Tobacco and Vapes Bill (First sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Dr Zubir Ahmed (Glasgow South West) (Lab)]

I declare an interest as an NHS transplant and vascular surgeon. My wife is a lung cancer doctor.

[Dr Beccy Cooper (Worthing West) (Lab)]

I declare an interest as a public health consultant and a member of the British Medical Association.

[Sadik Al-Hassan (North Somerset) (Lab)]

I declare an interest as a practising pharmacist. [Interruption.]

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[Gregory Stafford (Farnham and Bordon) (Con)]

Q Do you have any concerns about the impact of the Bill on vapes as a smoking cessation tool? As my hon. Friend the Member for Sleaford and North Hykeham said, vaping in children is abhorrent, and I am glad that the Bill is addressing that, but how can we ensure that, as a cessation tool, vapes remain part of the panoply of options for smokers who are trying to give up?

Professor Sir Chris Whitty: That is a very important question. I think everybody would agree on two things, and then there is a way of making sure that we get to the exact middle point of this argument.

First, as you imply, in this country—it is not universally true—there is a strong view that we should try to continue our support to allow current smokers who are finding it very difficult to get off because of their addiction, which has taken away their choice, to move to vaping as a step in the right direction. I think that is broadly accepted in this country. As I say, there are some countries where that is not accepted so, to be clear, that is not a universal view.

At the other extreme, as you imply—or state directly, actually—I think everybody would agree that the marketing of vapes to children is utterly abhorrent. I think almost everybody would agree that marketing vapes to people who are current non-smokers, given that we do not know the long-term effects of vapes because we have not had them for long enough, is a big mistake. We should not allow ourselves to get into a position where, in 20 years, we regret not having taken action on them.

The question then is: how do you get the balance? In my view, this is sometimes made more complicated than it needs to be. I think it can be very simply summarised: “If you smoke, vaping is safer; if you don’t smoke, don’t vape; and marketing to children is utterly abhorrent.” That is it, although it is sometimes made a lot more convoluted. Our view is that the Bill gets that balance right.

In general, if people’s profession is getting people who are current smokers off, they tend to be more at the pro-vaping end, because they see the dangers for current smokers. People who deal with children, such as Dr Johnson, who has taken great leadership in this area and is very much in the centre of her profession, and the Royal College of Paediatrics and Child Health take a very strong anti-vape view, because they have seen the effects on children. It is getting the balance between those two, and I think that the Bill does that.

But—and it is an important but—the Bill takes powers in this area, and that means that if we go too far in one direction or the other, there is the ability to adjust that with consultation and with parliamentary secondary legislation. That allows for the ability to move that point around if it looks as if we have not got it exactly right. It may also change over time as the evidence evolves.

[Dr Cooper]

Q My question is around inequalities. How effective or otherwise do you think the Bill will be in reducing inequalities? Are there any areas of the UK that have specific challenges related to tackling smoking prevalence that you would like to highlight?

Professor Sir Michael McBride: That is a really important question. We talked before about the blatant marketing of tobacco and vapes. There is also the preying of the industry on those more socioeconomically deprived areas.

If we look at smoking rates in those more socio- economically deprived areas, they are two to three times higher than in less socioeconomically deprived areas. If we consider the death rate from smoking-related conditions, it is twice as high. If we look at lung cancer rates, they are two and a half times as high in those areas. That is a direct consequence of the smoking incidence in more socioeconomically deprived areas. The health inequalities associated with the consumption of tobacco are significant and great.

If we look at smoking in pregnancy and all its consequences in terms of premature birth, stillbirth and low birthweight, we see that smoking among women from more socioeconomically deprived areas is four and a half times higher than among those in less socioeconomically deprived areas. The health inequalities argument and the case to be made for addressing that within the Bill is huge. This is an opportunity that we must not pass up to narrow the adverse health consequences.

Professor Sir Gregor Ian Smith: It is my very clear view that the provisions within the Bill will help us to tackle some of the inequalities associated particularly with tobacco smoking. If I look at the situation in Scotland, 26% of our lowest socioeconomic group are smokers, compared with 6% of our highest socio- economic group.

The gradient that Sir Michael has spoken about in terms of the subsequent tobacco-related disease that those groups then experience is really quite marked, whether that be cardiovascular disease or the numerous cancers associated with smoking. All of those can be addressed by trying to tackle the scourge of these tobacco companies preying on more vulnerable groups within our society, whether that be those who experience socioeconomic circumstances that are much more difficult and challenging for them, or whether that be particular groups that are more likely to experience mental health conditions.

All of these must be tackled; people must be assisted not to develop addictions that lead to lifelong smoking and problems with their health thereafter. I am very clearly of the view, both in terms of smoking and, it is important to say, of vaping, that the targeting of those groups that creates those inequalities within our society is something that this Bill can address.

[Sadik Al-Hassan]

Q Thank you for the evidence submissions so far. In your opinion, will the Bill’s restriction of flavours for vaping products prevent the appeal to children and ex-smokers, if they can no longer access such products?

Sir Francis Atherton: The issue of flavours and colours speaks to the issue of marketing towards children that we have been speaking about so far. I have no reason to believe that taking away colours and flavours that are appealing to children would remove vaping as a stop smoking tool. It remains an important tool in the box that we have to have alongside nicotine replacement therapy and alongside education, and it will remain an important tool to stop people smoking.

The prime aim here, of course, is to stop the marketing towards children. If you think back to when tobacco was advertised in shops, we saw big gantries in shops, and what we have seen in recent years is that we now have vape gantries in almost all our shops. Taking away that marketing opportunity towards children—the colourful and flavoursome displays—can only be of benefit to reducing childhood vaping and the nicotine dependency that comes as a consequence of that.

Professor Sir Chris Whitty: Let us be really clear about this: the vaping industry will claim it is not marketing to children while putting in flavours, colours, cartoons and placements that are clearly aimed at children. You just look at them—you do not need anything else—and you see the rates going up in children. It is very clear that the industry is doing that, and it needs to be tackled.

Professor Sir Michael McBride: If you look at products with names “gummy bear” and “rainbow surprise”, who are they actually aiming those products at? Our Public Health Agency did research with more than 7,500 children and young people in Northern Ireland, using focus groups and online surveys. Some 77% of them told us that what appealed to them about vapes was the colours and flavourings. The public consultation had the strongest and highest support for banning flavours and colourings. More than 75% of the population in Northern Ireland supported that ban. We should not delude ourselves about the exploitative marketing of those products.

In terms of next steps, it is really important that those who want to use vapes to quit smoking, as Sir Frank has said, can continue to access them. The Government undoubtedly will consult carefully on those measures to ensure that we do not—as the question is rightly exploring—restrict access or discourage individuals from using vapes to quit smoking.

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[The Chair]

Can I just, as is my job, remind everybody that we are finishing at 10.55 am, which is in about 15 minutes or thereabouts? I have six people who wish to ask questions, so can I ask that the questions and responses are as tight as possible? Thanks.

[Dr Cooper]

Q Thank you so much to our witnesses for being here. I just want to take you back to a conversation you were having with a previous questioner about smoking cessation in hospitals. Could you give us your thoughts about vaping being available in hospitals, to allow people in hospitals who are quitting smoking, or who want to continue quitting, to continue vaping? Our CMOs talked about a smoke-free place being a vape-free place. What are your thoughts about vaping in hospitals—where it is a smoke-free place—and about access to vapes?

Suzanne Cass: In Wales, we have obviously implemented smoke-free legislation. We have seven different health boards and various approaches to that legislation when it comes to the implementation alongside vaping. When it comes to indoor spaces, there is already a huge amount of compliance with voluntary bans. People generally do not smoke in indoor spaces, so there is already that public consensus in those areas. When it comes to the outdoor spaces, there is not necessarily a consistent approach across Wales regarding smoking and vaping, which can cause confusion among the public.

I think that we need to be considering this very carefully, in terms of providing as much support to smokers as possible in these areas. We need to be considering exemptions to vape-free spaces, particularly in smoke-free spaces in hospital settings, mental health units and places where vulnerable patients who smoke are situated. That would be the message: we need to really consider those exemptions.

Sheila Duffy: In Scotland, we put medicinally therapeutic products front and centre with smoking cessation. Smoking cessation is vital, but we need to remember that there is no medicinally licensed e-cigarette product anywhere in the world, and that medicinally licensed products have a very different set-up. With e-cigarettes, you are talking about more than 30,000 different variants listed with the Medicines and Healthcare products Regulatory Agency, and four or five generations of devices, with very different health profiles.

Most of the comparisons are made with the toxins in tobacco, but there are different additional toxins in e-cigarettes, and there is new research—for example, AI modelling—on the impacts of heating some of the chemicals in e-cigarettes to vapour point, where they produce highly toxic outcomes. We need to bear that in mind. We also need to look at the research on air quality, because e-cigarettes conclusively contain the kind of particulates that we worry about for air quality and that cause harm to health. I think that that is an issue arguing for vape-free spaces.

In Scotland, we are supporting people to quit smoking in whatever way works for them—we are supporting individuals—but we are actively recommending only medicinally licensed products, because they have that context of appropriate use, safety and quality control, which e-cigarettes do not have.

[Sarah Bool]

Q I want to follow up on that point, because clause 12 of the Bill will actually include a ban on vending machines for vaping, but I know that there have been mental health trusts that have said that, actually, they would call for those to be exempted. Is that one of the exemptions that you would perhaps go for, and actually allow those vending machines in hospitals?

Suzanne Cass: Absolutely. I think we need to consider the vulnerable smoker at the heart of this and how they are managing to abstain from that addiction. It comes back to that addiction all the time. With smoking, nicotine is such an addictive substance that it is very difficult just to tell somebody that they cannot do it. You need to give them the right support, as well as the support that they want. When it comes to choice, that is where we need to be looking at what their choices are and how they choose to move away from that deadly tobacco use.

Hazel Cheeseman: On the mental health settings, we have done a lot of work in England with mental health trusts, and vending machines have been one way in which they have been facilitating access to vapes in quite a large number of mental health trusts. It is certainly something that we would be interested in looking at, because it will make it a bit more challenging for them to implement smoke-free policies in mental health settings if the vending machine rule applies across the NHS estate.

Also, going back to Dr Cooper’s question, in mental health settings and those places with vulnerable smokers, vapes have been really important in England in facilitating. We do not have legislation in relation to smoke-free grounds in England, but obviously it is the policy across the NHS estate that they are smoke free. Allowing vaping, particularly in those mental health settings, has been very facilitative of creating smoke-free grounds and supporting those people to maintain their smoke- free status as they move out of mental health settings as well.

Sheila Duffy: Scotland already has a ban on e-cigarettes in vending machines and has had for some years.