Tobacco and Vapes Bill Debate
Full Debate: Read Full DebateBaroness Fox of Buckley
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(1 day, 8 hours ago)
Lords Chamber
Baroness Gerada (CB)
My Lords, I am also against these amendments. I will disclose a conflict of interest: I started smoking when I was 16—and 33 years later, like many of us who start to smoke at that age, because it is a childhood disease, I gave up.
We know and have heard about all the health effects of smoking, but we also have to realise that smoking is an easy addiction to start. I have looked after every addiction—heroin, cocaine, alcohol—and smoking is the easiest. You need only two cigarettes for 80% of people to be addicted, like me, for 33 years, and many people, like me, try to give up.
It is not just addiction that is the problem. It is not even about death, although death is a bad outcome to have. It is also about all the other complications. Like many smokers, I have lost many of my teeth. Our eyesight goes. We have skin problems. Smoking causes all sorts of things.
As a GP for nearly 30 years, I am pleased that I have seen a massive reduction in people with smoking-related diseases. My surgeries used to be full of what we call blue bloaters and pink puffers and full of people with premature heart disease. It is not an accident that I no longer see that in my consulting room; it is because of the hard work of our Chief Medical Officers, the Department of Health, ASH and many others to stop normalising smoking.
On the issue of the black market, there is of course a price differential. Wherever there is a price differential you will get a black market, whether it is diesel, cigarettes, alcohol or whatever. But the Bill is about stopping people starting—as the noble Lord said, preventing the next generation that has not even been born from starting. We have to focus on prevention, which is what the Bill is about.
My Lords, the noble Lord, Lord Rennard, called this a world-leading policy. It is world-leading, because no one else in the world has chosen this policy. One wants to know why. At least the noble Lord, Lord Stevens of Birmingham, admitted that this was novel and therefore untested. Can we at least have a little humility by admitting that the Bill is an experiment? It is a risk.
How you do age verification, as rather wittily described by the noble Lord, Lord Clarke of Nottingham, is a bit untested. How will we cope with the 84 year-old versus the 85 year-old—will there be a scrap? It is said that it is not going to happen for many years, but I thought the idea of legislators was that you were meant to think about the future, not just tomorrow, and the long- term implications of policies that pass.
Let us be honest: there is no good practice to copy with this Bill. There is no evidence about exactly how it will work or whether it will work. The claims on its behalf are largely based on modelling and speculation, and that is not evidence; it is not scientific. Therefore, the moral high ground and the sense of certainty deployed by those who are enthusiastic about the Bill, and the disdain towards those of us who are sceptical about it, are just a little misplaced.
I therefore request that, as we go through the very short Report stage, because a lot of us have been through a longer Committee stage, we are honest about things such as cost-benefit analysis—what is lost, what is gained—and, rather than moral righteousness, consider whether this is actually fit for purpose, even the purpose of those people who are putting the Bill forward. Whatever the intentions of those promoting the Bill, many of the clauses in it are counterproductive.
I know we are not on this section yet, but as an ex-smoker who started vaping, I am utterly distraught that we now have a Bill that, to all intents and purposes, treats vaping and tobacco as interchangeable, despite a denial by the Government. I do not think that there will be the health gain that is claimed.
My final point at this time—because I will be back —is that it is a little rich to sneer about freedom. Saying the word “libertarian” gives certain people a thrill; they can feel as though they are morally virtuous. I do not consider myself to be a libertarian, despite what Wikipedia says. However, I fully embrace living in a free society. I do not think that freedom is something I should be embarrassed about, nor that saying that people should be given choices about their lifestyles makes you to the right of Genghis Khan, or whatever it is that people are implying—or, worse, in the pay of big tobacco, which is the inference of many of the contributions. At some stage relatively soon, lots of adults—the 84 and 85 year-olds, because these kids do grow up to be adults—will be denied a choice. This Bill affects adults.
People can make choices about whether they take risks in their health. I suspect that practically everyone I know is using those weight-loss injections. To me they are a bit risky—I think, “Are they safe?”—but I am not mounting a campaign yet, because half this House would be out. People say it is worth the risk. A lot of people do daft things such as going skiing—mad; too risky for me. There are all sorts of things. People have been known to have the odd extra pint or eat the odd greasy breakfast. People take risks and make choices about their health all the time.
I do not want more people to smoke, but I also think that, in a free society, we have to give a certain degree of room for people to make choices—even the wrong choices. We live in a free society. Deciding the right and wrong choice is what happens in authoritarian regimes, but in a free society we say, “I don’t think you should do that, but I’m not necessarily going to legislate so that you can’t do everything I personally disapprove of”. We should not even say, “You shouldn’t do that, because I know best for your health what you should and shouldn’t do”. In medical ethics, there are times when you go to your doctor, who says, “Take this”, and you say, “I decline to take that medication; I do not want that intervention”. In a free society, a doctor cannot force you to do what you do not want to do—even the virtuous health professional who we are all meant to revere.
As we carry on this Report stage, can we all show a bit of humility? Living in a free society puts before us difficult moral decisions. There is no necessarily right or wrong. We are allowed to scrutinise a Bill that is put before us without being accused of somehow being evil because we do not go along with the Bill. Just because the Conservative Government, when they were in, and the Labour Government now agree—if that is the basis on which we should not scrutinise, we might as well all go home. I am sad to say that, for some of us, the Conservative Party has had far too much agreement with the Labour Party over recent decades.
I am a Conservative Member who, in the other House, voted against this proposition. Does the noble Baroness not share my concern that one of the unspoken nonsenses of this legislation is that far too many young people are already choosing to smoke cannabis, instead of cigarettes that they might legally obtain? That proves that, however we try to legislate or regulate this market, people will do what they choose to do. Virtually no effort is made to clamp down on the illegal smoking of cannabis.
I am allowed to come back on that. All I want to say is that I do not want it to go down in Hansard that I am such a libertarian that I support the smoking of cannabis: I am not Zack Polanski. It is also the case that we have to think of the unintended consequences and the real world and real young people, rather than imaginary ones.
I will briefly speak to Amendment 26, which is in my name, about the cost implications for small retailers and convenience stores. It is really a plea to the Minister to make some money available and introduce a grant system which can assist them. Age-verification technology is not cheap. They need to invest in a robust IT system. We need to build up a market for age verification. We also need one that protects consumers’ data and strengthens enforcement without penalising shopkeepers.
I think we all acknowledge that small shopkeepers are already in difficulty; it is not an easy time for them. We should look at anything we can do to help, and I think this would help. A simple act such as this would make it that much easier to ask the difficult question about age verification.
My Lords, I half support Amendment 26. I would also like to congratulate the noble Lord, Lord Moylan.
The introduction of this regressive and untested generational ban on tobacco sales obviously raises the thorny issue of how it will be implemented in terms of retailers checking ages. Following the discussion on the first group, it is worth noting that this is very different from standardised age checks, which we already have, where there can be challenges at 18 or 21 and over.
I would like to quote Trading Standards Wales, which described it as creating
“a two-tier age system for tobacco whereby someone born in 2008 would be legally able to purchase tobacco products whilst someone born in 2009 would not”.
It seems that, for this Bill to work in its own terms, enforcement is key, but it is not clear how that will be practical. Again, to quote Trading Standards Wales:
“Having a two-tier age system means that young people could still obtain cigarettes from older friends or family members that smoke and, it is unlikely that any parties would report each other to the authorities as both would face legal consequences in doing so”.
My Lords, I rise to welcome government Amendments 14 and 15, and I look forward to hearing from the Minister. I will not go through them in detail, as I am sure she will, but I note that this is a lovely practical example, and all credit to the Government that their campaigning has worked. We heard in Committee from both Action on Smoking and Health and the Mental Health and Smoking Partnership about the need for an exemption in in-patient mental health settings for vaping vending machines. The Government have clearly listened, and this is an example of how this all should work, so let us applaud and highlight that.
I support Amendment 16, which the noble Earl, Lord Russell, has just introduced. The ban on disposable vapes is clearly being widely, almost universally, got around. The noble Earl spoke about producer responsibility. Well, we have a profoundly irresponsible industry that is behaving in ways that have serious health and environmental impacts. I spent most of this afternoon hosting an event for the National Association of Local Councils. As soon as I said I was leaving to do the Tobacco and Vapes Bill, the reaction was, “Waste!” That is understandable. Let us look at some figures from Biffa on three recycling facilities, in Suffolk, Teesside and London. Before the ban on single-use vapes came in, they saw an average of 200,000 vapes mixed in with general waste; after the ban came in, that went up by about 3%. There was perhaps a rush of material being sold in that immediate period, but from everything we are hearing, the waste problem is still enormous, and the risk of these lithium batteries exploding and catching fire in waste lorries and recycling centres is absolutely enormous.
We need more action on public health, too. I spoke to a young person today who said, “Well, I’m a bit confused about how vaping relates to health and cigarettes”. Young people are not getting a clear message, and they are being sold these things everywhere. This amendment is saying we need to keep a watch on this and be ready to catch whatever the industry does next, because we know big tobacco is profoundly irresponsible. As the noble Earl said, this is perhaps not the exact way to do it, but we need to make sure we hear from the Government that they are prepared to take action against big tobacco at any time.
My Lords, I, too, warmly welcome government Amendments 14 and 15, which create an exemption for vape vending machines in mental health hospitals. This was really good to see: it is a humane step and will be very beneficial to patients. It proves that the Government can listen and amend, and I hope there might be more listening and amending, and exemptions, even at this late Report stage. It makes our debates feel as though they can get somewhere. This was an important concession for the Government to make, so I am really pleased to see that.
I have grave concerns about Amendment 7 in the names of the noble Earl, Lord Russell, and the noble Baroness, Lady Walmsley. There is a real danger here that we end up seeing this Bill as a vehicle for a relentless attack on anything to do with nicotine. Unless I am much mistaken, the Bill does not intend—even though this is its effect—to treat all nicotine products in an undifferentiated way. It is aware of Cancer Research’s statement that vaping is “far less harmful” than tobacco and is the most popular tool to help people quit smoking.
But, following on from the remarks of the noble Earl, Lord Russell, I do not want to say simply that vaping can be considered positive only if it is used as a smoking cessation tool, because people will then undoubtedly—and they do undoubtedly—vape as a recreational habit. Is the Government’s aim, or this amendment’s aim, to tackle dependence on any substance whatever? Nicotine is the one that is named, but will caffeine be next? Where do we draw the line? As far as I am concerned, that should not be what this Bill tries to do.
I worry that this will lead to mission creep in the Bill, which will create a kind of pre-crime. I listened to the noble Baroness and I do not think that we should have a moral panic about vaping: that is the main thing. It is not appropriate for this Bill to start doing a pre-crime anticipation of all the things that might or might not go wrong in relation to vaping. That would be a disastrous outcome of this Bill. So I urge the noble Baroness to avoid the siren voices of those urging her to take it even further down the line of prohibition. I urge her to hold firm to the notion that, although there will be some suggested regulation of vaping, we should not and must not make vaping indistinguishable from tobacco in the public’s eye by treating them as equally problematic through the course of the Bill.
I very much support my noble friend Lord Russell’s amendments, which seek to address the abuse of vapes and other nicotine products. When you go into any local shop or see adverts, you must mentally think that those promoting these should hang their heads in shame. I mentioned in Committee the example from my own extended family, where vaping has been the route for teenage relatives to become addicted to nicotine and, from there, to smoking. So I fully support everything that we are doing to reduce nicotine dependency, and I support my noble friend’s amendments here.
Despite that, we welcome the Government’s amendments that create an exemption for mental health settings, allowing the continued use of vape vending machines. Written evidence submitted to the Bill Committee by, for example, the Cambridgeshire and Peterborough NHS Foundation Trust and others made it clear that vape vending machines located in mental health wards are currently a crucial part of delivering effective smoking cessation services. Several trusts using these machines have reported that they provide a safe and straightforward way of ensuring that patients can access vapes when they need them. It is therefore welcome that the Government have listened to this evidence and made this concession.
In England, vapes are now the most commonly used smoking cessation aid, and it is awful that they have been exploited for other purposes. Nevertheless, vaping is recommended by NICE as the first-line smoking cessation tool and is more effective than traditional nicotine replacement therapies. Smoking prevalence in in-patient mental health settings remains extremely high, with estimates of about 50% overall and some studies reporting rates as high as 80% in individual hospitals, so I see why the Government have decided to take this particular measure forward.
Although it is technically possible for vending machines to be stocked with other forms of nicotine replacement therapy, this would not reflect patient preference, and we need to be guided by what works to support smokers to quit. As my noble friend Lord Russell said, that is what vapes should be about. The risks associated with proxy purchasing would seem to be low, particularly in closed wards, but I would be interested to hear from the Minister further on this point and to have clarification on how she envisages these machines operating within the new licensing scheme.
Therefore, although we accept the Government’s amendments in relation to mental health settings, we think that they need to do more to tackle the awful spread of nicotine addiction that we now see among young people. I look forward to the Minister’s response.