Standardised Packaging of Tobacco Products Regulations 2015

Baroness Tyler of Enfield Excerpts

Monday 16th March 2015 Lords Chamber

So all of your Lordships who have been on this mission with us deserve a big pat on the back. I support the regulations and oppose the amendment.

[Baroness Tyler of Enfield (LD)]

My Lords, I congratulate the Minister and the Department of Health on producing a high-quality and thorough set of regulations after a thorough consultation exercise. I join the noble Lord, Lord Faulkner, in adding my congratulations to the department for receiving the Luther Terry Award for Exemplary Leadership by a Government Ministry. It is measures such as these that make Britain a world leader in public health.

In our debates on this subject, I have spoken extensively about the need for these regulations and the evidence that they would make a real difference. The bare facts are these: only one in 10 smokers in the UK started after the age of 19, and two in five started before 16. We have already heard from the Minister the figures on how many people die each year from smoking-related diseases, and the number of children between the ages of 11 and 15 who take up the habit and risk their health by spending hundreds, if not thousands, of pounds a year on a toxic product.

The unconscious trigger of attractive packaging is an extremely successful marketing tool that encourages children and young people to glamorise and take up smoking. Bright colours, sleek designs and slim cigarettes—to name but a few—all make people falsely believe that such cigarettes are less harmful. I remember as an impressionable teenager the impact that some of those cigarette pack designs had on me. It made a big difference and I indeed wanted to start smoking, and did so; and I think I was influenced by some of that marketing material.

I should like briefly to turn to some of the objections that have already been advanced by opponents of these regulations in this debate. First, the tobacco industry has claimed that standardised packaging would increase the volume of illicit tobacco on the market. This is flatly contradicted by a recent HMRC assessment and an independent review by Sir Cyril Chantler, both of which indicated that there is no evidence for such a claim. Indeed, there is no evidence that standardised packs would be easier to counterfeit. Standardised packs are not “plain packaging”—that is a misnomer. They would carry the same security systems as current packs. There is no evidence that that there has been an increase in the illicit tobacco trade in Australia since the implementation of the policy. The total weight of illicit tobacco detected by Australian customs has remained roughly static since 2007-08. Indeed, a recent study shows that there was no change in the availability of illicit tobacco in Australian shops since the introduction of standardised packaging. At any rate, it seems logical that the way in which to reduce illicit trade is through more effective regulations, which these regulations clearly are.

Secondly, the tobacco industry has claimed that standardised packaging would damage small businesses because it would make it more time-consuming for shop assistants to retrieve packs, and that this delay would make tobacco less profitable for small businesses as opposed to large supermarkets. Tobacco companies based these predictions on interviews with just a handful of retailers. In contrast, peer-reviewed studies of small shops in Australia before and after the standardised-packaging policy demonstrate that there was no significant increase in serving time.

It is true that standardised packaging is likely to result in reduced tobacco sales. In fact, it is the very purpose of these measures; it is the Government’s hope and certainly mine. Every pound that consumers no longer spend on tobacco they will surely spend on other goods and it is very likely that small businesses will pick up some of this trade. After all, shops, including small shops, have adjusted to the continuous decline in the prevalence of smoking from half of the population in 1960 to roughly one-fifth now and there is no reason to suppose they will not be able to adapt further. On this point, can the Minister confirm that in the interests of reducing costs to retailers the measures will be implemented at the same time as the packaging and labelling measures in the EU tobacco products directive in May 2016? Can he also confirm that retailers will be given a full year after the implementation date to sell through existing stores of non-standardised packs? It comparison, retailers in Australia were given just eight weeks to do that.

The tobacco industry has made what I think is a very convoluted argument that standardised packaging will lower prices and thus increase tobacco consumption. In the process of conducting his review last year, Sir Cyril Chantler was told by tobacco companies that sales had increased slightly, despite the fact that the industry had told its investors the opposite. Analysis by the independent market research company Euromonitor concurred that there had been a decline in sales in Australia between 2012 and 2013.

As we have already heard, it seems to be contested—although frankly I do not know why—what the impact in Australia has been since the introduction of standardised packaging. I have looked very carefully at what the helpful leaflet Standardised Packaging for Tobacco Products, produced by very reputable organisations such as the British Heart Foundation, King’s College London, the University of Waterloo, Cancer Council Victoria and the UK Centre for Tobacco and Alcohol Studies, has said about the impact so far. It shows that there is a reduction in young people taking up smoking and an increase in the proportion of existing smokers who are trying to quit. Indeed, the National Drug Strategy Household Survey in Australia showed that the proportion of 18 to 24 year-olds who had never smoked increased from 72% in 2010 to 77% in 2013.

A 2014 study from Australia that reported in the British Medical Journal shows that the prevalence of smoking among adults fell by 15% in the second half of 2013 alone. Finally, following evidence that smokers find cigarettes in standardised packs less appealing—which of course is the very purpose of it—there is new evidence that calls to Quitline, a free smoking cessation service, have increased by 78% since the introduction of standardised packaging.

It is a credit to the very thorough and painstaking way that this measure has been developed by the Government that these are the best criticisms opponents can level. Above all, it is time to listen to the 72% of Britons and the majority of all political parties and support standardised packaging.

[Viscount Falkland (CB)]

My Lords, I am a non-smoker but having been in your Lordships’ House for some years one thing that concerns me about this measure is the unintended consequences. One is always worried in this House about them and so we should be. It seems very odd that so few people have expressed the view that tobacco is a legal product. How can you interfere with the marketing and the sales of a legal product? I think the product is undesirable and the arguments of the scientific community about its danger to health are indisputable. However, we have to think rather carefully about what may follow. If you get away with this without too much protest there are all kinds of bien pensants and vigorous politically correct people who will seek to do various things. For example, it could happen quite easily that in some local authority someone of limited life experience might suggest that, with obesity and the compulsion that people have to eat too much, it might be a good idea to prevent restaurants allowing people to eat on the pavement under an awning because that attracts people to sample the restaurant’s delicious wares. Noble Lords may think that this is a trivial, Clarksonesque point, but it bears thinking about.

I am grateful for the efforts that have been made to curb the ill effects of smoking. I am a frequent cinema goer—I have been a film buff since I was a boy. I do not think I would be talking to noble Lords today if they had not banned smoking in cinemas. I may have a husky voice, but I would probably be dead by now, I should think. These are things that have to be considered.

In the speeches so far, there has been scant respect for one thing that is very important to this country, and I hope it will be borne out in the speeches during the election campaign. This is a trading country, and trading countries require freedom in order to encourage the production of goods, to sell them and to market them correctly. If you do not like smoking, then ban it, for heaven’s sake. Do not try to pretend that this is going to deal with it—it is not going to deal with it. We have already seen the unintended consequences on the streets. In some of our best streets in the West End of London you see cigarette ends everywhere because people are smoking at lunchtime in doorways, smoking in the open air and smoking in groups; they are also smoking in their homes because it is unsatisfactory outside so that the smoke filters through badly constructed walls.

There are all kinds of aspects of this whole problem which have not been properly addressed, and I do not think that packaging is the answer. Should the noble Lord who introduced this amendment guide us towards the Lobbies, I shall follow him.

Mental Health Services

Baroness Tyler of Enfield Excerpts

Wednesday 25th February 2015 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, in a rapidly changing world, children and young people face a wide range of risk factors for mental health problems, both now and later in life. It is salutary to note that in an average classroom, 10 children will have witnessed their parents separate, eight will have experienced physical violence, sexual abuse or neglect, and seven will have been bullied.

Those in the particularly vulnerable group, children in care, are typically in care precisely because they have experienced neglect or abuse, and these traumatic experiences can affect them for the rest of their lives. The recent Barnardo’s report, The Costs of Not Caring, showed that children in care are five times more likely to develop childhood mental health problems and, shockingly, are five times more likely to commit suicide later in life.

Despite the widespread concern about the current state of mental health services for children and young people, it is important to acknowledge what the Government have done to improve things, including investing £54 million into the children and young people’s IAPT programme and the recent announcement by the Deputy Prime Minister that £150 million will be invested over the next five years to improve treatment for eating disorders. It is welcome, of course, but nothing like enough.

We are all aware of the impact of budget cuts on CAMHS services. As a consequence, children have too often been transferred far from home or placed in adult wards that are ill equipped to take care of them. Services provided by the voluntary sector have picked up some of the slack, but there is often a lack of awareness about these services and they may be ill equipped to deal with serious mental health problems.

In reality, the help that is available can be hard to find. A 2013 YoungMinds study found that one in three young people does not know where to turn for mental health support; and, as the National Children’s Bureau pointed out, only a quarter of five to 15 year- olds with anxiety or diagnosable depression are in contact with CAMHS. By the time young people do get support it can be too late. More than 80% of parents said that children and young people were at crisis point before they managed to get support.

What is to be done? I greatly look forward to the findings and recommendations of the Government’s Children and Young People’s Mental Health and Wellbeing Taskforce. What is on my wish list? First is far more joined-up commissioning for CAMHS, with young people’s voice at the heart of service design. Secondly, counselling in schools can provide an alternative and valuable route for young people to get therapeutic help. Schools in Wales and Northern Ireland are already required to provide counselling. In my view, children in England should have the same opportunity. Can the Minister say what practical steps the Government are taking to ensure that all children have access to school counselling?

Thirdly, as already stated, children in care are not only more likely to experience mental health problems in childhood, they are also more likely to experience the sorts of problems—emotional instability, substance abuse, self-harm—that lead to worse outcomes later in life. That is why I think that CAMHS, IAPT and school counselling should explicitly prioritise the needs of children in care as part of the corporate parenting role that government plays.

When we think about children’s mental health we should think not only about the 10% who already have a diagnosable condition. Relatively minor problems in childhood often snowball and develop into fully fledged mental health disorders in adulthood. There are good examples of effective early intervention, such as specialist support to help parents develop a healthy connection with their young babies, and parenting programmes, as we have already heard.

I believe that schools should have a responsibility to prepare children not only for exams but for the difficulties they may face in later life. That is why I would like to see PSHE programmes to address issues such as bullying, drugs and alcohol, and mental health being compulsory for all primary and secondary schools.

Finally, preventive mental health support should be offered to all children in care and care leavers so that they can access the support they need to overcome past trauma and achieve stability later in life. I thank the noble Earl, Lord Listowel, for having secured this debate.

Smoke-free (Private Vehicles) Regulations 2015

Baroness Tyler of Enfield Excerpts

Tuesday 3rd February 2015 Grand Committee

[Baroness Tyler of Enfield (LD)]

My Lords, I, too, welcome these regulations and congratulate my noble friend Lord Ribeiro on his unstinting efforts in this area. I stress that this new law and these regulations are not designed to turn smokers into criminals or to demonise them; they are about protecting children from the avoidable dangers that tobacco smoke presents to their health and welfare. For me, that is what it is all about. Right through these discussions, I always saw this legislation primarily as a matter of child protection. If noble Lords will excuse the terrible pun, it was about putting children in the driving seat.

When we had those early debates, I was very taken with the number of children who said that they felt that they had no control over the situation and that they were either too embarrassed or too scared to ask adults to stop smoking. The survey mentioned by the noble Baroness, Lady Finlay, referred to how children really want this legislation. In my professional life, we often talk about the voice of the child being at the centre of what we do. Based on that survey, we have a clear mandate from children and young people to take these regulations forward.

The Minister said that the start date will be October. In an ideal world I would have liked to have seen it earlier, but I accept the reasons that he gave. It will be incredibly important legislation in addressing health inequalities, and will go some way at least towards protecting children from the most disadvantaged backgrounds from smoke and enable them to have a healthier start in life. As others have said, this is very much about behaviour change. Certainly, the experience that we have seen on similar issues, such as public smoking and compulsory seat belts, suggests that educational campaigns, which are important, are most effective in changing behaviour when accompanied by appropriate legislation. For the effect of legislation on the proportion of people wearing seat belts, I have a figure that shows an increase from 25% to 91%, which seems extraordinarily large. Just imagine how many children’s lives will be improved if this legislation has even half that success.

The Minister referred to success being measured in terms of positive behaviour change rather than the number of fines handed out. I am sure that that is right, and I approve of that approach, but will he confirm precisely how that behaviour change will be measured?

There are very high levels of public support for the law. In previous debates, as one would expect, we heard that parents were very much in favour of this legislation. However, we also heard about recent surveys and the number of adults, including adult smokers, in favour of this legislation and the number of car drivers who support it. There is a real and growing consensus that these regulations are a good thing and should be introduced without delay.

I very much hope that, without much further delay, we will very soon debate the regulations on standardised packaging.

Mental Health Services: Sign Language Users

Baroness Tyler of Enfield Excerpts

Monday 2nd February 2015 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, I thank the noble Lord, Lord Ponsonby, for securing this debate and drawing attention to this important issue. A few weeks ago, I opened a debate in this House about the many challenges confronting mental health services as well as the important new policy and service development instigated by this Government. I particularly appreciate the chance to speak today about the problems that deaf people face in accessing effective mental health care.

It is really important to remember that when we speak of deaf people, we speak of a large and extremely diverse group. There are 9 million deaf or hard-of-hearing people and 700,000 severely or profoundly deaf people in the UK, 50,000 of whom use British Sign Language as their first or preferred language. While some deaf people were deaf at birth or from a young age, others become deaf late in life. The mental health needs of deaf people will differ depending on these factors.

Nevertheless, deaf people as a group share a disproportionately pressing need for mental health care. It has been estimated that 40% of deaf people have a mental illness. The prevalence of common mental disorders such as anxiety and depression in the deaf community is nearly double that of the hearing population and behavioural and personality disorders are between two and five times more common among sign language users.

Deaf children are particularly in need of mental health services as the particular challenges of their life make it more likely that they will experience mental health problems. More than 90% of deaf children are from families with no first-hand experience of deafness, which can lead to isolation and troubled relationships with their families. It is salutary to note that deaf children are twice as likely to be abused or neglected as hearing children.

Let me now turn to the issue of prevention. For many people who lose their hearing as adults, the experience of becoming deaf can adversely affect their mental health. For example, research shows that older people with hearing loss are twice as likely to develop depression as their peers without hearing loss as well as increased feelings of loneliness and social isolation. Like, I am sure, other noble Lords, I am conscious of this from the first-hand experience of close relatives. By providing people with hearing aids, we can reduce these risks. Those who wore hearing aids experienced less depression and anxiety, had more and better family and social relationships, and felt better about themselves than those who did not.

It is impossible to avoid the issue of funding and it is complex. To set the overall context, while very welcome additional funding has been made available for specific mental health initiatives, our recent debate made clear that mainstream mental health services have suffered from disproportionate cuts in comparison with physical health services for both adults and children. Within this context, specialist services for deaf people remain a particular concern, not least given the current architecture of health service commissioning. In short, while secondary and tertiary mental health services for deaf people are commissioned on a national basis, primary mental health care is the responsibility of local clinical commissioning groups, and this, of course, includes mental health services for deaf people. So while the specialist in-patient units for deaf people in London, Birmingham, and Manchester that we have already heard about may receive adequate funding, commissioning for community services is extremely patchy. That is mainly because the deaf community within the area covered by each CCG is relatively small and there is therefore little incentive for it to prioritise the needs of deaf service users. The result is that only a handful of services receive local commissioning.

Let me try to bring this to life. Until early last year, deaf service users were able to access a deaf therapist fluent in sign language through the British Sign Language Healthy Minds IAPT service developed by the charity SignHealth, which was referred to by the noble Lord, Lord Ponsonby, with funding from the Department of Health. The programme was extremely successful and nearly doubled the rate of recovery from 44% to 75%, which is extremely impressive and important. However, in the restructuring of the NHS, clinical commissioning groups were often hesitant to commission the service, preferring to use hearing therapists with interpreters, even though the evidence shows that this is not as effective. Meanwhile, the service was often considered too small scale to qualify for national commissioning. Because of these challenges, the service is rapidly shrinking and some staff have been made redundant. Can my noble friend the Minister say what the Government are doing to support CCGs to increase the data collected in their local community to help inform mental health commissioning for deaf people?

In such circumstances, deaf people seeking talking therapies, which I greatly support, often have little choice but to resort to mainstream services. Deaf people are often not given adequate access to interpreters, as we have heard. Indeed, a 2012 survey of British Sign Language users found that 68% of respondents did not get an interpreter for their GP appointment, despite having asked for one. Many others must wait longer for treatment and travel further in order to secure access to an interpreter. What plans do the Government have to increase the provision of medically skilled interpreter services?

Even when there is access to an interpreter, going through therapy with an interpreter can present significant challenges. The 2012 survey indicated that 41% of deaf patients felt confused following their appointment as they had trouble understanding the interpreter. This may be due to cultural reasons. It is important to recognise that the life experiences of deaf people differ in ways that go well beyond language, especially if they have been deaf from birth or a very young age. The relationship between a hearing therapist and a deaf service user can be made more difficult by cultural barriers as well as linguistic ones. It is no surprise or indeed criticism that mainstream mental health service providers often lack the specific expertise necessary to understand the unique life experiences of deaf people and work effectively with deaf clients. It is just that a specialist service requiring specialist expertise is needed.

Moreover, the inclusion of an interpreter, as the noble Lord, Lord Ponsonby, said, inevitably changes the dynamic in a therapeutic situation in ways that can be detrimental. For example, the sorts of topics discussed in therapy can be difficult enough to tell to a therapist without having to wonder whether one’s words will be faithfully conveyed by the interpreter. As the deaf community is small and close knit, there is a real chance that the patient will know the interpreter, and because qualified interpreters are hard to come by, the options are limited and there are few alternatives if a patient is uncomfortable with his or her interpreter.

As we have heard, there are specialist in-patient psychiatric units for deaf people in London, Manchester, and Birmingham, but the quality of care that deaf people receive is adversely affected by a lack of community resources. A recent report by the National Deaf Mental Health Service has shown that deaf adults in specialist and general in-patient programmes were in hospital for twice as long as hearing patients, not because of actual clinical need but because the community services they would need on discharge were not available. The current dearth of specialist services for deaf people is not inevitable. As Dr Sally Austen, a specialist for deaf people with mental health problems and a former chair of the British Society for Mental Health and Deafness has pointed out, if specialist deaf services were to include partially deaf people, the economies of scale would change. Dr Austen has also suggested that what is called “tele-mental health”, including online services, may also provide a solution for deaf patients with poor access to appropriate providers having to travel very long distances.

This is an extremely important discussion, and yet is not one that we often have. The last government strategy on the topic was back in 2005. If nothing else, what we have already heard—and more is to come—about the wide array of challenges that deaf people face in securing access to mental health care should surely convince us of the importance of updating our aims for this type of healthcare provision. I therefore, finally, ask my noble friend the Minister what plans the Government have to update the 2005 Mental Health and Deafness: Towards Equity and Access document so that it can become the cornerstone of all our work.

The UK has had a proud history of providing excellent mental health services for deaf people. It would be a tragedy to neglect that history by failing to give deaf people the access to therapy that they so clearly need and deserve.

London Health Commission: Smoking

Baroness Tyler of Enfield Excerpts

Thursday 15th January 2015 Grand Committee

[Baroness Tyler of Enfield (LD)]

My Lords, I rise to speak briefly in the gap. The UK is a world leader in tobacco control, of which I feel very proud. I have worked and lived in London for virtually all my life, and I would love to see London set a real lead and a real example by becoming a smoke-free city in the way described by the noble Lord, Lord Darzi. I congratulate the noble Lord on securing this debate, on all his work and on the recommendations of the London Health Commission, which were very far-reaching.

I also pay tribute to the Government for all their work on tobacco control and, indeed, to the Minister personally for everything that he has done. I remember very clearly the strength of feeling in this House when we debated the Children and Families Act 2014 around the standardised packaging of tobacco and about banning smoking in cars carrying children. The way the Government responded to that strength of feeling, looked at the evidence and then came back and accepted those things was an example of Parliament at its very best. The fact that the work was done very much on a cross-party basis really showed what can be done in this House when people come together and work together very sensibly.

I had the great privilege during that period of briefly meeting with the Minister in Australia, who was personally involved in steering this measure through in her country. It was wonderful to hear from her how they had got that through and the impact that it was starting to have. I want to add my voice to others in this afternoon’s debate to say how important it is that the standardised packaging regulations are laid in sufficient time for them to be considered, and for a vote to take place before the election. I also hope that the Minister will be able to give us some comfort on that because so much has been achieved in this Parliament that it would be a real travesty if we fell at the final hurdle.

Mental Health Services

Baroness Tyler of Enfield Excerpts

Wednesday 26th November 2014 Lords Chamber

[Earl Howe]

My Lords, on the noble Earl’s second point, yes, a survey is most certainly being actively considered. On his first point, he is absolutely right. One of the task force’s focuses will be to consider and make recommendations on how we can provide more joined-up, more accessible services built around the needs of children and young people, looking at sometimes innovative solutions about how to get there and how to improve access to health and support across different sectors, including in schools, through voluntary organisations and online. I am very encouraged by the task force’s terms of reference.

[Baroness Tyler of Enfield (LD)]

Given that some 60% of children and young people in care are currently reported to have emotional and mental health problems, can the Minister say what plans the Government have to set access standards for these children as part of their wider drive to increase access to mental health services, to ensure that these very vulnerable people get the support that they need?

[Earl Howe]

My noble friend is absolutely right: there is a high prevalence of mental health issues in those leaving care. The Government are dedicated to supporting NHS England’s work to develop a service specification for the transition from CAMHS that is aimed at CCG-commissioned services. CCGs and local authorities will be able to use the specification to build on the best measurable services to take into account the developmental needs of the young person. A separate specification for transition from CAMHS to adult services is also in development.

Learning Disabilities: Community-Based Support

Baroness Tyler of Enfield Excerpts

Tuesday 22nd July 2014 Lords Chamber

[Earl Howe]

I do agree with the noble Baroness. For people who, with the right support, could and should be living in community-based settings, there is a variety of reasons why sometimes that does not happen. The lack of appropriate housing can be a barrier. For others, we know that clinical decisions are preventing discharge. NHS England is looking very carefully at how to strengthen second opinion to support people in in-patient settings to challenge the reasons for their placement as and when they need to. We are looking at making some capital funding available to support the transfer of people from in-patient care to community-based support.

[Baroness Tyler of Enfield (LD)]

My Lords, given the figures we have just heard about the number of people with learning disabilities being admitted to costly assessment and treatment units rather than leaving them, will my noble friend the Minister say what action the Government are taking to ensure that local commissioners—in both local government and the NHS—have the necessary skills and competence to deliver the high-quality local services that are needed to allow as many people as possible to return to their communities?

[Earl Howe]

My noble friend is absolutely right to focus on the role of commissioners. The Winterbourne View joint improvement programme has already stepped up its activity in working with local areas, including identifying 35 areas for in-depth review. NHS England is engaging with commissioners to reinforce the importance of ensuring appropriate services for people with learning disabilities close to their homes and families. That includes looking at how funding streams can be shared with local authorities so that there is no procedural blockage in the way that money moves across the system.

Mental Health: Social Work

Baroness Tyler of Enfield Excerpts

Monday 23rd June 2014 Lords Chamber

Asked by

[Baroness Tyler of Enfield]

To ask Her Majesty’s Government what plans they have to improve the provision of mental health social work, given the incidence of mental health problems among the population.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, the Government recognise that improving mental health services remains a significant challenge. Social workers play a vital role in delivering high-quality mental health services, and the Chief Social Worker for Adults is taking forward a number of initiatives with the sector to help address these challenges. Along with the College of Social Work, we recently launched The Role of the Social Worker in Adult Mental Health Services.

[Baroness Tyler of Enfield (LD)]

I thank my noble friend for his Answer. Does he share my concern about the shortage of good social workers who are able to work effectively in mental health settings in many places in the country? What further steps are the Government taking to address this? What specific plans do they have to ensure that social workers working in integrated health and social care teams feel valued by their medical colleagues and that their professionalism is indeed recognised?

[Earl Howe]

My noble friend makes some excellent points, and I acknowledge her role as a member of the programme board for the Think Ahead programme, which is designed to attract, in particular, new graduates into social work, and specifically into mental health social work. Good-quality social work can transform the lives of people with mental health conditions. It is an essential part of multidisciplinary and multiagency working. As we move forward into new ways of working, particularly in the context of integrating care, my noble friend’s point about other professionals understanding and appreciating the value that mental health social workers can give will be key, not just in terms of earlier intervention but by building resilience, reducing and delaying dependency and ensuring that people have all the information and enabling support that they need to look after themselves better.

Tobacco: Packaging

Baroness Tyler of Enfield Excerpts

Thursday 3rd April 2014 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, I strongly welcome Sir Cyril’s report, which is an extremely thorough piece of work. The central message from it is crystal clear and compelling; the introduction of standardised packaging would reduce the number of children and young people taking up smoking. I look forward to reading the draft regulations and the consultation, which I hope will be short. I would be grateful if the Minister would confirm that he talked about six weeks. Does he agree that, if the Government introduce this, we are going very much with the grain of public opinion? A new poll, issued today by YouGov, found that 64% of adults in Great Britain support or strongly support plain, standardised packaging, with only 11% opposed to the measure.

[Earl Howe]

I am very grateful to my noble friend. I confirm that we intend to have a consultation period of six weeks. That is as long as we think it needs to be to enable everyone with an interest, both for and against this measure, to make their views known and to enable us to factor in any considerations we may not yet have had an opportunity to consider. Although I have not seen the YouGov report to which my noble friend refers, I suspect she is absolutely right that public opinion is moving in the direction that Sir Cyril has advocated, and that we are going with the grain of what most people think. Most right-thinking people want children to be protected from the harms of tobacco. I hope that we will have public opinion behind us, should we decide to go ahead with this.

Children and Families Bill

Baroness Tyler of Enfield Excerpts

Wednesday 29th January 2014 Lords Chamber

[Lord Faulkner of Worcester]

I added my name to Amendments 57BB, 60 and 62 and will speak briefly to those, but I start by congratulating the noble Earl on bringing forward his Amendment 57B and for overseeing a significant change in government policy on the subject of standard packaging. Like many of your Lordships, I was heartened when I heard the then Public Health Minister, Anna Soubry, around a year ago saying that the Government were minded to go down the standard packs route and then bitterly disappointed last summer when the plans were suddenly dropped. Various conspiracy theories were propounded at the time and I will not go into those now, but it looked as if the issue was dead, at least for the foreseeable future.

At that point, it seemed sensible to look at whether there was any possibility of adding a standard packaging amendment to another Bill, which might not immediately present itself as the most appropriate, in order to be able to give the House the opportunity to debate the issue and come to a view on it. With the help of staff in the Public Bill Office—about whom I cannot speak highly enough, as their help was invaluable in framing our original amendment in Committee and the subsequent amendment that we tabled for today—we were able to bring the issue to the Committee and approach the issue in an entirely cross-party and non-party way. The amendment that we put together was signed by the noble Baronesses, Lady Finlay and Lady Tyler, the noble Lord, Lord McColl, and myself.

Amendment 60 is an improved version of what we had in Committee, but the Government’s amendment today is a great improvement on that as well. I congratulate them on picking up a number of the points that were defective in ours and coming forward with one that, I think, is very effective. Tobacco control should not be a party-political matter; it should be the common concern of everyone who cares about the health and the well-being of the public. As we have heard from the Minister, smoking-related disease still kills more than 100,000 people across the UK and is by far the most common form of preventable death—it accounts for more premature deaths than the next six most common causes put together.

As most smokers start as teenagers, the teenage market is the one which the tobacco companies are anxious to promote, which it is the responsibility of all of us to try to prevent. Two-thirds of existing smokers report that they started before their 18th birthday, and around two in five before they were 16. The younger the age at which they start, the greater the harm is likely to be, because the early uptake of the habit is associated with subsequent heavier smoking—of the sort that the noble Lord, Lord Forsyth, experienced with his mother and her 60-a-day habit—high levels of dependency, a lower chance of quitting and a higher chance of death from smoking-related disease.

For the tobacco industry to keep its market, it is necessary for it to recruit new smokers every year. That is because older smokers die or quit—or indeed lose their lives prematurely as a result of their habit. Since most smokers start when they are young, it follows that, for the industry, young people are the most important target group of potential new consumers.

We know what the tobacco industry would do in this country to promote its products if the law and the authorities allowed. Indeed, we probably know more about the commercial strategies of the tobacco industry than about any other major industry in the world, in large part because so many previously confidential documents were made public as a result of the US master settlement agreement with the industry in 1998.

Given the restrictive legislation around marketing and advertising tobacco in the UK, the industry is left with few options to promote its products. Of these, the most important is now packaging. Packs can be used to market and advertise, to create brand identities and to help present an image of smoking that may indeed seem “cool” to a curious teenager. There are many diversionary arguments advanced by the tobacco industry and the front groups it funds so lavishly about why we should not proceed with standardised packaging. So we hear tobacco industry claims that the UK is being flooded with illicit tobacco and that standard packs will make the problem worse. But the level of illicit trade has fallen sharply since it peaked back in 2000, and the security features on existing packs will also be present on standard ones. Both our amendment and the Government’s would allow the Secretary of State to specify packaging requirements that would enhance and not reduce product security, and make smuggling and counterfeiting more difficult.

However, the tobacco industry’s real, core argument is quite simple. It is advancing the proposition that its claimed so-called “intellectual property rights” trump the requirements of public health—or to put it more sharply, that its right to design products designed to get children addicted is more important than the children’s right to be protected from that addiction and the health damage that it causes. I believe that the overwhelming majority of your Lordships, and indeed Members of the other place, reject the tobacco industry’s arguments and want to make cigarettes as unattractive to children and young people as possible. So, as I said at the beginning, I warmly welcome the Government’s amendment. I congratulate the Minister on bringing it forward and on his announcement regarding proxy purchasing of tobacco products by adults for young people, and the regulation of e-cigarettes, about which we shall hear more at Third Reading.

I am not going to speak about smoking in cars because the speeches on that subject by the noble Lord, Lord Ribeiro—with whom I agree, and whom I congratulate on his perseverance in taking a Private Member’s Bill through your Lordships’ House on this subject—and the noble Baroness, Lady Finlay, have covered the main points. However, I strongly commend the points that my noble friend Lord Hunt made about the desirability of moving towards a smoke-free atmosphere in cars where children are trapped and subject to appalling levels of second-hand smoke.

I am very happy indeed to support the government amendment. We shall not be pressing our own amendment on standard packaging, but I shall be supporting my noble friend.

[Baroness Tyler of Enfield (LD)]

My Lords, my name is also attached to Amendments 60 and 62. I will speak briefly to them and try not to repeat some of the arguments we have already heard. I will also say how much I welcome government Amendment 57B. In Grand Committee, the strength of feeling across your Lordships’ House on the issue of standardised packaging of cigarettes was crystal clear, and the Government are to be strongly applauded for responding with their own amendment, which is very well founded and very persuasive. I, too, look forward to Third Reading, when the Government will introduce additional measures around proxy purchasing and e-cigarettes.

At the beginning of these debates, some noble Lords raised questions about the logic of including an amendment on the packaging of cigarettes in a Bill whose stated remit is children and families. To my mind, the relevance is unequivocal—this is the very nub of the issue, which is why we are discussing it today. Preventing the uptake of smoking among the young is primarily an issue of child protection. As we have already heard today, each year around 200,000 under-16s take up smoking. For some, it is the start of a lifetime of addiction which will result in debilitating health conditions and, for some in turn, premature mortality. As the noble Baroness, Lady Finlay, pointed out, many of those children will come from particularly deprived backgrounds. We have already heard about children in care and I would draw your Lordships’ attention to teenage mothers, who, according to an ONS survey, are six times more likely than the average mother to smoke throughout their pregnancy, to the detriment of both their own and their baby’s health.

Standardised packaging, bearing clear anti-smoking messages, is the first key step to reducing the attractiveness of this lethal habit to children and young people. As we have just heard from the noble Lord, Lord Faulkner, we should be absolutely clear that tobacco packaging and branding is not innocuous. It is undoubtedly, at the moment, targeted at the young—the industry documents released in the USA about this were very telling indeed, although I do not intend to repeat the details of that. Equally critically, the weight of evidence is mounting that standardised packaging does work to reduce the incidence of smoking. I was very persuaded by the Department of Health’s systematic literature review, which found that, compared to current cigarette packs, standardised packs are less attractive to young people, improve the effectiveness of health warnings and reduce the mistaken belief that some brands are safer than others. I eagerly look forward to the outcome of the review by Sir Cyril Chantler, who will look at all of this in the round. I will be very surprised if he does not come out supporting the various literature reviews that we have already seen.

Very recently, thanks to the noble Lord, Lord Faulkner, I had the privilege of meeting with Nicola Roxon, the former Australian Minister for Health who was instrumental in the implementation of standardised packaging there. I was very impressed as she explained to us the impact that standardised packaging was having as part of—this is absolutely critical—a wider anti-smoking strategy in no longer portraying smoking as cool and glamorous or cigarettes as a “must have” accessory, but instead portraying a much less desirable, and far more truthful, image.

It is revealing that hard data are already coming from Australia—something that I am sure Sir Cyril will want to look at. A study in Victoria, Australia, published in the British Medical Journal, concluded that when consuming cigarettes from the new packs, smokers are 66% more likely to think their cigarettes were of poorer quality, 70% more likely to say they found them less satisfying and 81% more likely to have thought about quitting at least once a day. Why is that? Because standardised packs carry powerful health messages that expose the reality of smoking. Frankly, having seen some of the images, it would take a very strong stomach or tightly closed eyes to be unaffected by them.