Tobacco and Vapes Bill (First sitting)

Debate between Alex Barros-Curtis and Jim Dickson

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Mr Barros-Curtis]

Q Some of the evidence that has been submitted referred to the gateway effect and how there is perhaps not the evidence to suggest that there is a transition from one to the other. Are your organisations still concerned about the increase in vaping among groups who have not previously smoked cigarettes?

Sarah Sleet: That is a tricky one. We know that a lot of people who use vaping to stop smoking end up dual-using for a while. Some then move on to just vaping, and some eventually move completely away from it. We seriously need a comprehensive programme for nicotine cessation and smoking cessation to support people on that journey and make sure that people who go on that journey do not come back in. We heard earlier from ASH Wales about some really good measures that have been put in place, but without that wider context it is hard to cement the behaviour needed to move completely away from it. We need to think broadly about the whole support structure to help people to get off smoking and eventually to move away from nicotine altogether.

Dr Ian Walker: I agree. The real killer in the room, if you like, is cigarettes and tobacco. There is no safe way of consuming tobacco. The alternative of smoking versus vaping is very clear; even though we do not know the long-term health implications of vapes, we know that you are much better off vaping than smoking. Having said that, of course we do not want young people and never-smokers to vape either.

The power of the legislation is its double-pronged approach: preventing people from ever smoking in the first place by raising the age of sale by one year every year, and putting in place a comprehensive package of measures alongside that to control vaping, particularly the access to vaping and the appeal of vaping for young people, to reduce uptake in those communities. All those things together, alongside—you will forgive me for saying this—the investment that will be required for smoking cessation services and to support enforcement by Border Force, HM Revenue and Customs and retailers, will be important components of the Bill’s ability to drive the change that it can make.

[Jim Dickson]

Q Thank you for all your work to advocate for smoke-free legislation. Can I ask you about differential smoking rates across the country? Which parts of the country are likely to benefit most from this legislation as we see a decline in smoking rates and in tobacco use more generally?

Sarah Sleet: Health inequalities relating to lung disease are profound. The three conditions with the biggest gap in health outcomes between rich and poor are lung conditions: asthma, COPD and lung cancer. All three are profoundly affected by smoking, and smoking is concentrated in socially and economically deprived areas. Those in the poorest part of the country are twice as likely to smoke as those in the richest part of the country.

It is even more profound in certain segments. We heard that young mothers are four times more likely to smoke in poorer parts of the country than in richer parts. If we can drive down smoking, particularly among young people, the impact will be greatest in those areas that are most in need of help and support. This is probably one of the biggest things that can be done to tackle health inequalities. For that reason, I think the Bill is probably the most important public health measure being passed through Parliament in a very, very long time.

Dr Ian Walker: Thank you for the question, which I think is a really critical one. At CRUK, we have done a lot of research and work on cancer inequalities, which are part of broader health inequalities and which generally mirror similar trends. We know that people in the most deprived communities have higher incidences of cancer. They typically present at a later stage, they typically engage less with screening, they typically have worse outcomes and they typically do not get optimal treatment —it is a pretty difficult story right along the pipeline. The reasons behind that can be very complex and involve lots of different things.

Despite all that, the one thing we do know is that higher smoking rates, particularly among children and young people in the most deprived communities, are a really significant contributor to health inequalities. It is very clear from the evidence that the most deprived communities across the UK are the ones that suffer most from the impacts of tobacco.

This Bill is clearly not a magic switch—it will not change those things overnight—but it sets us on the pathway to fundamentally reversing some of those inequalities and to reducing some of the cancer inequalities that we see across the UK. Alongside the important measures in the Bill, a really clear, targeted set of actions around health marketing interventions in those communities and the effective funding of cessation services where we need them most will contribute to reducing health inequalities much more quickly and much more effectively. Again, it is a very positive story in terms of the potential impact on health inequalities.