(1 week, 5 days ago)
Grand CommitteeMy Lords, I want to dispose of this very quickly. I must start with an apology because I am trespassing greatly on the indulgence of the Committee; I must also declare a non-interest by making clear that I do not have an interest.
This amendment is very awkwardly and almost misleadingly worded, as it is limited by scope and reasons; I am perhaps trespassing beyond the scope of the Bill in raising this matter at all. That is the first thing I have to say. The second is that I am advancing this argument on behalf of a firm, Allen Carr’s Easyway, which is deeply involved in the smoking cessation business. I have no financial or other interest in the firm; in fact, apart from email exchanges, I have never met the people involved, as far as I am aware.
I wish my noble friend Lord Bethell were here—he does apologise. As a former Health Minister, his experience is that Allen Carr’s Easyway is a firm that does tremendous work in the field of smoking cessation. It produces books and booklets that encourage and inspire people and facilitate them, psychologically, to stop smoking. It also runs seminars and other in-person group sessions. When I gave up smoking three years ago, it was partly with the help of a copy of one of its books, which was given to me as a present by my sister.
It is also—this is perhaps the crucial factor—one of the four different smoking cessation methods recommended by NICE. It is not only recommended: the guidelines for local smoking cessation services which receive government funding say that there are four different smoking cessation methods that local stop smoking services must ensure are accessible to adults who smoke. They are behavioural interventions; medicinally licensed products, including nicotine replacements; nicotine-containing e-cigarettes; and Allen Carr’s Easyway in-person group seminars. However, it is the case that, throughout the country, most stop smoking services do not offer Allen Carr’s support as one of those options; they go for the easy options, if you like, of nicotine replacements and e-cigarettes.
The crucial difference is that, if one stops smoking in the old-fashioned way, one gives up not only cigarettes but nicotine. If, as some of us have found, you move from cigarettes to vapes or other nicotine-replacement devices, you may give up smoking, which may be very good for you, but you do not break the habit or the addiction to nicotine. It is much easier for the local stop smoking services to encourage that path, and so very often they do not follow the NICE guidelines, despite the fact that they are required to.
The Government provide, I believe, about £150 million a year in grant funding for local smoking cessation services. My request is that the Government make it a condition of those grants that all the NICE-recommended methods be supplied by the local smoking cessation service before it receives a grant. I do not expect the Minister to give that commitment at the Dispatch Box today, because of a lack of preparation—I have given her no warning of what I was going to say—but I hope she will be able to write to me and say that that will be a course that the Government will want to follow. If necessary, I am very happy to facilitate a meeting between her and the people from Allen Carr’s Easyway, so that they can describe the good work they do and explain the difficulty they have in reaching smokers through local smoking cessation services, despite the requirement placed on them to facilitate that. I beg to move.
My Lords, I shall say a few words in support of Amendment 147 from the noble Lord, Lord Moylan. I think his intention is quite correct for the following reason. Many of those who wish to stop smoking want to be released from the addiction to nicotine altogether, as they did in the old-fashioned way, as he has just said. They do not just want a less harmful nicotine hit. It is an expensive and harmful addiction, particularly for the developing young brain, yet we are told that many young people are becoming addicted to nicotine through vapes and tobacco pouches, and there is no help for them to quit in many places. As the noble Lord said, NICE guidelines list four services that should be available, including behavioural interventions and in-person group sessions, to help people quit, as well as nicotine-containing replacements for tobacco, which are available in most local stop smoking services. I have received a briefing from Allen Carr’s Easyway, although I have never come across the company before.
There is some evidence that some people who manage to stop smoking tobacco by using a nicotine replacement go back to smoking tobacco in the end. Quitting nicotine altogether has been shown to be more sustainable; people go back to smoking less often when they have managed to kick the nicotine habit as well. I assume that that is why NICE has recommended that services to get off nicotine addiction must be offered as well as vapes and patches. I note that, in its guidelines, NICE does not say “should” or “could”; it says “must”.
The ultimate role of NICE is to ensure that people across the UK have access to the most effective and cost-effective treatments and services; that is why it says that all four methods of quitting should be available. It may be much easier, quicker and even cheaper just to hand out patches and vapes—it is certainly much more difficult to arrange behavioural therapies and group therapies—but, for some people who want to quit smoking, it is more effective for them to have behavioural therapy, group therapy and the help of Allen Carr’s Easyway. That company must be good, authentic and of a high quality if it is recommended by NICE.
I certainly support the intention of the noble Lord, Lord Moylan, in his amendment.