Smoking-Related Diseases

Lord Ribeiro Excerpts

Wednesday 14th September 2016 Lords Chamber

[Lord Ribeiro (Con)]

My Lords, I thank the noble Lord, Lord Faulkner, for taking on this debate from my noble friend Lord Young of Cookham.

The Wanless report in 2011 warned of a sharp rise in avoidable deaths if we did not take prevention seriously. The NHS Five Year Forward View identified the future health of millions of children, the sustainability of the NHS and the economic prosperity of Britain as dependent on a radical upgrade in prevention and public health. The Government are to be congratulated on achieving their targets under the old plan. Targets for adult smoking rates down to 18.5%, smoking rates among 15 year-olds down to 12% and smoking rates in pregnancy down to 11% have all been met. It is an excellent record but more is needed to achieve the Prime Minister’s stated aim to reduce inequalities in health and the gap between rich and poor.

Smoking prevention can also be achieved in acute settings. Anesthesiology noted in 2011 that smokers were 38% more likely to die after surgery than non-smokers. In my own specialty of colon and rectal surgery, smoking was a predictive factor in causing anastomotic breakdown and poor wound healing. I was accused of being draconian for advising my patients to stop smoking before surgery. However, we have evidence to show that stopping smoking two months before surgery provides the most benefit for patients and reduces complications. It strikes me that this would be a good time to offer a smoker an e-cigarette—preferably on prescription. This approach was endorsed by the Royal College of Physicians and the Royal College of Surgeons and others in a joint briefing in April 2016, which encouraged healthcare providers to be proactive in supporting those who want to use e-cigarettes. We must of course be careful not to encourage young people to try them. We must use every means, including mass media, as the noble Lord, Lord Faulkner, mentioned, and social media to change public attitudes to tobacco smoking. A campaign to stop smoking in cars with children present was a case in point. Can the Minister say what plans he has to consult the public on a new tobacco control strategy?