of my problems with this overcertainty is that it feels like a very white, English conversation, when actually this country is a global community, with people from many different cultures, all over the world. What concerns me is the practicality of much of the discussion that I have listened to today, and I have no idea how you actually understand coercion or encouragement—I think that is a really important word—in practice. Having spent many years of my life with these people, I would not pretend to know what I was really hearing, at such a point, and what it meant for their life in practice.

[Lord Falconer of Thoroton (Lab)]

I completely agree that the noble Lord and I might well not understand what people from different cultures would say, but the two doctors and a panel would have to understand that sufficiently to reach a conclusion. If they do not, they cannot provide the satisfaction that is required by the Bill. The idea that the people who will make the Bill work are all from a particular class, demography and education is, with respect, wrong.

[Lord Mawson (CB)]

Will we have enough people from these different cultures with the skills and knowledge to enter into that kind of understanding, whether they are doctors or on the panels? It is really difficult to understand how that practical proposition will work in the real world—in the East End of London.

[Lord Falconer of Thoroton (Lab)]

That will very much depend upon the number of people who apply from particular groups, and I think one can be pretty sure, on the basis of the impact assessment, that there will be sufficient numbers.

Mental Health Bill [HL]

Lord Mawson Excerpts

Committee stage
Wednesday 22nd January 2025 Lords Chamber

If the Minister is minded to resist the amendment, can she tell the House how the Government propose to deal with these massive problems of withdrawal? I am very happy to receive a letter or to have a meeting to discuss this. I commend the amendment to the House.

[Lord Mawson (CB)]

I support Amendment 148 from the noble Lord, Lord Crisp. I have just arrived back from a three-day event with Professor Brian Cox in Northern Ireland, where we had been bringing together the NHS, schools, the business community and the public sector around a whole programme on innovation and how we think about the future with regard to these matters, taking the principles that we originally developed at the Bromley by Bow Centre in the East End of London, now nationally across the country.

If I look like I am in recovery, it is because I am—I have literally just landed trying to get back here. I apologise that I could not take part in the Second Reading, because being a working Peer, sometimes it is not very easy to fit all this into the diary. One does one’s best.

I am very aware of the questions that the noble Lord, Lord Crisp, is raising. Indeed, I tabled a number of Written Questions this week about this very matter. I support the amendments because we have a very serious problem out there. My GP colleagues are telling me, as the noble Lord, Lord Crisp, has said, that one in five adults in England is on antidepressants; it is one in four in Scotland. This is a really serious problem.

As a country, we need to return to a discussion and a conversation, as the Health Secretary—I hope, in the spring—prepares to help us rethink the future of the NHS. We need to return to the question that we asked 40 years ago in the East End of London, the fundamental question: “What is health?” What we see happening here is serious for hundreds of thousands of people and is driving a culture. We also need to start to worry about what is happening within the machinery of the NHS and the state, as it drives these sorts of cultures.

Finally, as I put down in one of my Written Questions, we need to be asking, practically, “How much is it costing the taxpayer to drive these kinds of cultures?” It is serious, but the problem is also an opportunity, if interest is raised in the work of those of us who have been doing stuff on the front line for many years with our GP colleagues. I see the noble Lord, Lord Clement-Jones, there: we have rebuilt a street together, with a £40 million school, a £60 million health centre, 600 homes and now a primary school, exploring this, in what when we began was a dysfunctional housing estate.

There is a real opportunity out there, but we now need to get real about antidepressants.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I have some points I would like to probe in this group.

I especially welcome Amendment 95 and the proposed new clause:

“Ascertaining and learning from patients’ experiences of hospital treatment”.


The noble Earl, Lord Howe, made very powerful and moving points; we could really take those on board. I have some reservations, however: we live in a complaints culture. I am concerned that this important notion of learning from patients’ experiences does not become a way of stigmatising hospital staff and psychiatrists, with people queueing up to point the finger. There are many people I know who have experiences of hospital who will, at a particular time, tell you it was a terrible experience, and then, at another time, acknowledge that it saved their life. It depends on what phase they are in, in relation to their illness, in some ways—it is about their perspective. So I both welcome it and challenge it.

I am very keen, as we all are, that treatments are taken seriously, whether administered in hospital or in the community. As the noble Lord, Lord Crisp, and the noble Baroness, Lady Hollins, note in Amendment 148—for me, the most important amendment in this group—we need to be alert to when, for example, the use of psychiatric medication as a treatment creates a problem of dependency. We all know that this is a growing problem. We must consider that.

On the tenor of Amendments 50 and 51 from the noble Baronesses, Lady Tyler and Lady Bennett, on non-drug-based forms of medical treatment, I am less convinced by the emphasis here. I am worried about simply giving a wholly positive view of psychological and therapeutic treatments, because it perhaps misses some of the changes in today’s culture that lead to the overprescription of, for example, antidepressants.

When I was working in community mental health many moons ago, the fashion among progressives in the therapeutic community was often anti-psychiatry, anti-hospital and most definitely anti-pharmacological interventions, with a huge hostility to the pharmaceutical industry. I did not always go along with it, but that was the kind of mood. Peculiarly, I would argue that, today, it is therapeutic experts, counsellors and psychological practitioners who, by becoming diagnostically trigger-happy in labelling people as ill, are creating a huge demand both for third-party interventions, as I have discussed in previous speeches, and for treatment. That often leads to a clamouring, especially among younger people, for pills to help them to cope with the travails of life, and it has been egged on in some ways by therapeutic practitioners.

I had my attention drawn to this when, at the Academy of Ideas, I organised a debate on young people, mental health and those kinds of issues. The audience was largely young people, who said that the problem was that psychiatrists, GPs and doctors would not listen to them and would not believe that they were mentally ill. They demanded treatment and were quite aggressive. It was young people saying, “Where are my tablets?”, and I thought, “Oh, life’s changed slightly”. The psychiatrists in the room were trying to hold the line and gently suggest that maybe they were not ill, but that led to an even more hysterical reaction: “How dare you say I’m not ill?” They went on to explain how they had had a chat with their school counsellor, and they were sure they were ill, and they wanted the tablets.

If we can take a popular example that I appreciate might get me into the heart of an argument that I do not want to be in regarding the slippage between autism and mental illness, I am going to talk about ADHD. ADHD is the fashionable disorder of the day. Huge numbers of students and school pupils are demanding that their neurodevelopmental disorder is recognised and catered for. In my view, it is often diagnosed promiscuously and that is leading to huge demands that are detrimental to education and likely to make councils go bankrupt and schools collapse—but that is for a different debate and a different Bill. ADHD is also leading to a demand for tablets.

I go along with those who were warning about overdiagnosis. The Times reports that 278,000 people in England are on central nervous system stimulus to treat ADHD, and there was an 18% hike in prescriptions for ADHD drugs between April 2023 and March 2024. In the US, the figures are startling, and we should be wary of them, with 7 million American children who are said to have ADHD. As the New York Times has said, there is a danger that we are using stimulants to suppress

“all spontaneous behaviour in normal children”

by pumping them with Ritalin and other calming drugs and sedating normal children. In a broad sense, that is a worry.

Talking of treatments, I think the noble Lord, Lord Crisp, made the point that a social problem is being created of people feeling that if they are ill, they cannot go to work and of over-giving them drugs. All sorts of problems go along with that. Is it not tragic that so many people want to have these drugs, either for themselves or for their children, in order to feel that they can cope, when they are really not that ill or not ill at all, but they have the label? I am wary of inappropriate treatments, but perhaps the problem needs to be looked at differently, as stemming from inflated and expansive diagnostic criteria often deployed from within the therapeutic community rather than psychiatry.

We should not be naive in thinking that non-drug-based therapeutic interventions are virtuous per se. Counselling, for example, has extended its reach into British society so much that it is now a rare family that has no experience of the phenomenon. I am sure that we all know that going to a therapist or counsellor is, to say the least, a mixed bag when, ironically, they end up saying that you need to have third-party intervention or medical intervention. It is bad for the nation’s health.