Tobacco Control Plan

Alex Norris Excerpts

Tuesday 16th November 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve with you in the chair, Mr Bone. I add to colleagues’ congratulations to the hon. Member for Harrow East (Bob Blackman) on securing the debate, and on his leadership on this issue in Parliament through the all-party group and beyond. He made an outstanding case in his opening speech and set the tone for a debate that will, I hope, be practical and impactful.

The hon. Gentleman characterised his all-party group as a critical friend. That is very much the case, and in that sense it is the best example of a parliamentary group. It has been very impactful, especially through its most recent reports, which I will borrow from liberally. I hope to continue in the spirit of cross-party support that he and my hon. Friend the Member for City of Durham (Mary Kelly Foy) have established. There is not much politics in this area, and I think the less politics, the better. This is a big prize for the nation’s health, and together we can find a lot of the solutions. The hon. Gentleman led the debate in that spirt.

My hon. Friend the Member for City of Durham is the leading Labour figure on this issue, as she showed during our very long proceedings in the Health and Care Bill Committee—you shared in a significant portion of those, Mr Bone. I thought her amendments were excellent and I was proud to support them. I had hoped that the Government would be minded to accept them, and the ideas are still good ones. The hon. Member for Harrow East has kindly offered the Minister another opportunity to do so during the next stage of proceedings on the Bill, and I dare say the noble Lords may offer similar opportunities. The Government need to pick up these ideas, the vast majority of which are very basic things on which I think there is complete consensus. I hope to hear from the Minister about some progress.

The hon. Members for Rugby (Mark Pawsey) and Northampton South (Andrew Lewer) made points about vaping. It is important to keep talking about vaping in debates such as this—if nothing else, about some of the misinformation that the hon. Member for Northampton South mentioned. Vaping does work as a quit aid. Of course, we do not want people to start, and we always need to say that. I am unable to recall by rote the phrase that the hon. Gentleman’s wife used, but I will sometimes take 95%, certainly when it comes to health. With the things that my constituents disproportionately lose their lives to, 95% seems like pretty good progress. I hope that that is part of the tobacco control plan, and that the Government focus on improving quality and standardisation in the market. From looking in shops, I know how difficult it is to find the same product twice. That tells us about the vagaries in that market, which could be greatly improved.

When the hon. Member for Strangford (Jim Shannon) was speaking, I was struck by the fact that much of what he said about Strangford could equally be said about Nottingham North. He could have said “Nottingham North” instead of “Strangford”, and we would have heard the same thing. Health is a devolved matter, and it is important to respect that, but I hope we can move forward, by consent, as four nations on this matter. That would resolve some of the issues around illicit tobacco mentioned by the hon. Member for North Antrim (Ian Paisley), as well as building public support and understanding. We would not want massive variances on this issue, so I hope we can reach a consensus.

I agree with the hon. Member for North Antrim that we need to be evidence-based and to promote innovation. In my view, the evidence strongly shows that tax works as a driver for reducing smoking, and it has done for consecutive decades. I am not blind to the increased risk of illicit tobacco and I am aware of it in my community, but I do not see this as an either/or situation. We can have a higher tax regime and be very serious about organised crime, and I would support that approach.

This is a really big prize for our country. As we have heard, 7 million people, or about 15% of adults, smoke, which has devastating consequences for illness and death. In 2019-20, more than half a million UK hospital admissions were attributed to smoking. We have made great progress over recent decades—that should be a point of great pride for all parties—and we have the lowest rates of smoking since records began. However, there must be a recognition that these gains are not equal, and I hope the Minister will say that that will be a focus for the next tobacco control plan.

Poor communities, such as mine, have benefitted less. In 2019, fewer than one in 10 professional and managerial workers smoked—that is well on the way to the smoke-free 2030 target of less than 5%—compared with nearly one in four workers in routine and manual occupations. That is a serious variance, and it is a big part of the reason why the life expectancy gap between the richest and the poorest has widened in recent years.

A child born in Nottingham today is expected to live for seven years fewer than one born in Westminster today. Looking at healthy life expectancy, rather than pure life expectancy, the gap is probably double that. If we were to tot up all the environmental factors involved, half of the difference is attributable to smoking. “Levelling up” is the phrase of the day, and this is a real levelling-up issue that I hope we can all coalesce around. That is reflected in the fact that three quarters of the public support the smoke-free 2030 ambition. As politicians we can see that, for once, the right thing is also the popular thing, which is rarely the case. We should take that opportunity.

In Health and Care Bill Committee debates, we explored these issues at length. I hope the Government will revisit the amendments that were proposed, and we will certainly be doing so. I hope the Minister will tell me that I am wrong and being uncharacteristically cynical, but I am anxious that we will not see a new tobacco control plan in the next six weeks. If that is the case, why not use the Health and Care Bill in front of us as a vehicle?

As the Minister is pulling together a tobacco control plan, I hope she will actively consider some of Opposition Members’ suggestions for that plan. First, there must be a resumption of the promotion of stopping smoking. Over the past 11 years, this Government have stopped evidence-based behaviour change campaigns, which have virtually disappeared. It is no surprise that quit attempts have reduced by a quarter. Such campaigns are good investments, and we have lost them from the public health grant. We need them to be returned.

I mentioned vaping, and that point has been well explored. We need access to stop smoking services, which have really good evidence bases on their impact. We know that they are most likely to be used by people in occupations where smoking remains stubbornly high, but we have lost them as the public health grant has been clobbered over the past decade. I know for an absolute certainty that any savings we have made there have been hoovered up by losses in the health service, and I hope we can do a bit better there. Three weeks ago, in the Budget, we did not hear about a reversal of those cuts in funding to public health, and that is really disappointing. However, if there is a financial issue here—as I say, I do not think there should be, because this should be seen as an investment rather than a cost—we can, as colleagues have said, help the Minister to pay for those services and still have some change left over for an uplift in the poorest communities through a levy based on the “polluter pays” principle. I hope that the Minister will mention that.

The hon. Member for Broxbourne (Sir Charles Walker) asked the hon. Member for Harrow East whether the tax system could be a way of promoting changes within the tobacco industry. I think that is exactly right. When I meet representatives of the tobacco industry—I know it is out of fashion these days, but I meet anybody who asks me to meet them—they all tell me that they want to stop selling tobacco products to people. The tax system is a really good way of making good on that, and of taking the eye-watering profits that come through the system and investing them in effective ways of stopping people smoking. That would be a very good thing for everybody.

In the meantime, however, let us close the loopholes in tobacco control. The first, as my hon. Friend the Member for City of Durham says, is that the packaging of e-cigarettes clearly shows they are being pushed to children. Secondly, hon. Members were shocked—although they should not be—that companies can give out vaping products to under-18s for nothing. That loophole is clearly outside of the spirit of the law, so let us do better there. The final point is about characterising flavours in tobacco, such as menthol. That should be a real problem for the Government, and indeed for Members of this House. The regulations that we passed had a clear intent, but they are being routinely circumvented to the point where, if hon. Members had their phones in front of them, they could find menthol products in seconds. This will not do, and it behoves the Government to come back to those regulations and make good on them, either by making them more effective or by promoting greater enforcement.

I know that colleagues are keen to hear the fullest response possible from the Minister, so I finish by reiterating Opposition Members’ support. I think we can do something really impactful here, and we should use this tobacco control plan to do so. The sooner we see a draft, the better, so we can begin that work.