Tobacco Control Strategy

Andrew Gwynne Excerpts

Thursday 17th December 2015 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Betts. I begin by thanking the Backbench Business Committee for granting the debate, and I take the opportunity to wish all hon. and right hon. Members, the Clerks and everyone else sitting in this room a very merry Christmas.

Clearly, it is always a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford), because she speaks about these issues with such passion and a great deal of knowledge. She adds greatly to our debates. The need for a strategy and for funding to make it happen is pressing, and I am glad we have had the chance to discuss it today. I thank my right hon. Friend the Member for Rother Valley (Kevin Barron). His interest in the issue is, as we are all fully aware, not just passing; he has been championing the issue for a great number of years, and I commend him and the hon. Member for Harrow East (Bob Blackman) on the work that they have done on it through the all-party group.

I start with the problems with the autumn statement—an issue raised by all Members who have contributed so far. It is clear that the autumn statement brought yet more cuts to the public health grant. As a result of year after year of cuts to public health budgets, there has been a consistent fall in the number of people using local smoking cessation services. It is not the kind of thing that can be done half-heartedly. We can throw a little cash at the problem and suggest we are tackling it, but if we spend too little, the returns will be minimal. We may as well spend a sufficient amount and enjoy much greater returns on the investment in public money. We all know that a smoker may throw themselves into an attempt to stop—usually in the new year period, following a new year’s resolution—but if the support is not there, many of them might fail in their attempts. Even worse, after a failed attempt with insufficient support, they are unlikely to try again; that is just human nature. It is worth getting it right the first time round, and giving people the support that they need. That is why some of the cuts to the public health budget have been short-sighted and are the falsest of false economies.

I fear that most smoking cessation services will not survive a 24% cut to the non-NHS part of the Department of Health’s budget. I want public health bodies to be able to push to make children born today the very first smoke-free generation, but I am worried that their ability to do so will be damaged by the reduction in funds.

Let us consider just one aspect of the cost of smoking that may be overlooked. The general health implications of smoking are well known and documented, but mouth cancer often gets overlooked. Oral cancer kills more people in the United Kingdom than cervical and testicular cancers combined, yet there is still an alarming lack of public awareness about oral cancer. Nine out of 10 oral cancer cases are preventable, and two thirds of cases are a direct result of smoking, so improved awareness of all the possible health problems caused by smoking is one role of local public health services. Awareness as a concept can often be dismissed, but when it comes to deterring people from using tobacco products, it is invaluable, yet such services will be slashed in the upcoming public health bonfire. I call on the Government and the Minister, for whom I have a great deal of respect, to think again and try to reverse some of the cuts to public health services.

I welcome the introduction of standardised packaging for cigarette packets by May next year. There are powerful arguments in favour of it, and I am pleased that the Minister pushed ahead with the policy, with cross-party support, albeit that there were a few recalcitrant members of Government, and even louder voices against on the Back Benches. Nevertheless, we got that through, and I commend her on the work she did in pushing for that.

This month marks the third birthday of plain packaging. Australia’s Tobacco Plain Packaging Act 2011 came into force on 1 December 2012, which made it the first country to halt the use of figurative trademarks on tobacco products. In the past few months, both France and Canada have taken significant steps forward in introducing a similar ban. France should be introducing a ban in May, at the same time as our standardised packaging laws come into force.

The importance of removing legitimacy from such activities cannot be overstated. Take the example of the ban on smoking in cars, championed by my predecessor as shadow Public Health Minister, my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger). The purpose is obviously not to punish every single driver smoking in a car with children; that would be impossible to enforce. The real purpose is to send a very strong message that it is not acceptable to smoke in cars with children, and that it is punishable by law. A similar example is the ban on driving without a seatbelt. There are not many convictions, but the number of people using seatbelts soared after the ban was introduced. Our approach must include encouragement as well as enforcement.

I come on to my main point. The previous tobacco strategy was, on the whole, a success. It has encouraged the introduction of measures such as standardised packaging, which are to be welcomed, but I am concerned that a new strategy has not been developed yet. I welcome the Government’s commitment to establishing a new strategy in the new year, but I have concerns about their ability to implement it fully and comprehensively.

In October last year, the five-year forward view noted that

“The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

As the hon. Member for Central Ayrshire said, Simon Stevens has gone on record to say that as part of the efficiencies that the NHS is looking to implement, £5 billion will come from prevention, but how can we achieve £5 billion in prevention when preventive services are being cut back—or, in some cases, removed altogether? I hope the Minister can give Members of all parties, who want the same outcomes, assurances that cessation and other public health services at a local level will not see the axe fall on them in the way it is suggested they might, and that the £5 billion of efficiencies that Simon Stevens has identified as coming from prevention are achievable through the role and remit of the Minister with responsibility for public health.

I will return to the point that I opened with. A person is four times as likely to quit smoking successfully with the help of specialist support, but those services are under attack. In the autumn statement, the Chancellor announced further cuts in the public health grant, amounting to an average real-terms cut of 3.9% each year to 2020-21. That translates to a further cash reduction of 9.6%, in addition to the £200 million-worth of cuts announced in the summer Budget.

Meanwhile, tobacco, as we have heard from other Members, is still the single biggest cause of premature and preventable death, responsible for 100,000 deaths every year in the UK. Some 10 million adults still smoke. More than 200,000 children aged 11 to 15 begin smoking every year. This is an income inequality issue, too. In 2014, 12% of adults in managerial and professional occupations smoked, compared with 28% in routine and manual occupations. People with mental health conditions, prisoners and the homeless are far more likely to smoke than the general population. In my constituency, smoking rates are still far too high and well above the national average. In Tameside, where smoking is prevalent—a quarter of the population smokes—450 deaths a year and 2,500 hospital admissions are attributable to smoking. I know how much this contributes to poor health, which places a huge pressure on health and care services locally, and causes untold misery for the communities and the families of those affected.

I want to touch briefly on the point made by my right hon. Friend the Member for Rother Valley about e-cigarettes, because I have seen them work for people who have smoked for a very long time. The e-cigarette not only helped to wean them off tobacco, but, by reducing nicotine levels over a long time, removed the need for nicotine and got them off cigarettes altogether. I implore the Minister to ensure that any regulations she introduces are proportionate, as my right hon. Friend said.

I ask the Minister to keep a watching brief, though, because I am a little concerned. I am starting to see in my constituency the glamorising and normalising of smoking among young people through the use of e-cigarettes. I fully support them as a product to help people come off smoking, but as a gateway product to smoking, they worry me considerably. I accept that there is probably nothing more than anecdotal evidence at this stage, which is why I urge the Minister to keep a watching brief, but having seen the marketing of some e-cigarette products, I am concerned that it uses precisely the same marketing tactics as we saw used by tobacco companies, which brought about the introduction of the regulations on standardised packaging. Let us make sure that e-cigarettes are used for their correct purpose: to bring people off smoking. If there is evidence that they are starting to become a gateway product to smoking, I hope very much that the Minister will look again at whether action is required.

Health inequality is one of my biggest bugbears, and smoking is one of its most virulent causes. A comprehensive strategy to reduce smoking rates is imperative if we are to tackle the issue. The Opposition will support the Minister with responsibility for public health and the Government in developing such a strategy, building on the achievement of both her Government and the previous Labour Government over a number of years. I hope that she can give some assurances on the issues that Members have raised, and some Christmas cheer to Members looking for a renewed strategy on this very important issue.