(1 week, 4 days ago)
Public Bill CommitteesQ
Professor Sir Chris Whitty: Would Sir Michael like to go first?
Professor Sir Michael McBride: Yes. Thank you for the important question. You are quite right that the evidence on the potentially harmful effects of vapes is still developing, and we are not at the stage that we are with our knowledge of tobacco. Certainly, as we have said already, the harmful effects of vapes are, and are likely to be, significantly less than those of tobacco, but are unlikely to be zero. This is an area in which there is ongoing research. The World Health Organisation has raised concerns about the potential impact, particularly in children, in terms of brain development. I know you will hear more about that later from other panellists. That is something that we will obviously need to continue to keep under review. The Bill provides us with the opportunity to introduce further measures, should that be required.
However, in all this there is a need for balance. Obviously, the Government—and certainly the Northern Ireland Assembly, when they will be debating this in the coming weeks—will wish to ensure that there is a balance between ensuring that vapes are accessible to individuals to assist cessation of smoking and help them to quit, but also that we are guided by the evidence to ensure that any legislation that is introduced is proportionate. That is incumbent on all of us at this time. Certainly, should further evidence of harmful effects become available, there is the opportunity and flexibility within the Bill to look at this again.
Professor Sir Chris Whitty: I would add only that it took us some decades to work out the extraordinary impact of smoking. Much of that tends to be cumulative over time, so you do not see the major effects of someone starting to smoke in their 20s till they are in their 50s, 60s and 70s. What we do not want is to be looking back in 20 years’ time and saying, “We knew these were addictive; we knew that people were smoking things.” Things that go into the lungs are much more dangerous than things you eat, for a variety of reasons. Just basing it on lab studies is not a safe way to proceed. I think all of us were therefore thinking that the sensible thing to do, while maintaining vapes as a smoking quit aid, is to avoid a situation where people who are currently not smokers take up vapes, because they will definitely get addicted—the nicotine is there, and there is a high chance in our view that they will have harms, although the size of those harms is currently difficult to put an exact number on over time. Some people come to extreme harms quite quickly, actually, but those numbers are fortunately relatively small.
Q
Professor Sir Gregor Ian Smith: It is very difficult to disentangle the evidence about vaping, because so many of the people who are currently vaping are either current or ex-smokers as well. To do some form of longitudinal study that actually gets to develop the evidence base for any potential harm that is caused by vaping is difficult—although there are attempts to try to do that, such as through the Our Future Health study. At this moment, I think the provisions within the Bill represent a proportionate and reasonable approach with the flexibility that exists within it to be able to respond as new evidence develops, either towards or against the harms that are associated with vaping. I think it is proportionate in that it maintains vaping as a potential tool in the armoury to help people to stop smoking, but similarly it is proportionate in stopping the abhorrent marketing of vapes to children, which Sir Chris has already mentioned, and in allowing the position, which I think is correct, that if you have never started vaping or smoking, you should not. The proportionality of the provisions just now is heading in the right direction, but with the ability to flex as future evidence emerges.
(1 week, 4 days ago)
Public Bill CommitteesQ
Secondly, linking to the economic argument you made earlier, you are right that deprivation is key. There is more smoking in deprived communities. I have asked all the witnesses this question. Is there a concern that because of the concurrency of people vaping and smoking, the people who are doing both will move to an economically cheaper option—that is, pick up smoking again because vapes might become more expensive because of other measures that are introduced? Has that concern been raised in academia?
Professor Linda Bauld: Let me start with the first part of your question. Those data come from the Action on Smoking and Health survey covering Great Britain, which was funded by Cancer Research UK and conducted by YouGov for ASH. Those harm perceptions are really concerning to me because we do not want people who have never smoked or young people to be vaping but, from the evidence I have seen, if more of those 6 million smokers could switch to vaping, we would see health benefits. I think those misconceptions are largely driven by the media and some of the myths—the really harmful stories that get the front page. We need to deal with that and make sure that health professionals and others are empowered to give accurate advice about vaping. We have got a distance to run on that, and anything that the Bill can do to assist that would be welcome.
On whether people who are dual using, which is a significant proportion of smokers, are more likely to switch to smoking if we take action on, for example, removing point-of-sale displays or take other measures on vaping, I am actually not sure about that. The key point is that we need to continue to make smoking more expensive than vaping and to make sure that we address the availability of tobacco in our environment and in different settings. If we can keep that balance to show that vaping is a good option for cessation and is more affordable than cessation, while we keep doing the research on it, I would be optimistic that we are not going to see masses of smokers who are currently vaping to cut down just switch back to smoking in its entirety—hopefully.
Q