Tobacco and Vapes Bill (First sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Kirsten Oswald]

Q I am grateful to you both for your comments so far. Would you say more about your thoughts on groups of people, particularly young people —this is a thing you will hear around the table—who are taking up vaping but have not previously smoked. Do the measures in the Bill go as far as you want in trying to prevent that from being the direction of travel?

Dr Griffiths: If the Committee is minded to strengthen anything that would prohibit people from starting vaping in the first instance, where they are not doing so as a cessation tool—I hope it is really clear that we believe that, as a cessation tool, this is a product that has its place that would help thousands of smokers give up and, ideally, prevent them from losing their quality of life or, tragically, their lives; I hope that is explicitly clear—I think that could have incredible impact. What we are worried about is people using vaping as a start and an entry point to nicotine. Nicotine is so highly addictive. You see that in the number of smokers who desperately want to give up. We have spoken to such people in abundance. Anything that helps us get to that point would be welcome.

Sarah Sleet: Nicotine, we know, is as addictive as heroin and cocaine. It is a terrible addiction. However, in terms of vaping, it is going to be quite tricky to get that balancing act right. We really need to have vaping as a cessation tool. We know it is more effective than just about anything else you can have in terms of cessation. For example, when it comes to flavouring, if you make that too difficult or make it problematic for people to switch, then there is a chance that we may have a real problem in terms of stopping smoking. On the other hand, we really do not want people to be attracted into vaping who have never smoked. I understand that that bit of the legislation is in secondary legislation and can be adapted over time; I think a lot of attention is going to need to be given to how people are actually responding and how they are behaving, and then adjusting that over time.

[Angela Richardson (Guildford) (Con)]

Q You have been quite clear that even though we do not yet have the evidence to understand the impacts of vaping, it is a very important cessation tool. Do you see a world in which it could be prescribed as a cessation tool, as opposed to being available as a retail product?

Sarah Sleet: I believe that is the system in Australia—it is prescribed. I think it is a possibility. It needs to be well researched. Would it still encourage people who need to stop smoking to use it as a tool, or would it put a barrier up to using that tool? Before we move to that system, we would need some really good behavioural evidence that it is not going to be a further barrier for people. If it is not, then that could be a really good option.

[The Chair]

I am going to take the Minister at this point, and then Preet Kaur Gill.

--- Later in debate ---

[Mary Kelly Foy]

Q Following on from Bob’s question, you are in a position to educate young people about the harms of tobacco. Is there a point here about educating young people about the harms, about the unscrupulous measures that the tobacco industry takes and about the horrific products that it is making? Young people are often interested in climate change and wider issues. These industries and organisations are having an impact across the whole world. It could be something that young people are interested in—not just for their health, but for the wider impact on their local communities and across the world. If we had more funding for education, maybe with a payer levy, those types of measures could be looked at. Is there any opportunity for that type of education in schools?

Matthew Shanks: That is happening at the moment within education, in curriculums and so on, but there is a lack of messaging around vaping, its harmful effects and its cheapness compared with tobacco. Even with the teaching of the harmful effects and the messaging compared with tobacco, there are still some families who smoke and you still see celebrities smoking. You are fighting that all the time.

It is good that we are educating young children about the harmful effects of things and the need to change, and we will continue to do that. We talk about big tobacco companies, big pharma, the global environment and so on, all within the curriculum.

Patrick Roach: The reality is that we need more space in the curriculum to do all that and to make the connections between vaping, the impact on a child’s health, and how these companies are profiteering, often from the most vulnerable. The producers of vaping products, the degradation of the environment, the way products are manufactured—all of this is very rich territory.

I would like to see more by way of permission for teachers and school leaders to engage with their pupils about the real everyday concerns that young people have. There should be more scope and space in the curriculum to do that. That is not to argue against the teaching of maths, science and languages; it is about saying that we want to produce well-rounded individuals. For us, that is the purpose of education. This is an area where educators have an important role to play.

Matthew Shanks: I would just add to that by encouraging you to visit your local schools and see what they are doing.

[Angela Richardson]

Q This morning, in evidence from previous witnesses, we heard a lot about how vaping is a great smoking cessation tool, but there is not enough evidence about the harms of vaping. You have described social harms; you probably see health harms as well. You have surveyed people, and you have come to give evidence this morning. Have you been asked, outside this, for evidence of the harm from vaping to the young people you look after? Do you believe that the evidence gathering on whether vaping is harmful is going at a fast enough pace?

Matthew Shanks: No, prior to now. This is very welcome, which is why we have both given our time because this is important. There was something in the papers this morning about evidence of harms of vaping for children, but it is not the headline; it is seven or eight pages in, so people will not read it.

I absolutely think that there should be more about the harm of vaping or just the unknown. You do not know necessarily what the dangers are, so therefore why would you engage in it? We talk a lot when we are doing drug prevention with children about—apologies if this offends—where the drugs come from, what the base of them is and what they contain. In the same way, you do not know what is in a disposable vape or another type of vape, so why would you put that in your body? Those are the lessons we are talking about, so we would certainly welcome more evidence to support that.

Patrick Roach: We know, from the feedback we have had from teachers as part of the research we have done, which includes both quantitative and qualitative feedback, that children are getting ill as a result of using vaping products. That is the daily reality that school leaders and teachers have to deal with.

The more that we can systematically collect and collate that data and evidence—whether that is a child who ended up being rushed into hospital because they became very ill on the school premises or, indeed, a near miss within the school—the better we will be. But the reality is, on an everyday basis, that teachers are experiencing this and having to deal with these issues and to intervene on and support pupils who are impacted physiologically by other harms of vaping products.

[The Chair]

A very brief final question from Dr Caroline Johnson. We have to finish at 10 past 11, so I ask the witnesses to bear that in mind.

Tobacco and Vapes Bill (Second sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[The Chair]

We have two minutes left. Is anyone burning to ask the last question? We have had very clear evidence and it has been an excellent session, but is anyone sitting on a question they have not yet asked?

[Angela Richardson (Guildford) (Con)]

Q Yes. Greg, I am picking up from the witnesses and evidence sessions we have had so far that there is almost an ideological feeling about vapes as a smoking cessation tool. You talked about the unintended consequences of people going back to smoking or not giving it up if we were to take a tougher line on vaping or the effects of vaping on others. I am slightly worried from a public health point of view: what if we discover that vaping is dreadful and we have taken the really strong stance of maybe not looking into it enough and giving it the urgency it needs?

Greg Fell: Again, without wanting to take the fifth amendment, that is a question for some of the experts behind me, who will give you a full view based on the science. We are 20 years into vaping now—we would probably have started to see significant amounts of vaping-related harm. Cases can always be found of somebody who has terrible lung damage as a result of vaping, but they are usually the exception rather than the rule. The comparator is always tobacco smoke: is it safer than tobacco smoke on the basis of all the science that we know, 20-odd years in? Yes, unequivocally. Is it safer than fresh air? No—hence we do not recommend that people who do not smoke start vaping. As the chief medical officer has said repeatedly, the tobacco industry marketing vapes to kids is completely unacceptable. I am happy—hand on heart, I can say that ADPH pretty much follows the line that it is a route out of tobacco smoking, as we know that smoking kills half of its customers or more. Should the science change in another 10 years, then we would change our view, but on the basis of the evidence we have now, I am happy that we have got the right position.

[The Chair]

Thank you very much, David and Greg, for an excellent session with some very clear evidence.

Examination of Witness

Ailsa Rutter gave evidence.

Tobacco and Vapes Bill (Third sitting)

Angela Richardson Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Mary Kelly Foy]

Q I have seen a product that is just a plain bottle with “vape” and a number written on it, which is exactly the same flavour as the one that is clearly marketed to children with a teddy bear on it. If we get rid of that packaging and advertising, could we still use some flavours?

Professor Sir Chris Whitty: Possibly, but this Bill gives powers that allow us to vary it depending on what the industry does. That is really the point.

[Angela Richardson (Guildford) (Con)]

Q I have just looked online and found the top influencers on social media for vaping. I know the Government sometimes use influencers in order to change behaviour. Has the NHS been involved in paying influencers for vaping? Related to that, a lot of young people and children feel under pressure a certain way, and nicotine is known as an appetite suppressant. What message do you have for young people on that basis?

Professor Sir Chris Whitty: I wonder whether I can turn to Sir Gregor first, and then maybe Sir Michael.

Professor Sir Gregor Ian Smith: I am not aware of the NHS ever engaging any of these influencers, in terms of how we approach the subject of vaping. There is certainly a real danger that social media is sometimes used by younger people, and they see things that become really attractive to them in terms of lifestyle. The misinformation and disinformation that exists across those platforms can lead them to participate in activities that are potentially harmful.

Directly to your question, my very strong answer to any young person thinking about using one of these products as an appetite suppressant is: please don’t. Please safeguard your health. Do not begin the potentially addictive journey of using these products. Do not do it for any reason.

Going back to the point we made earlier on, I would love to see a society where our sports organisations promote much more healthy behaviours, where we have a much better understanding of the huge variation in body image we have across our society, and where we promote the very positive and broad representation of who we are as the general public, because there is no “one size fits all” answer to who we are. We are beautiful in our diversity. Anything we can do to have a more positive representation of society across these platforms would be very beneficial.

Professor Sir Michael McBride: Believe it or not, I was a teenager once too, and I remember what it was like. Teenagers tend to push boundaries and experiment. It is all about finding yourself and your place and space in life. It is not cool to vape. It is not cool to succumb to peer pressure. Be yourself. Make sensible choices about what it is right for you. That is the message I would add to Sir Gregor’s point. We have an unfortunate situation where teenagers like to experiment and push boundaries and we have an industry that is only too willing to exploit that and market products at them with, as we heard, cartoon figures on the front, attractive colours and flavours that taste and smell nice. They are extensively marketed by opinion leaders. So don’t follow the crowd. Be yourself.

[Preet Kaur Gill]

Q We should all be concerned about the increase in the use of vapes by young children, so it is important that the Bill will ban the sale of vapes to under-18s. It will also close the loopholes for under-16s, because we know that vapes are being marketed and given out for free. That is the issue we must address. My concern with the Office for Health Improvement and Disparities being disbanded is on public health messaging. Parents and families are really concerned that some of their children are going through a number of these vapes per day or per week, and they do not know what is a safe amount.

There is a growing illicit vape market, but how would parents know what is illicit or what the Medicines and Healthcare products Regulatory Agency has notified as being compliant? Where is the public health messaging to support schools? We heard really good evidence yesterday from the union. This is my concern: where can people access support and information? We already have a generation of kids addicted to vapes that are marketed as having 0% nicotine, but we know that there is nicotine contained in them. What would you say to that?

Sir Francis Atherton: There is some messaging going on through the various Governments. In Wales we have a “No Ifs. No Butts.” programme, which tries to work at an individual level, to alert people to the dangers that we have been discussing, and with wider society, about the dangers and links between illicit tobacco and illicit vaping and organised crime. Bringing that awareness to the population is really important for those two reasons.

We work with trading standards to try to tackle the issue of illicit tobacco and vapes. It is important that we continue that. My understanding is that wherever we have been successful in reducing demand, which the Bill intends to do, the illicit supply also decreases. We would expect that to be a consequence of the Bill.

Professor Sir Chris Whitty: One of the many talking points of the cigarette industry is, “Well, any kind of downward pressure on cigarettes would lead to an increase in the illicit market.” All the evidence shows that the reverse happens. When you bring in reduced demand, the illicit market decreases.

--- Later in debate ---

[Rachael Maskell]

Q As you have just set out, we understand the harmful impact of tobacco, but I want to look at vaping. Is there any evidence of the impact on individuals who vape, or of a secondary impact, such as on triggering asthma or NHS admissions, or of an impact on admissions from the contents of vapes? We often talk about vapes, which are a delivery mechanism for substances. How should we regulate so that people understand what they are vaping, not least because it is now moving to an illicit market?

Professor Sir Stephen Powis: As I outlined earlier, the impact on the NHS of vaping at the moment is relatively small compared with the impact of smoking. Nevertheless, there is an impact, and we are seeing growing numbers. I have highlighted the number of admissions per year, but they have doubled over the past few years, so that impact is becoming apparent. For example, yellow card reporting to the MHRA is a mechanism for reporting harm, and again the number of incidents related to vaping is increasing, although still in relatively low numbers.

As I said earlier, however, what is important here is that the evidence base, although emerging, is growing. This is an opportunity for us not to get into a position where, in years to come, we regret that we did not take the steps early on to change the trajectory. Instead of seeing rising impact on the NHS—small at the moment, but with the potential to be greater—that trajectory should be changed. This is a golden opportunity for parliamentarians to step in early and to prevent further pressure building over time on the NHS, while recognising that the evidence is still emerging.

I agree with the chief medical officers you heard earlier: I do not believe that vaping is safe. It is undoubtedly safer than smoking, which is why we support its use as a means of smoking cessation, but beyond that the evidence is building that it is not safe. Unquestionably, it will have a building impact on the NHS.

[Angela Richardson]

Q My question is for Kate. I think we all fully accept that vaping is a great smoking cessation tool. About a year ago, the NHS was helping women who smoked to transfer to vaping while they were pregnant. We know that nicotine crosses through the placental barrier, and earlier you outlined the difficulties that mothers and their children have in terms of health outcomes.

How much do we know about the difference between the impacts of smoking and vaping? Thinking of the impact of vaping on babies, is vaping still an okay thing for pregnant women to be doing? Do we need to specifically address the impacts of vaping and smoking on pregnant people in the Bill?

Kate Brintworth: If we start with the evidence, as we have heard this morning there is a limited evidence base around vaping, but that does not mean we should be complacent. We know there is evidence around the transfer of chemicals and the reduction in lung capacity, which we see. As Chris said, while that is an improvement against the very, very low bar of smoking, we would see it as one step on a journey—an interim measure to being nicotine and tobacco free. On that basis, I do not think I would frame it as being okay to vape. We would see it as a tool—a means to an end—to reach the position of being nicotine and smoke free.

We will absolutely support research monitoring the impact of vaping. We cannot be complacent that it is going to be all right. However, at the moment, vaping is absolutely better than smoking, with the very well documented impacts that I have described on not just the mother but the baby and the future health of the family; we know that children born into households where smoking occurs are likely to start smoking themselves.

[Angela Richardson]

Q Can I follow up quickly? Nicotine is having an impact on babies; we heard from teachers about nicotine having an impact on young children when they are in school. Obviously, other substances are involved in tobacco smoking. Do those other substances cross through the placental barrier, or is it just the nicotine?

Kate Brintworth: It is all of it—all the elements. In some babies born to smokers, the children can almost suffer withdrawal symptoms and be jittery and restless in the neonatal period because they themselves are having to go through that withdrawal that is so difficult to enact. We also know of the numerous chemicals—arsenic, carbon monoxide—all of which are toxic to infants, so in no way would you want to distinguish out. It is a whole package of things, all of which we would like pregnant women and babies not to be exposed to.

[Mary Glindon (North Tyneside) (Lab)]

Q We hope that this really important Bill will prevent future generations from smoking. In your professional opinion, what impact can the Bill have on that stubborn figure of 6.4 million people who currently smoke? What in the Bill can help those people? It is such a high figure; when you describe the kinds of illnesses and what happens to pregnant women who smoke, it is horrifying.

Professor Sir Stephen Powis: Over time, this Bill will lead to the eradication of an addictive condition that causes the immense harm that we have described. But of course, that will occur over time, so it is also important that we continue with a range of other measures to encourage those not immediately impacted by the raising of the age of sale of tobacco products to cease smoking.

We have a number of smoking cessation programmes within the NHS, which was part of our ambition in the long-term plan for the NHS five years ago. We have been rolling out and supporting those services within hospital settings, and we should continue doing that. Of course, local authorities should also continue their work in supporting smoking cessation. Much of that is also targeted at women who are pregnant.

Part of that work is also supporting staff. Smoking rates across the 1.3 million or 1.4 million people employed within the NHS are lower than across the general public, but we nevertheless continue to see NHS staff who smoke. It tends to be in the lower pay grades within the NHS, but of course for all sorts of reasons we would like that rate to come down. Obviously there is the health benefit, but also, as you all know, smoking causes illness, illness causes absenteeism and absenteeism is a cost to the NHS. Although, as I said, we strongly support the Bill, it is important for us within NHS England and the wider NHS to continue to take other measures and put in place other programmes that will assist the public and our own staff to quit cigarettes.

Tobacco and Vapes Bill (Eighth sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Dame Andrea Leadsom]

I am grateful to my hon. Friend the Member for Copeland for moving the new clause tabled by our hon. Friend the Member for Sleaford and North Hykeham. I think all hon. Members are keen to see much more evidence on this issue, and I absolutely share that concern. I have urgently commissioned research into the impact of vaping on both the vaper and those second-hand breathers-in. As we all heard during the public evidence sessions, and as my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow set out, we do not have the evidence. We therefore need to provide evidence-based regulation as a matter of urgency, and I absolutely assure hon. Members that that will be forthcoming.

It is certainly the case that the ban on smoking in indoor spaces has been a great public health success story since its introduction in England in 2007 and across the UK from 2006. There is no doubt that the ban has protected many adults and so many children from the harms of passive smoking; it will have saved lives.

We know that vaping is less harmful than smoking, and indeed is a very effective quit aid for adult smokers. Although I have grave concerns about whether we err too far on the side of saying “Vaping is much better than smoking,” and are therefore inadvertently saying to young people that it is fine to vape, which of course it is not, that is why we also always say, “If you don’t smoke, don’t vape, and children should never vape.”

Although smoking in a public place may be seen as a nuisance by some, and there is some evidence that it can trigger asthma attacks, in the same way that pollution or car exhaust fumes can, there is very limited evidence of the potential harms of vaping in enclosed spaces, and simply none to suggest that it is at all similar to tobacco smoking. Vapes emit vapour, not harmful tobacco smoke. Vaping does not burn tobacco or produce tar and carbon monoxide—two of the most harmful elements in tobacco smoke. Evidence of the harm from exposure to second-hand tobacco smoke is well established, and because of its carcinogenic content, there is no safe level of exposure. It is totally incomparable to vaping, where there is very little evidence to suggest that second-hand vapour is anything more than an irritant. I repeat: that is not to say that vaping is good for anyone or a good thing to try. It absolutely is not. We know it is extremely harmful to children, whose lungs and brains are still developing.

In addition, many businesses, venues and spaces have already introduced their own bans on the use of vapes where smoking is prohibited, such as on public transport, on work premises and in many restaurants and bars. In 2016, Public Health England produced guidance regarding the use of vapes in public places and workplaces, which has helped businesses to make informed decisions on their vape-free policies, but given the lack of evidence of any harm from second-hand vapour and the way that the majority of businesses, restaurants and bars self-regulate and have vape-free policies in place, as well as the fact that vaping in enclosed spaces was not raised in our call for evidence as a major issue to address youth vaping, we just do not feel that the new clause is necessary at this time.

We will of course keep this under review and continue to monitor the evidence base. As I said, I have urgently commissioned proper research into the effects in the short, medium and long terms, and I hope to make further announcements on exactly what I am doing during the Bill’s passage.

[Angela Richardson (Guildford) (Con)]

Sometimes I think that when people listening to this debate hear the words “no evidence” or “lack of evidence”, they assume that that means there is nothing at all wrong with vaping. Will my right hon. Friend make it clear to anyone listening that there is a difference between not having done sufficient studies to gain the evidence and having no evidence of any harm?

[Dame Andrea Leadsom]

Yes, I am very happy to do that. My hon. Friend is exactly right: saying that we do not have the evidence right now is not the same as saying that vaping is not harmful. As I said, the chief medical officer has said that although we can be fine consuming strawberry sherbet ice cream in our tummies, it may not be so good to inhale it. We simply do not know what the truth is. We do believe that carcinogens may be innate in some flavours, and we know that vape products can contain heavy metals in the coils. We know that there can be significant harms from vaping, especially to children. I am happy to state once again, “If you don’t smoke, don’t vape, and children should never vape.”

With those remarks, I hope that my hon. Friend the Member for Copeland will not press the new clause to a vote.