Tobacco Harm Reduction
Viscount Ridley Excerpts(5 years, 8 months ago)
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Viscount Ridley
To ask Her Majesty’s Government what assessment they have made of the levels of smoking and incidence of lung cancer in Sweden as a result of steps taken by that government; and what plans Ministers have to visit that country as part of their forthcoming review of tobacco harm reduction.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)
My Lords, the current smoking rate in Sweden is 13%, compared to England where the rate is 14.9% and, across the UK, 15.1%. There are no current plans to visit Sweden. Smoking is at the lowest level recorded in England but we are not complacent and remain committed to reducing the rate to 12% or less by 2022, as outlined in the tobacco control plan for England.
Viscount Ridley (Con)
My Lords, I thank my noble friend for that reply. She will be aware that the policy of harm reduction, whereby a less harmful new technology is used to displace a more harmful technology, was pioneered in this country by the noble Lord the Lord Speaker when he was Health Secretary in the 1980s with respect to needle exchanges and HIV. Such a policy has since proved effective in the introduction of e-cigarettes. However, in Sweden, the adult smoking rate is now down to 5% because of another harm-reduction technology, snus—the little teabag of snuff tobacco that one presses against one’s gum and is widely used in Sweden. As a result, there are low lung cancer rates in that country but, because snus is banned in the EU, we are currently unable to follow. Could we not save tens of thousands of lives if we were to legalise this technology when we left the EU at the end of next week?
Baroness Blackwood of North Oxford
I thank my noble friend for his question and join him in paying tribute to the noble Lord the Lord Speaker’s role in harm reduction. No tobacco product is safe to consume, due to its links to cancers. As my noble friend says, snus is banned under the EU tobacco products directive as an oral product, except in Sweden. We have made a commitment under the tobacco control plan that, following EU exit, the Government will consider reviewing the position on snus and whether the introduction of the product to the UK market would promote the kind of proportionate harm-reduction approach that he proposes. However, there is no evidence that snus in Sweden has reduced smoking rates, so the matter is very much under review.
NHS: Artificial Intelligence
Viscount Ridley Excerpts(6 years, 7 months ago)
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Lord O’Shaughnessy
The noble Baroness has highlighted two of the recommendations from the report. I support the proposal for a regulatory framework; it is a piece of work that I have kicked off in the department. I cannot put a timing on that, but I understand the need to provide a safe operating environment so that people who want to get into this field, whether from NHS trusts or businesses, can do so knowing that they are operating on a legal basis. That is something that we are working on.
On digitalisation, she is quite right: the £4 billion programme known as Personalised Health and Care 2020 is trying to deliver before 2020—as the name suggests—the kind of digitalisation that will enable AI to bring those benefits across every corner of the health and care systems.
Viscount Ridley (Con)
My Lords, is the Minister aware that many parts of the world envy Britain’s strengths and opportunities in AI, particularly in the health area, and that government procurement could turn this early lead into a golden opportunity for the UK?
Lord O’Shaughnessy
Yes, I absolutely agree with that. As the report highlights, we have a unique opportunity because of the nature of the way that the NHS was set up and its potential for realising a comprehensive data set of 65 million people. It is not just about those procurement rules; we have talked about having the right framework. It is about providing reassurance within the system—at a time when the public are beginning to understand just what data can do for good and for bad—that the NHS will use their data safely, securely and legally so that they can trust that it is being used for proper purposes from which they will benefit.
Smoking: Vaping
Viscount Ridley Excerpts(7 years ago)
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Viscount Ridley
To ask Her Majesty’s Government whether, in the light of Public Health England’s decision to include vaping within its stop smoking campaign for 2017, they will review vaping regulations in line with the commitment in the Tobacco Control Plan for England; and if so, when.
The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)
My Lords, the Government are committed to a review of the Tobacco and Related Products Regulations 2016 by May 2021. There is limited scope for amending the regulations in advance of the UK exiting the EU, so the Government envisage a review taking place after 29 March 2019. Protecting the public’s health will be the priority in any review.
Viscount Ridley (Con)
My Lords, I thank my noble friend for that Answer but I am a little disappointed. Given the strong evidence that vaping is much safer than smoking, that it is very effective at getting people off smoking and that the strength of the vaping industry in this country is one of the main reasons why we are now the second-lowest smoking country in Europe, and given that the Government promised some sensible deregulation in the tobacco control plan, does the Minister share my regret that the EU’s tobacco products directive restricts advertising in particular, making it very hard for vaping companies in this country to bring to smokers the news of the health benefits that can come from it? Will he consider a public information campaign to bring the country’s attention to what vaping can do? Will he perhaps also consider giving clear advice to businesses and councils that they should not be treating vapers as smokers?
Lord O'Shaughnessy
The noble Viscount is right to highlight the benefits of vaping: it is considerably safer than smoking and is a very effective quitting aid. There is no particular evidence that it encourages people to take up smoking or to transition into smoking. Government policy has, obviously, been made under the EU regulatory framework—and we think that it is pragmatic and evidence based. Direct advertising is, as he will know, banned, but the department, Ofcom and the Advertising Standards Authority are looking at the current guidelines in this area. I should point out that Public Health England includes in its public health campaigns positive messages about the relative benefits of vaping, so that message is getting out. In the end we must beware of renormalising the act of smoking, even if with a different device, particularly for children, so there is a balance to be struck.
Gene Editing: Agriculture and Medicine
Viscount Ridley Excerpts(7 years, 8 months ago)
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Viscount Ridley
To ask Her Majesty’s Government whether they have plans to encourage gene editing in agriculture and medicine.
The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)
My Lords, the UK is a world leader in the understanding of genetics, which is already leading to significant advances in medicine and agriculture. Gene editing has the potential to accelerate progress in both areas, saving lives and improving quality of life. The Government continue to support the assessment, refinement and use of genetic editing techniques.
Viscount Ridley (Con)
I thank my noble friend for that reply. Is he aware of widespread concern that, although we are pioneering and leading this essential work using CRISPR and TALEN to edit genes so as to help in both agriculture and medicine, we are falling behind in the race to apply this technology because the use of gene editing in cell therapy for cancer and in producing better crop plants requires and could be encouraged by better regulation? I declare my interests as listed in the register.
Lord O'Shaughnessy
My noble friend is a leading advocate of this technology and is correct that getting the regulation right is absolutely important. It is currently regulated at the EU level, and there is debate on and an inquiry by the European Court of Justice into current exemptions for gene editing. We support the current exemptions, although others have challenged them. But it is also important to recognise that any discussion about gene editing, whether in agriculture or especially in a human health setting, involves big ethical questions and it is only right that we tread carefully as we move ahead.
Health Workers: Training
Viscount Ridley Excerpts(7 years, 11 months ago)
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The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)
It is the turn of the Cross Benches, but they will have to work out who is going to speak for them—and then we will have the Labour Benches.
Consumer Rights (Enforcement and Amendments) Order 2016
Viscount Ridley Excerpts(8 years ago)
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The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
My Lords, the Consumer Rights Act came into force last year. It simplified UK consumer law and it empowers consumers, improves consumer choice and drives competition. The Act provides clear rights for consumers when buying goods, services and digital content. It also provides clear remedies for consumers so they know what they are entitled to when things go wrong and can take action where needed. The Act also provides enforcers, such as trading standards officers, with a set of updated powers, to aid them in investigating potential breaches of consumer law while ensuring businesses have relevant rights of appeal.
The Consumer Rights (Enforcement and Amendments) Order 2016 before us today makes a number of small but essential amendments to Schedule 5 to the Consumer Rights Act 2015. It adds a number of pieces of legislation to the list of legislation in the Act so that enforcers, such as trading standards, can access the updated investigatory powers contained in that schedule. The order will ensure that a comprehensive range of powers are available to enforce the Tobacco and Related Products Regulations 2016, which harmonise trading rules on how tobacco products are manufactured, produced and presented, and the Standardised Packaging of Tobacco Products Regulations 2015, which require cigarettes and roll-your-own tobacco to be packaged in a standard colour with a standard typeface.
Noble Lords will recall that a number of tobacco companies have challenged the standardised packaging legislation in the courts. I am pleased to say that the Government have won on every ground raised, not only in the High Court but also more recently in the Court of Appeal. It will be important, then, that trading standards have wide-ranging enforcement powers to ensure that this legislation now has the maximum impact on discouraging children from taking up smoking and helping smokers to quit.
Lastly, the order also makes consequential amendments to two pieces of legislation so that the investigatory and enforcement powers contained in Schedule 5 are referred to. The legislation affected by the order is the London Local Authorities Act 2007, which tackles rogue traders by requiring mail forwarding businesses in London to register with their local authority, and the Weights and Measures (Northern Ireland) Order 1981, which regulates the quantity of goods and weighing and measuring equipment used by traders. The Government consider that this order provides for the application of the most modern suite of enforcement powers to these pieces of legislation and, importantly, will allow trading standards to play their full part in enforcing the new tobacco legislation introduced by this Government, and in turn continue to drive smoking rates down in this country. I beg to move.
Viscount Ridley (Con)
My Lords, in relation to the tobacco and related products directive, my noble friend mentioned several times the aim of driving down smoking in this country. We are now in a situation in which there are many varieties of tobacco products available to people, many of which do not involve smoking. Could he bear in mind that good intentions in regulation often lead to unintended consequences? Would he ask his officials to brief him on Yale University’s recent research, demonstrating how increases in regulation of e-cigarettes are pushing up smoking rates among young people?
Lord Hunt of Kings Heath (Lab)
My Lords, I thank the noble Lord for his comprehensive analysis of the order before us this afternoon. I declare my interest as president of the Royal Society for Public Health.
We have made great strides in this country in reducing smoking. I am particularly proud of the last Labour Government’s measure in relation to the ban on smoking in public places—and, indeed, of my own amendment in the last Parliament, which the Lords passed, to ban smoking in cars when children are present.
Although the number of smokers in this country has halved since 1974, currently one in five adults still smoke. Enforcing the regulations and legislation relating to the sale, packaging and marketing of tobacco is, therefore, important. In that regard, I want to ask the Minister about progress on the enforcement of the Tobacco and Related Products Regulations 2016 and the Standardised Packaging of Tobacco Products Regulations 2015. Can the Minister confirm that enforcement officers have already had a number of options available to enforce these regulations? Secondly, how much enforcement activity has there been? Thirdly, how good does he assess compliance to be?
I want to pick up the point made by the noble Viscount, Lord Ridley, on e-cigarettes. The noble Lord, Lord Prior, will recall that e-cigarettes were embraced within the tobacco regulations. I want to ask him about the recent alarmist and, I believe, misleading report of the US Surgeon General, on the use of electronic cigarettes by young people, in which he urges greater restrictions on access to vaping products. Would the Minister go so far as to agree with me that it was a pretty shoddy piece of work, which does not seem to be evidence based? Does he agree that it focused on risk to teenagers without looking at potential benefits to adult smokers; that while the science is detailed in the body of the report, the headlines and marketing material are not appropriately caveated; that the report does not put vaping risks into context with smoking or other risks; and that the Surgeon General proposed restrictive policies on e-cigarettes for the supposed benefits to young people without considering the likely harmful consequences for adult vapers or smokers? He also appears to be treating vaping products as just another form of tobacco, which of course is absolutely wrong.
Will the Minister say that the Government will not go down the route that the US Surgeon General has taken? Will he confirm that vaping has been outstandingly successful in helping adult smokers to stop smoking? Will he also confirm that there is no evidence of vaping in the UK being a gateway to smoking for young people? Has he also noticed that, in reality, in the US the most recent data on youth smoking, published, just after the Surgeon General’s report, actually contradicts the alarmist nature of that report, since it shows that vaping is in decline? That point was made by the noble Viscount.
The relevance of raising this in your Lordships’ House today is that the risk is that the kind of alarmist headlines that we heard in our own media in relation to that report might dissuade smokers from switching from smoking to vaping. There are concerns that a large and increasing number of smokers incorrectly believe that vaping is as harmful as smoking, and there is a real danger that smokers may decide not to switch to safer alternatives, such as e-cigarettes, and are potentially missing out on what I can describe only as a very useful smoking cessation aid. Will the Minister reiterate that evidence to date on e-cigarettes indicates that they present a safer alternative to smoking and, for many—for thousands and thousands of people—are a useful cessation tool?
Tobacco and Related Products Regulations 2016
Viscount Ridley Excerpts(8 years, 5 months ago)
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Viscount Ridley (Con)
Surely the tobacco industry looked around the world and saw—like Kodak looking at digital photography coming along—a huge threat to it. Of course it is now trying to muscle in on the act, but this is a good thing. If it starts making electronic cigarettes and becoming more profitable, it will give up on other cigarettes. The reason it got into this industry was because it saw it as a threat.
Lord Faulkner of Worcester
My Lords, I would be a little more convinced if the tobacco industry took its responsibilities seriously in countries where the restrictions on smoking were not the same as in the western democracies. The attempt to promote, advertise and sponsor tobacco smoking, particularly in the Far East, is utterly deplorable. The industry views the whole tobacco and vaping market in a very cynical way, so I am afraid I do not agree with the noble Viscount.
Viscount Ridley
In South America, vaping is banned altogether. Why? Because the tobacco industry is big and powerful in that part of the world.
Lord Faulkner of Worcester
It is very interesting, because in countries which take tobacco cessation seriously, the tobacco industry is switching to vaping, as it knows its traditional market is largely lost. Only last month, in this country, it attempted to undermine public health by trying to overturn the standardised packaging regulations. It cannot be trusted.
Finally, I share my noble friend Lord Hunt’s call for continued funding for stop smoking services, making them accessible and available to all smokers, and for such services to work with electronic cigarettes. It is wrong that these services are being cut back while the regulations are being introduced.
Our aim must be to be as ambitious as the most committed nations are in achieving a tobacco-free society over the next few decades. Over the last 10 years, we have already come a huge distance in changing public attitudes towards smoking, which is now largely seen as a socially unacceptable behaviour. My concern over vaping is that it must not in any way renormalise the smoking habit.
Viscount Ridley
My Lords, I will be extremely brief, because we need to press on to what the Minister will say. However, it is very important to point out that this is smack in the tradition of harm reduction, which was pioneered in this country with needle exchanges for HIV addicts. We did not go round saying, “That’s a bad policy because needles are dangerous things”. We said, “Let’s look at the relative risks”. We now know that there is a motorway out of smoking by vaping, and on the other carriageway there are virtually no cars at all. We have heard the data from my noble friend Lord Cathcart.
One final very quick suggestion is: if we want to get public information out there, why do we not insist that cigarette packets, which already carry a warning label, carry a label which says, “Have you tried vaping instead? There is very good evidence that it is much safer”? That would be factual and targeted at smokers. It would be beneficial, save lives and cost nothing.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
My Lords, before this debate started I had feared that it would be a bit like Groundhog Day in relation to what happened in the Grand Committee Room earlier. However, it has been a fascinating and excellent debate. I thank the noble Lords, Lord Callanan and Lord Hunt, and the noble Baroness, Lady Walmsley, for tabling their various Motions and amendments. This has been a very good debate.
I start from the premise that all my instincts are always against regulation. In my view, there is normally a presumption against regulation. I should also make it absolutely clear that there is no doubt that vaping is far better for you than smoking. If, as a result of these regulations, more people were to carry on smoking, we would indeed have shot ourselves in the foot. To pick up the analogy that my noble friend Lord Ridley used about needle exchanges, the point is that they should at least be clean needles. I agree with his argument but we need some regulation to ensure that vaping is not abused, if I can put it that way.
I wish to make a small number of important points which have been raised by noble Lords. First, we have fought long and hard to denormalise smoking behaviours, and Members of this House have been at the forefront of that. It is right to take a precautionary approach to managing any risk that e-cigarettes renormalise smoking behaviours, particularly by restricting children’s exposure to e-cigarette marketing and imagery. Glamorising these products, with adverts reminiscent of those from the tobacco industry many years ago, can only make them more attractive to children. Recent research by the Cambridge behaviour research unit also suggests that exposure to e-cigarette adverts influences children’s perception of smoking tobacco. It reduces their belief in the harm of occasional smoking. This has the potential to undermine some of the great progress we have made over the last six decades in controlling the smoking of tobacco.
I know that there are calls for a return to self-regulation, but just last week we saw the Advertising Standards Authority rule on a glamorous advert. I do not think that props are allowed in this House, but this is a four-page advert on the front and back of the Evening Standard. On the front, there is a very attractive young woman looking out over London while smoking a cigarette. On the back, there is a James Bond lookalike jumping out of a helicopter. That is not aimed at people who are smoking but at young people who might then think about smoking. Figures have been put about showing that there is no evidence that young people are influenced by this kind of advertising. However, that is not the case everywhere. The US is seeing an upward trend in children who have never smoked cigarettes using e-cigarettes, and data from Poland show that 30% of children surveyed use e-cigarettes. The Government have therefore taken a precautionary approach to any possible risk of the renormalisation of smoking behaviours.
Some 96% of smokers are already aware of e-cigarettes, so I am clear that promotion is not about raising consumer awareness, which already accounts for 96% of that market. While businesses’ ability to communicate about their products may have been curtailed in the interests of protecting children, they have not been banned outright. The regulations will not prohibit information being provided to customers either online or in physical retail outlets. Nor will they ban independent reviews of these products or discussion in e-forums. Some advertising will be allowed, such as point-of-sale, billboards and leaflets. Essentially, these are the information routes that were used when e-cigarette sales and use were growing the fastest. My noble friend made a point about billboards, buses and the like. The reason for the distinction between outlets is to try to minimise the impact on young people. That is what lies behind the differentiation between advertising media.
Secondly, the regulations provide minimum product standards and reporting of ingredients and emissions. This should reassure smokers who are looking to quit that e-cigarettes are safe and high quality, and give the Government and health professionals such as GPs confidence in recommending them to smokers. The product standards in the regulations are a result of balancing user needs and risk of accidental exposure to children. Of the reported poisoning incidents, running at some 250 a year, one-third relate to young children under the age of four. The regulations require child-resistant packaging, and the 20 milligrams per millilitre limit for nicotine, combined with the size restrictions on tanks, ensures a maximum exposure of 40 milligrams of nicotine, which is below the level of 50 milligrams that the European Chemical Agency assesses would cause acute toxic effects for toddlers. ASH recently published data indicating that only 9% of vapers report using e-liquid containing 19 milligrams per millilitre or more of nicotine. I know that my noble friend Lord Cathcart is a heavy user of this particular substance, but he is among only 9%. Moreover, the changes in technology will make it increasingly possible for users to get high levels of nicotine uptake for any given strength. Producers can of course get a higher strength approved by the MHRA.
My third main argument in favour of these regulations is that the UK’s approach to the regulation of e-cigarettes has, and will remain, pragmatic and evidence-based. We have one of the most liberal approaches to e-cigarette regulation in the world. We have implemented domestic age-of-sale legislation, preventing sale to under-18s, but we have not banned flavours in e-liquids or cross-border distance sales, nor have we restricted vaping in public places. I remind noble Lords that the latter two measures have been introduced in around two-thirds of all other EU member states and are also common in other parts of the world. I am not sure whether the noble Lord, Lord Forsyth, is right when he talks about gold-plating in this context.
Tobacco and Related Products Regulations 2016
Viscount Ridley Excerpts(8 years, 7 months ago)
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Viscount Ridley
That the Grand Committee takes note of the Tobacco and Related Products Regulations 2016 (SI 2016/507).
Viscount Ridley (Con)
My Lords, first, I apologise for springing this debate on my noble friend the Minister, in particular, at such short notice right at the end of a Session, but he will appreciate why this is an urgent matter. In 10 days’ time, the EU tobacco products directive may become law through a negative statutory instrument recently laid before this House. I emphasise right at the start that I have no problem with most of the regulations—just the parts relating to e-cigarettes and vaping, which are essentially Parts 6 and 7. My Motion is a little vague on that; the original draft was a little more specific.
As noble Lords will know, it has long been my view that the directive scores an own goal by bringing in measures that would discourage the take-up of vaping and thereby drive people back to cigarettes or prevent them quitting. However, it is not just I who take that view. Increasingly, it is the view of Public Health England and of the Royal College of Physicians, whose recent report on this topic is, I think, a game-changer in this debate. So I am here, at the 11th hour, to help my noble friend prevent a historic mistake being made, or at least to raise the issue. In passing, I note that I have nothing to declare: I own no shares and take no income from anything related to vaping or smoking.
The horrific death toll from smoking—100,000 of our citizens die every year—has, I suspect, touched the lives of many in this Room. It is the biggest cause of preventable death on a scale that is hard to comprehend: it is a Hillsborough every eight hours. It is a scourge that deserves the very best of technical ingenuity and policy-making skills to solve.
Vaping offers, as the Royal College of Physicians said, a great opportunity to apply to smoking the principle of harm reduction—an idea pioneered in this country. When people behave in harmful ways, how do you stop them? You can punish them in the hope of deterrence, as we do with murder and fraud; you can hector them, as we do with alcohol and sugar; or you can try to offer safer alternatives, which is how we tackled HIV infection and heroin addiction in this country in particular, and it is how I believe we should now deal with tobacco. In the case of addictions, where people find it genuinely very hard to resist temptation, harm reduction surely makes sense.
Britain is probably the world’s leading vaping nation. Virtually all of South America has banned the practice entirely, at the behest of the tobacco industry. In America, it is largely demonised and quite a lot of people do not know what it is. Almost all the 2.6 million vapers in Britain are smokers or ex-smokers, and the quit rate for those who try vaping is faster and greater than it is with nicotine replacement therapies or cold-turkey cessation. In other words, this is a public health revolution, and it is costing the taxpayer nothing. By saving smokers a fortune, rewarding entrepreneurs and averting ill health, it is boosting the economy.
However, we have before us a piece of legislation that strangles that breakthrough in red tape. It is the product of big-company lobbying and back-room deals in Brussels. It is legislation which last month the Department of Health admitted, in its impact assessment, risks increasing, not reducing, the amount of smoking. I hope in his remarks today that the Minister will be fully candid and accept that this part of the directive is a mess which does not deserve defending but does need ameliorating. I have alerted him already to three specific matters on which I seek clarity.
First, given that the Royal College of Physicians last month told the Government that they should promote vaping to smokers “as widely as possible”, what new, emphatic and unambiguous statement will the Minister make in support of vaping?
Secondly, given that the department estimates that the tobacco products directive rules will ban 90% of advertising that would have helped to promote switching, what budget has the department specifically set aside for a public information campaign to encourage smokers to move to vaping, as the royal college and Public Health England both want?
Thirdly, given that the regulatory burden that the department is about to place on the industry is so extreme that his officials estimate—at least, this is the only estimate in the impact assessment—that the number of notifiable products will be reduced by 96%, from 25,000 to possibly as low as 1,000, what expenditure will the department make specifically to reduce the cost of the onerous testing regime on the industry?
I would ask the Minister to avoid repeating the erroneous suggestion his officials have been making that any of the £13 billion of public health benefits that his department surmises will come from the tobacco products directive would be the result of Article 20, or Parts 6 and 7 of these regulations. In the table set out on page 45 of the impact assessment, the department has not been able to quantify a single benefit from vaping regulation.
Let me put this in a little context. At the beginning of this decade, attempts to reduce smoking were stalling. We had taxed the habit to the point where the main beneficiaries were black market traders, we had barred smoking from every public building, and nicotine patches were proving unpopular with smokers. Then along comes a technical breakthrough, thanks to a man who I have met named Hon Lik, working in central China. It was something that gives a nicotine hit in the same fashion as smoking but is far safer and cleaner. It is a fantastic piece of luck, or rather ingenuity. As the Prime Minister told the other place in December, vaping has now helped more than 1 million people in this country to stop smoking altogether.
How safe is vaping? We know that concentrations of harmful and potentially harmful constituents such as carbonyl compounds, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons and other constituents are in the order of 1,500 times higher in cigarette smoke than in vapour. A well-controlled trial has recently been carried out by Dr Grant O’Connell and colleagues working for the vaping manufacturer Fontem Ventures. They asked 15 smokers to give up altogether for five days, 15 to vape only for five days, and another 15 to mix vaping and smoking for five days. They measured the harmful and potentially harmful constituents in the urine, blood and breath of each group, and the results were striking. After five days, the vapers’ carboxyhaemoglobin levels—an indication of how much carbon monoxide they had in their systems—had dropped by 83%, which was an even bigger drop than in the cold-turkey cessation group, whose levels dropped by 75%. Even the dual users had seen a drop of 23%. The amount of carbon monoxide they exhaled had halved in both the vapers and the cessation group. Much the same was true for all the other biomarkers except, of course, for nicotine.
In other words, in terms of harmful constituents vaping is almost indistinguishable from not smoking at all. Both Public Health England and the Royal College of Physicians agree that it is much safer than smoking. As far as we can tell, nicotine addiction without smoking is about as dangerous as caffeine addiction.
Vaping is therefore a public health triumph that the Department of Health has, to its extreme shame, done its utmost to block. In 2010, the department’s medicines regulator, the MHRA, tried to ban vaping devices completely. In 2013, the agency—which is financed largely by the pharmaceutical industry—tried to insist that every e-cigarette should be licensed as a medicine. This would again have amounted to a de facto ban. After six years of trying, the agency has so far only managed to license one e-cigarette, which is still not available to the public. If the Department of Health had had its way, there would not be 25,000 varieties of vaping product on the market today, but zero. The only winners from the Department of Health’s policy prescriptions would be undertakers.
Thankfully—and my noble friends will know how painful it is for me to say this—the European Parliament voted down the folly of exclusive medicinal regulation, but it did not vote down the rest of Article 20 of the tobacco products directive which, in that wonderfully undemocratic way, is now being forced upon us. The truth is that these regulations were scripted in Brussels by pharmaceutical companies desperately trying to protect the sales of their widely unloved nicotine replacement therapies. What we have before the House is still a piece of legislation that is not fit for purpose. When even the Department of Health says that it risks increasing smoking, we know that we are facing a moral responsibility as legislators to review this in great detail. It most certainly should not just be nodded through.
It is no defence to say that some regulation is required. No sensible person would argue against us knowing what is going into e-liquids and what comes out in vapour. Potential toxins should be tested, as happens with food, cosmetics and other consumer products. But as the department admitted in an Answer to a Written Question, far more adverse incidents are reported by doctors about pharmaceutical nicotine replacement therapies than e-cigarettes. At most, a bit of tidying up of the testing process was needed.
Let me put three more questions to the Minister. The Royal College of Physicians describes the big warning labels that will deter smokers from using vaping devices as “illogical”. Does the Minister agree with the royal college on this?
Secondly, the ban on stronger vaping devices—the ones most likely to wean heavy smokers into vaping—was criticised two years ago by a dozen scientists writing to the Commission, which ignored their advice. Economists now predict that 105,000 extra deaths every year across Europe will result from the ban on stronger devices. Does the Minister agree with this estimate? If not, what is his estimate?
Thirdly, the directive proposes that, to cut down the risks of children starting smoking, it is necessary to create a minimum cigarette packet size of 20, yet it imposes a maximum size for vaping devices. This miniaturisation will raise prices and generate more packaging waste. Where is the logic in making the most successful substitute to tobacco more difficult to use?
The Minister has a choice. He can blame Brussels and say this is now a good reason to quit the EU in order to help people quit smoking—a lot of the country’s vapers, who are natural libertarians, are beginning to take that view and to dream of the day after Brexit when Britain abolishes the tobacco products directive and goes back to pioneering the virtual elimination of smoking and its replacement by something much less harmful. Or, if the Minister does not wish to turn this into a referendum issue, he can have a quick rethink and try to alter the implementation of the directive. We have a statutory instrument before us, about a third of which is devoted to stifling an exciting innovation that is saving lives. I beg to move.
Lord Brabazon of Tara (Con)
My Lords, I thank my noble friend Lord Ridley for raising this issue today. Like him, I intend to concentrate solely upon e-cigarettes and vaping. I have no views whatever on the rest of the directive.
Unlike my noble friend, I must declare a major interest in this subject, in that I smoked 20 cigarettes, a packet, a day for the best part of 50 years. I tried a number of different ways of giving up—patches, chewing gum and will-power, none of which worked—until two years ago when I took up using an e-cigarette. I have not had a cigarette since. I am pleased to hear of the health benefits my noble friend has described, which I hope I am now enjoying. I am also pleased that I now have the endorsement of the Royal College of Physicians and Public Health England in my course of action. It is, I believe, recognised by the Department of Health as the number No. 1 tool for helping smokers give up.
I do not know whether my noble friend has the figures—I do not—but I would estimate that 99% of people who smoke e-cigarettes are those who are trying to give up, or have given up, smoking real cigarettes. I cannot believe that anyone would start using an e-cigarette if they had not smoked an ordinary cigarette beforehand. Maybe some people have, but I do not know.
I can also tell the Committee that it is extremely good for the pocket, as well as the health, in that 20 cigarettes now cost something like £9 a packet, a large amount of which goes to the Treasury of course. I was spending £9 a day on cigarettes, whereas now I use a nicotine liquid, which comes in a 10 millilitre bottle, costs £5 and lasts me a whole week. So it is very good for my pocket.
I understand that nowadays a large proportion of cigarette smokers come from the lower-income categories of people and therefore it would be of great benefit to them if they were able to give up smoking cigarettes. I hope my noble friend can confirm that the type of nicotine liquid I use—which is 1.1% in 10 millilitre plastic bottles—will not be banned by this new regulation.
This directive was dreamt up in 2012, quite a long time ago before I—and, I suspect, most people—had heard of e-cigarettes. Like a lot of things that come from Brussels, it has not been adapted to the facts, including the fact that e-cigarettes are now recognised as a good thing. I hope my noble friend can assure me that he will do all he can to limit the damage that this directive might have on people who are trying to give up smoking.
Lord Prior of Brampton
My Lords, I am not responsible for public health in the Department of Health but I will talk to my honourable friend Jane Ellison, who is the Minister for Public Health and will put that view to her very strongly.
Viscount Ridley
My Lords, I will be brief because I know that other noble Lords are waiting to start the next debate. I am most grateful to all those who have spoken in the debate: my noble friends Lord Brabazon, Lord Callanan and Lord Cathcart; the noble Lords, Lord Stoddart, Lord Hunt and Lord Snape; the noble Earl, Lord Erroll; and my noble friend Lord Prior. I say to the noble Lord, Lord Snape, that he looks in extremely good shape. He did not get the advice he was looking for about his health and I am not medically qualified, but he looks fine to me.
Lord Snape
I apologise for interrupting, but what are his medical qualifications in reassuring me?
Viscount Ridley
I withdraw the advice.
I agree with the noble Lord, Lord Stoddart, and the noble Earl, Lord Erroll, that we need to change the vocabulary in this area. Indeed, I myself now use the phrase vaping device rather than e-cigarette whenever possible because it makes more sense and it is a shorter term. I was also fascinated to recall when listening to the noble Earl, Lord Erroll, how one kept awake on motorways before Red Bull was invented. I did not realise that cigarettes had that effect. The noble Lord, Lord Hunt, has put his finger on it. There is still a real issue of public confusion, which we have seen reflected in recent opinion polls. Over the past couple of years, people’s suspicions about these products have increased because of the misinformation in the studies that were cited by others. The issue of harm is a tricky one to get across to the public because you cannot say that vaping is absolutely safe or that it is good for you. Vaping devices are certainly good for smokers, but in absolute terms they are not good. However, that is not the point. The point is relative harm and harm reduction.
I had originally wanted to put down a regret Motion to express stronger dissatisfaction with the directive and the way it is being brought into law, but the best chance of getting a debate before the end of the Session was through a take note Motion. I am sure that the Grand Committee wants to take note. Perhaps I may make a couple of other brief points. My noble friend Lord Brabazon mentioned that smoking is very regressive at the moment: it bears down much more heavily in terms of cost and suffering on poorer people than richer people. It is no longer an equal opportunity killer, if I can put it that way.
I am most grateful to my noble friend the Minister for the very different tone in his response from that of his predecessor, when we first debated this matter some two years ago in this Room, and for his unequivocal statement that it is a good thing for smokers to take up vaping. I was also encouraged to hear him make the point, and I will press him on it as we go forward, that although the directive prevents advertising, it does not prevent public information campaigns to get the point across to smokers. With that, and the promise of Italian light-style implementation, I beg to move.
Health: Treatment Rationing
Viscount Ridley Excerpts(8 years, 7 months ago)
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Viscount Ridley (Con)
My Lords, in relation to the reduction in smoking, last week the Government published an impact assessment of the European Union tobacco products directive, which comes into force on 20 May. Does the Minister agree with the estimate by London Economics that aspects of that directive, including the ban on vaping liquids of 20 milligrams per millilitre or more, could increase deaths across Europe by 105,000 people?
Lord Prior of Brampton
My Lords, I am not able to answer that question, as I do not have the facts at my fingertips. However, I will investigate it and write to the noble Viscount.
E-cigarettes: Regulation
Viscount Ridley Excerpts(8 years, 9 months ago)
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Viscount Ridley
To ask Her Majesty’s Government what effect they expect Article 20 of the 2014 EU Tobacco Products Directive, when implemented in May, to have on the rate at which people give up smoking by the use of vaping devices.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
The tobacco products directive, which will come into force from May this year, will provide a new regulatory framework for vaping devices and e-liquids, assuring their safety and quality. The Government recognise that e-cigarettes can help people to quit smoking and that quitting smoking completely is the best thing a smoker can do for their health.
Viscount Ridley (Con)
My Lords, I thank my noble friend for that helpful reply. Given that the Prime Minister said in the other place that 1 million people have given up smoking as a result of taking up vaping— including, I believe, my noble friend Lord Brabazon of Tara—given that the public health benefits are in the order of £74 billion, and given that the main loser from this is the pharmaceutical industry, which is seeing falls in the sales of patches and gums, does he agree with me that pharmaceutical industry lobbying may be behind the attempt to regulate these products too heavily and possibly to shackle them with an excise tax? Could he give a Department of Health estimate of the size of the black market that is likely to result from this directive and whether or not it will result in people going back to smoking?
Lord Prior of Brampton
My Lords, the benefits of e-cigarettes are well understood. The figure of 1 million people who have given up smoking by taking up e-cigarettes is a valid and true one. The tobacco regulation that the noble Viscount refers to does not have any proposals for an excise tax—it purely relates to ensuring that these products are used safely and are of a given quality.