Tobacco and Vapes Bill

Beccy Cooper Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Nigel Farage]

It is quite possible that sugar should be banned, so yes, I agree. It is possible, but I do not think that is what the Government are here to do. The Government can educate; individuals should make up their own mind.

Some of the nonsense I have heard this afternoon has been quite extraordinary. A smokefree generation! We even had the hon. Member for Harrow East (Bob Blackman) suggesting we would be smokefree by 2030. To begin with, the idea that nobody born after 2009 could buy the tobacco products that those born before then could is just another aspect of two-tier Britain. And not a single Member—not one, despite the fact that we are discussing nicotine and tobacco products—so far has mentioned drugs. Oh, no! Let’s forget about that, because drugs are illegal already and we cannot do anything about them. I have been hearing for decades that there will be a war on drugs. Where is it getting us? Drug use is rocketing, and class A drugs in particular, with all the associated crime, are proliferating everywhere.

Here is the danger: believe it or not, an ounce of tobacco is now more expensive, if purchased legally in a shop, than an ounce of silver, so already we have a rocketing trade in illegal cigarettes and loose tobacco. If we carry on down this route, with age bands and so on, we will find ourselves in the position that Australia has stupidly put itself in by over-taxing tobacco and making it very difficult to smoke. There have been 40 fire-bombings of premises in Melbourne alone in the last two years. Do not drive tobacco into the hands of the criminals. Do not create a new black market. I totally agree with the Minister: this is not an activity that we should encourage. We are not keen for our kids to smoke, but please treat us as grown-ups. Educate us. Let us make our choices. Do not let the criminals win.

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

First, I should say thank you to the Minister for presenting this afternoon, and for allowing me to be on the Tobacco and Vapes Bill Committee, which was incredibly interesting. There were differing views and there was robust conversation. It is always good to listen to different views, but overall the Bill generally had cross-party support. As Conservative Members have pointed out, many Members of their party have been campaigning for this Bill for a long time.

I am a public health consultant—I trained for 10 to 15 years to be one—and the precondition for public health policy is data and evidence. Opinions are interesting—they can add great colour and character to a conversation—but data and evidence will ultimately deliver better population health outcomes. This public health Bill will stop people dying and will take away addiction to a substance—an addiction that is not a choice.

For many years, there have been public health conversations about whether we should impose measures. This conversation is not new. I wonder how many of us in the House feel strongly these days about wearing seatbelts, but we do not have to go too far back to find a time when people really objected to being told to wear a seatbelt. Tobacco is undoubtedly still the leading cause of premature death and disability in the United Kingdom, as has been mentioned by my hon. Friends. Every day, around 160 people are diagnosed with cancer caused by smoking, and smoking causes at least 16 different types of cancer.

I will talk primarily about new clause 13, proposed by my hon. Friend the Member for City of Durham (Mary Kelly Foy). The Bill will do outstanding work to enable a smokefree generation, but we also need to continue to tackle health inequalities for existing smokers. Smoking is harmful, and differences in smoking prevalence across the population translate into major differences in death rates and illness. We in this place come together from across the country and represent different constituencies. We want the best health outcomes, among many other things, for our residents. It is therefore incumbent on us to look at inequalities and where they reside, and to legislate against them where possible.

Smoking is the single largest driver of health inequalities in England. It is far more common among people with lower incomes, and I am happy to discuss with any Members why that is. The more disadvantaged someone is, the more likely they are to smoke, to suffer from smoking-related disease, and to suffer a premature death. Smoking-related health inequalities are not related solely to socioeconomic status. We represent different parts of the United Kingdom. The poorer health of people in the north of England is in part due to higher rates of smoking there. Smoking rates are also higher among people with a mental health condition, people in contact with the criminal justice system, looked-after children and LGBT people. We all have different types of people in our constituencies, and we should be mindful of those inequalities and the need to address them.

Health inequalities will be reduced through measures that have a greater effect on smokers in higher prevalence groups. In practice, that means prioritising population-level interventions that disadvantaged smokers are more sensitive to, and targeting interventions on those smokers. Having run smoking cessation services during my time as a public health consultant, I can absolutely say that it is incredibly difficult for anybody to give up smoking. We have Members who have succeeded, and who are perhaps still trying to give up. To give up smoking, a person needs to be in a place where they have the mental resilience and can put time and energy into quitting. If they are fighting all the other issues that come with the burdens of being poorer—if they are fighting for employment or trying to feed their children—it is so much harder.

My hon. Friend has proposed a road map to a smokefree country, and a report to this place every five years. I am not particularly wedded to that, but we should be laser-focused on reducing health inequalities across all populations. I therefore hope that our Government will consider having a reporting process similar to the one in new clause 13 among the changes to the national health service. In the Health and Social Care Committee this morning, we were talking about where the Office for Health Improvement and Disparities will go following the dissolution of NHS England. This is an ongoing conversation that we need to be mindful of.

We need to ensure that the ongoing importance of addressing health disparities is not lost, and I think that is front and centre of the Secretary of State’s agenda in the 10-year plan. On behalf of public health consultants and professionals, I commend the Bill to the House, and I am proud to be part of a Government and a Parliament that will bring this life-changing piece of legislation to the country.

[Sammy Wilson (East Antrim) (DUP)]

I want to speak to amendment 4 and the subsequent amendments in my name, and to new clause 3. It is right that where a public health issue is identified, this body should look at whether anything can be done about it through law, fiscal policy, or the other levers available to us, but we should ask ourselves, when we introduce laws, what the consequences are. Are there any unintended consequences, and how practical and enforceable are the measures? If they are unenforceable, all we do is bring the law and this place into disrepute. While some have described this Bill as well-meaning, essential, a flagship Bill, and a show of leadership, I am concerned that we have given little thought to, and had little debate about, the consequences, which are hitting us in the face. Let us be honest with ourselves: it would be good to walk away at the end of today’s sitting and say, “We have done a wonderful thing for future generations; we have introduced laws that will do away with smoking and will improve the health of the nation,” but we are ignoring the fact that we have introduced legislation that is unworkable, and to which I believe, through my amendments, there is an alternative.

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[Sir John Hayes]

In our post-spiritual or at least post-religious age, two phenomena are evident. When God is forgotten and faith declines, people do not believe in nothing but, as G.K. Chesterton said, they believe in anything. They find new causes and crusades, and I know the advocates of this Bill believe that they are crusading in a noble cause.

The second thing that occurs is that, as demons are regarded as purely mythical entities, things that were once regarded as normal and regular become demonised. The curious paradox is that while cocaine is widely available—and, I am told, de rigueur among certain elements of the urban liberal elite—pipe smokers are now seen as heretics. Were that not so alarming, it would be the subject of a comic satire. That is the kind of world we live in: we are simultaneously becoming more prurient and more puritanical.

The amendments that stand in my name and those of other hon. and right hon. Gentlemen are designed to improve the Bill to avoid unintended consequences. The hon. Member for Worthing West (Dr Cooper) said— I think I am quoting her accurately—that we need data and evidence. What is clear from the data and evidence is that previous attempts to deal with the issue of smoking have resulted in a huge surge in illegal tobacco. Some 83% of smokers report purchasing tobacco not subject to UK tax in 2024. That number has increased hugely since that earlier legislation. Three quarters of smokers claim to buy tobacco not subject to UK tax from under-the-counter suppliers, who have become legion in constituencies such as mine and, I am sure, in small towns across the whole of the country.

Those are the unintended consequences of well-meaning crusaders who thought they were doing noble things when they passed legislation in this House. That is the data. Those are the facts.

[Dr Beccy Cooper]

Will the right hon. Member give way?

[Sir John Hayes]

I will give way. As I have cited the hon. Lady, how could I do anything other?

[Dr Beccy Cooper]

I thank the right hon. Gentleman for giving way. Is he making the argument that we should not address population health issues—population health interventions have seen a reduction in smoking and a reduction in health-related damage from smoking—because of the consequences of illegal tobacco? Those issues do need to be addressed, but is he saying that we should keep it legal and therefore not see a reduction?

[Sir John Hayes]

What I am saying to the hon. Lady is that the Government—and the previous Government should have done the same—need to take concerted and decisive action to deal with the unintended consequence of well-meaning legislation that led to a huge growth in the illegal sale of tobacco and cigarettes. Rather than introducing a rolling age of consent, which, by the way, is entirely unenforceable, they ought to target their efforts, draw on their resources and seek the almost limitless expertise that is available to Government to deal with an issue that, frankly, is going largely unrestricted.

Good work is being done by trading standards in my constituency in Lincolnshire and by local police, but they struggle, because the legislation is inadequate. I would have supported a Bill, had it come to the House— I will not digress too much, Madam Deputy Speaker, because you will not allow me to do so—that licensed the sale of tobacco. Most tobacconists and most newsagents, I suspect, would welcome that measure. I know that police would like to see that kind of measure, which is rather like what we do with alcohol. There is a precedent there, but that is not what is before us today.

On the rolling age of consent, the right hon. Member for East Antrim (Sammy Wilson), who has tabled amendment 4, is right that it cannot be enforced. I am in favour, by the way, of raising the age of consent. To be honest, I am in favour of raising the age of consent to 21 for virtually everything. That could be enforced, although it would not be straightforward. But the idea that someone will go into a tobacconist or a newsagent and say, “I am 29” and the tobacconist will say, “Actually, I think you could be 28” or in years to come, “I am 57” and the tobacconist or newsagent will say, “No, no, I think you could be 55” is nonsense. It is never going to happen. No retailer is going to do that. Either the Bill will fail—I think the law would be broken daily—or we will devote undue resources to policing something that frankly does not warrant such attention. Let us recognise that this is a preposterous proposal. As the right hon. Member for East Antrim said, by and large we should not do things in this House that are preposterous.

Maternity Services

Beccy Cooper Excerpts

Tuesday 25th February 2025 Westminster Hall

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

I thank the hon. Member for Chichester (Jess Brown-Fuller) for calling this debate. As neighbouring parliamentarians on the south coast, we are both passionate champions of the health of our residents and want the best healthcare provision for all, and that includes maternity services.

Unfortunately, despite numerous reviews, plans and strategies, too many maternity services remain shockingly, stubbornly poor, as the hon. Member pointed out. Successive investigations into high-profile failures have described a pattern of dysfunctional and even dangerous cultures, with a failure to listen to families and missed opportunities to address known issues. As a result, too many mothers and babies have experienced substandard care and unacceptably poor outcomes.

In the past year, the number of maternity services in England receiving ratings of inadequate or requires improvement from the CQC increased from 54% to 67%. Of the 131 maternity services inspected from August 2022 to December 2023, only 4% were rated outstanding, and not one was rated outstanding for safety. In that context, we see stagnating progress on improving stillbirth and maternal mortality rates not seen in the UK for over 20 years.

As we have heard, black women are almost three times as likely, and Asian women almost twice as likely, as white women to die during birth or post-natally. Maternal mortality rates for women from the most socioeconomically deprived areas are twice those for women from the least deprived areas. Closing the black and Asian maternal mortality gap and tackling profound health inequalities such as those is rightly a priority for this Labour Government, and it is the reason I went into politics.

Poor outcomes exist, too, for the most vulnerable and marginalised women, such as refugees, LGBTQ+ women, prisoners, those who have been through the care system and those who have experienced domestic violence or sexual abuse. All of them are more likely to experience poorer maternity care and the resultant trauma. Poor standards in maternity services are part of a wider picture of a healthcare system that has not prioritised women’s reproductive health.

The Women and Equalities Committee highlights that gynaecological care waiting lists have grown faster than lists in any other specialty in recent years. As a public health professional, it saddens me to say this, but the NHS Confederation reports that the UK stands out as the country with the largest female health gap in the G20 and the 12th largest globally, with women spending three more years in ill health and disability compared with men. Those systemic failings underpin the poor outcomes and health inequalities that we see in maternity care.

As a public health doctor, I have worked in and led health teams, and as the proud MP for Worthing West, I have heard from dedicated staff across our local services. I understand that systemic issues fail staff as well as patients. In our hospital in Worthing, the maternity services are staffed by hard-working, capable healthcare professionals who want to get on with the job they have trained for. They are as frustrated and saddened as the rest of us when processes, equipment, staffing levels and governance are simply inadequate for the provision of excellent healthcare.

Our Government have pledged to recruit and train thousands more midwives, which is to be warmly welcomed. The forthcoming 10-year plan for the NHS is an opportunity to address the underlying problems of a deskilled and demoralised workforce, which impact maternity services. We must take action to improve midwife training and retention, address the numbers of qualified medical staff on maternity wards, improve patient voice and bring a relentless focus to safety and compassion.

There is an urgent need to transform the health and social care system. In doing so, we have a superb opportunity to look at innovative models of integrated and accessible “neighbourhood health” maternity services, delivered alongside hospital care. Finally, I welcome the recommendations of the APPG on birth trauma for a national maternity improvement strategy and a maternity commissioner to drive improved outcomes and rebuild our services.

Tobacco and Vapes Bill (Thirteenth sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Gregory Stafford]

I agree with my hon. Friend the shadow Minister. It seems strange that the Government want to have such wide-ranging powers in this area. Unlike other parts of the Bill, where technologies and such may move on and where I appreciate the need to future-proof, here it is very clear. I do not think that at some point in the future we will believe that smoking in playgrounds, or smoking in a field with nobody else around, are better or worse than they are now.

I have a lot of sympathy for the Liberal Democrats’ amendment 4 and our amendment 95. As my hon. Friend pointed out, the amendments are relatively similar, if not word for word the same. It almost takes us back to coalition days in 2010—let us hope that does not happen too often—and shows that His Majesty’s Official Opposition and the Liberal Democrats have significant concerns. While the Minister and his colleagues have said that they will not extend a smoking and vapes ban to hospitality venues, there is a lack of trust on our part, because even if it is not in the current Minister or Secretary of State’s mind, a future Secretary of State may be minded to put such a ban in place. That is why the amendments tightly define exactly where the smoke-free areas could be.

It is obvious that we do not want people smoking in children’s playgrounds, nurseries, schools or higher education premises. We have had some debate about this on other clauses, but I personally believe that we should not be smoking in NHS properties either. None the less, to return to a point I made previously, if we are going to permit people to do something within the law—people born before 1 January 2009 if we are talking about smoking and everybody over the age of 18 if we are talking about vaping—they must have somewhere safe to be able to do it.

The point of the clause is to address the impact of smoking and vaping on others. I take the shadow Minister’s point that clearly, if someone is smoking in a playground, it will have a greater impact on other people than if they are standing in the middle of a park or field with nobody else around. There needs to be an element of proportionality. As the shadow Minister and the hon. Member for Winchester said, we do not want to do anything that could harm our already stretched hospitality industry, which is under extreme pressure. If the Minister or Secretary of State were minded to start imposing bans in hospitality, that would have a significant impact on the hospitality business. I support the two amendments.

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

This is an interesting debate, and I want to add some thoughts from a public health point of view. There is a balance to be struck in Government between supporting the hospitality industry and making sure that we are being fair and proportionate and encouraging businesses. We should also be mindful of public health evidence about passive smoking in an area—for instance, outside a pub where there are multiple people and some are passive smoking. It is clear that the Government, the current Secretary of State and our Minister have taken the proportionate response that the law will not extend to public spaces with hospitality. We should be mindful, however, that history does play out in public health and that people’s attitudes about what is acceptable does change. Therefore, leaving this issue open to allow that debate to continue within our political sphere is absolutely fair and proportionate.

[Gregory Stafford]

The hon. Lady makes a very good point, but it is almost one that supports mine—although she said she believed that the current statements from the Government are proportionate, I can already hear in her voice that actually, she would like to see this provision extended to those areas.

[Dr Cooper]

The hon. Gentleman raises a fair point. I am perhaps a public health consultant first and foremost and a politician second, but I do appreciate that in politics, we have to find fairness and balance and support people in their businesses, as well as being mindful of their health. As a public health consultant, I am looking at people’s health first and foremost, but I think this is the right place in Government to have this sort of legislation and this debate, so I am supportive of what is in the Bill. It is for people like me to make the argument that passive smoking outside hospitality, for example, is not the way forward, but as a politician, I absolutely appreciate that I have to be mindful of businesses. I therefore maintain that the proposals are balanced, but I take the hon. Gentleman’s point that I am a public health consultant, and I declare that as an interest.

[Gregory Stafford]

I thank the hon. Lady for her clarification. I have great respect for her public health abilities and knowledge. I accept the points that she made, but Opposition Members feel that including in the Bill areas that will potentially be consulted on being smoke-free is proportionate to ensure that there is not overreach. I know that if the amendments are accepted and, at a future point, attitudes and science change, she will be a doughty campaigner to have the law changed, and I am sure that she will achieve it, if that is the way she wants to go.

Tobacco and Vapes Bill (Eleventh sitting)

Beccy Cooper Excerpts

Committee stage
Thursday 23rd January 2025 Public Bill Committees

[Gregory Stafford]

I do not intend to opine for very long on these clauses, because they have been covered amply by my hon. Friends. I caveat everything I am about to say with an absolute commitment: I continue to believe that this is the right Bill, that the clauses that we are discussing are the right clauses, that we should be trying to stop people smoking tobacco products and that people under 18 should not have any access to vapes.

However, I have mentioned on a number of occasions that vapes could be and are used as a smoking cessation tool. This is why I perhaps go further in my desire than the shadow Minister does in relation to the amendments that she has put forward. I do not know whether she will press them, but I do ask the Minister to think about the issue of smoking cessation. The shadow Minister talks about how someone who is promoting smoking cessation might fall foul of these rules as they are written—the Minister shakes his head, and I am sure that he will be able to give us reasons for that in a minute.

I would go one step further. For example, we allow the promotion and advertisement of gums and nicotine patches, because they are classed as a medical product, being effective smoking cessation tools. Of course we do not want anybody who does not smoke, either an adult or a child, to be chewing nicotine gum or wearing nicotine patches—to be frank, I am not clear whether there is any evidence that they do, but I suspect they are not seen as, to use the word I think the Minister used last week, “sexy”. I do not think anyone thinks that chewing gum is particularly sexy, and certainly a patch on the arm is not sexy, so I accept that those are not in the same bracket as a vape with colourful packaging and so on. However, gums and nicotine patches are monitored by the MHRA.

I know that the Minister has indicated that a new home is being sought for vapes, but as it stands in the law, they would be monitored by the MHRA. If we are going to say that they are in a similar vein to a patch or a gum in terms of smoking cessation, it is possible that we might want to be able to promote and publicise them, maybe through something in a doctor’s surgery or in a maternity ward, as my hon. Friend the shadow Minister said, that says, “Don’t smoke. Instead, use a vape, a patch or a gum.” If that advert in a doctor’s surgery said “gum” or “patch”, there would be no problem, but if it said “vape”, my understanding is that it would fall foul of these clauses. As my hon. Friend said, they may not want to fall foul of the law, but we might want to be able to advertise vapes as a smoking cessation tool in that very limited circumstance and in an appropriate place—that is, in a pharmacy or a doctor’s surgery.

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

I want to add something to what the hon. Gentleman is saying, which is interesting and relevant, about smoking cessation services and how they currently work. I have run and managed smoking cessation services. As it stands, when a smoking cessation adviser is talking to a person who wants to stop smoking, they discuss nicotine patches, gum and whatever other options may be available. They do not promote vapes or actively say that they are an option.

The reason for that is the public health evidence. In public health, we apply the precautionary principle, by and large, where we think that there may well be harms ensuing from using a particular product, but the evidence is not yet sufficient. The hon. Gentleman is absolutely right that, in the case of smoking, using vapes is much more preferable for a person’s health, but in terms of smoking cessation, as clinicians and advisers, we need to be careful in how we apply clinical norms, and that is relevant here.

[Gregory Stafford]

The hon. Lady makes an interesting point. I will not labour my point any further, because I think I have made it; I am sure that the Minister can respond to it when we get there.

The only other thing I will mention is the online advertisements mentioned in a number of the clauses. Is the intention to do with the website displaying the advert, the person who has put forward the advert or the intermediary companies? Online, a lot of adverts are now tailored via cookies. When the Minister goes on to a website, the adverts that he sees are tailored to the things that he has been looking at. I could go on to exactly the same website at exactly the same time and receive a different set of advertisements based on my internet viewing preferences—[Laughter.] I do not know why my hon. Friend the Member for Windsor is laughing. I get a lot of weird stuff, mostly for hoof trimming videos—I am not sure what I typed in to get those. Maybe it is my rural seat. I do not know.

My point is that those advertisements are totally unconnected to the website that I am looking at, which essentially has no control over what adverts are being displayed, as far as I understand it. Because the internet is so complicated, what thoughts does the Minister have about the fact that essentially, the internet provider and the website may not have any knowledge of what adverts are being put on?

Tobacco and Vapes Bill (Twelfth sitting)

Beccy Cooper Excerpts

Committee stage
Thursday 23rd January 2025 Public Bill Committees

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

From a public health point of view, I just point out to the hon. Member that we are basing this Bill on evidence and therefore we are looking at the evidence of tobacco harm, which I think we agree on. There is incontrovertible evidence; tobacco is undoubtedly harmful. People should not start smoking tobacco, and we should assist those who come forward to stop.

In relation to vaping, I go back to a previous comment I made, about the precautionary principle. There is evidence on vaping; there do appear to be some harms associated with vaping. There is not sufficient evidence right now for it to be incontrovertible, but it would be irresponsible not to adopt the precautionary principle that we use in public health.

In relation to gambling, I just urge caution—again, on the evidence. There may not be incontrovertible evidence about gambling, but there are undoubtedly health harms from gambling that we need to look at as we move forward.

[Jack Rankin]

I thank the hon. Member for her intervention.

Tobacco and Vapes Bill (Ninth sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 21st January 2025 Public Bill Committees

[Gregory Stafford]

I agree entirely with my hon. Friend. He has two Windsor castles in his constituency: the big one where the royal family lives and a Lego model of it at Legoland. The enforcement of this clause should apply equally to Legoland and the real Windsor castle. But I agree that there is a power imbalance: it is unlikely that trading standards enforcement officers from the royal borough of Windsor and Maidenhead will go into Windsor castle.

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

What does the hon. Member think happens currently? On various issues, there is obviously enforcement across the board, including tobacco control, and the Crown Estate has to comply. How would this extension of that enforcement differ from what happens now at Windsor or any other Crown Estate?

Obesity: Food and Diet

Beccy Cooper Excerpts

Monday 20th January 2025 Commons Chamber

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

I echo earlier comments by thanking all Members who have contributed to this debate. As a new Member, it has been heartening to hear so much agreement across the House and so many colleagues putting their evidence, enthusiasm and opinions into finding a solution to this epidemic.

I thank my hon. Friend the Member for Stroud (Dr Opher) for introducing this debate. Unlike my hon. Friend, who has a medical degree and has become a GP, I took my medical degree and went into public health. I am a public health consultant and that is why I am here. It has been fantastic to hear everybody in this House talk in such resoundingly positive public health terms. It is past time for us to address this issue.

Many great points have been made and I do not intend to repeat them, but I would like to stress a couple of things, starting with an interesting observation about the term “obesity”. It carries with it a certain load and stigma, which as a female I very much recognise. I want to put on record that this is not about fat-shaming; this is not about how people look or how society tells us we should look. This is about our health; this is about being well and feeling well and being able to live well and thrive.

I also want to put on record something about body mass index. This is a slightly controversial subject in my area at the moment. It is a useful tool, as people have said, but as my hon. Friend the Member for Ilford South (Jas Athwal) mentioned, there are different levels of BMI for different ethnicities, and also it can be a limited metric. The House might be aware of the case of a female Olympic bodybuilder being classed as obese. We need to be careful about BMI and what we are saying to people— children or adults—when we see their BMI. This is about taking health in the round, and looking at what we eat, not what we look like.

There is no debate about the evidence of obesity’s cost to our population’s health and our health system. We have heard the figures from multiple Members across the House, and £6.5 billion annually to the national health service is no small figure. We are literally eating ourselves into our sick beds, from diabetes to heart attacks, from liver disease to cancer; as we have heard, this is the second most preventable cause, after tobacco, of cancer.

I have spoken before in the House, and will continue to do so, about creating conditions for people to thrive and to make healthy choices. Today, as so many hon. Members have highlighted, we live in an obesogenic environment—an environment that promotes unhealthy eating and does not make it easy to undertake regular exercise. A less familiar term is the opposite of that, and perhaps Hansard has never heard it: a leptogenic environment promotes healthy food choices and encourages physical activity. The comments on housing and on fair pay for good work were about a leptogenic environment. We might reflect on our own environment, Madam Deputy Speaker—whether it is an obesogenic or leptogenic environment. I wonder how many of us have managed to have dinner yet this evening, and how we are feeling. That is something for the Modernisation Committee to reflect on.

To achieve a leptogenic environment we need to look at measures that create a functioning food system. As we have heard, we need to work with our farmers and food producers to produce a skilled food sector and a vibrant food economy. For our food system to allow us all to enjoy healthy food—again, we have heard this before—we need to ensure that it is accessible, affordable and attractive. We are visual creatures: what we see really influences us and our choices, and, boy, do the food organisations and the food companies know that.

On accessibility, how easy is it to buy nutritious food? We have heard Members across the House talking about their constituencies, their residents, food deserts and how for some people, when they go into a shop, the choice is not from an array of vegetables, fruits, decent carbohydrates and decent proteins, but from processed, often cheap, quite filling, nutritionally poor food. That is not making healthy food accessible.

On affordability, we have heard several times from different Members that healthy food—this is worth repeating—on average is more than twice as expensive per calorie as less healthy options. If people feeding their children across the country this week on a budget are faced with two different options, and one is cheaper and will fill their children’s stomachs, the odds are that they are likely to take that option, and there is no judgment in that at all. It is on us to make healthy food much more accessible and affordable for people.

On attractiveness, how attractive is healthy food? We have heard this evening about the marketing and branding of ultra-processed, high-fat, high-sugar, high-salt food. It is fantastic that our Labour Government and our Minister for Public Health and Prevention, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne) have taken the step to ban junk food advertisements before the watershed. That is a great step forward, but we need to be mindful of how much investment the major brands of high-fat, high-sugar and high-salt foods put into advertising. In digital advertising alone, that figure was £87.5 million. Food organisations do not put money into things if they do not make profit from them. Profit essentially remains their bottom line, not our waistlines.

These are systemic issues, but we do not need to reinvent the wheel. We need to implement the wide-ranging recommendations of the national food strategy. The last Government missed that opportunity, but as we move forward with this Government, let us look at those recommendations, many of which have been mentioned in the House this evening. They include introducing a sugar and salt reformulation tax and expanding the Healthy Start scheme.

In conclusion, we need to ensure that we in this place are legislating to make good nutrition an easy choice for all and that we are curating a healthy leptogenic environment. In that way, we will ensure that we are enabling healthy choices for all our residents and reducing obesity to a slim, historical footnote as we move forward into a healthier future for everyone.

Tobacco and Vapes Bill (Fifth sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

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

I have quick and pragmatic point about the different uses of cigarette papers. I am a mum and a saxophone player myself, and I suggest that other materials can be used in the place of cigarette papers. I appreciate the debate, but I do not think this is about a pragmatic use.

[Andrew Gwynne]

That is precisely the point I was coming to. We will take the argument away because it is a reasonable argument, and we will perhaps consider returning to this issue on Report.

I know that the shadow Minister has every sympathy with the fact that cigarette papers are dangerous when used for the consumption of tobacco, which is what we want to bear down on. As I have said, there are powers in part 5 to restrict the flavours of cigarette papers, but we want to get the balance right so we will take the argument away and consider it.

--- Later in debate ---

Therefore, when developing guidance on the size of the notice, how will the Minister balance the need for it to be easily readable by someone at a relevant distance—that is, when they are standing at the till—with the need for it to be practical? If the retailer—perhaps a small retailer—is required to produce signs for not just the age for tobacco products but, potentially, the age for alcohol or other products, and is required to display signs for each of those individual notices and regulations, how will the Minister ensure that it is actually possible to display all the different signs in all the different right fonts? Would he consider that, if a retailer is selling a range of products that are age restricted, there could be signs that cover more than one product to make this clear to the public while not taking up all of the potential advertising and—

[Dr Beccy Cooper]

I just wanted to clarify something with the hon. Lady, because she is talking about the size of the signs in Wales, under clause 6, I think. Clause 6(4) says:

“The notice must comply with any requirements set out in regulations made by the Welsh Ministers”.

I presume that that is the response that she is looking for: the Welsh Ministers will absolutely be able to decide on the size of the signs.

[Dr Johnson]

I thank the hon. Lady for that.

Tobacco and Vapes Bill (Sixth sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[Andrew Gwynne]

Clauses 12 and 78 prohibit vape and nicotine product vending machines in England, Wales and Northern Ireland, and similar provisions are made elsewhere for Scotland. However, it is really important that the Committee understands that Scotland already specifically prohibits vape vending machines.

Clause 12 makes it an offence for any person managing or controlling a premises to have a vaping or nicotine product vending machine available for use, which effectively prohibits the sale of vapes and nicotine products from vending machines. I will try to clarify this point for the shadow Minister. She asks, “Who is responsible? Who is that person?” The offence is linked to the person with management control of the premises, as that is the most appropriate mechanism; they have control over whether the vending machine is present. That is the answer to her question.

This Government will stop the next generation from becoming hooked on nicotine. To do that, it is essential that we stop children from accessing harmful and age-restricted products. Prior to the prohibition of tobacco vending machines, we know that children who smoked regularly used those machines as their source of cigarettes. We cannot allow the same thing to happen with vapes.

Vending machines do not require any human oversight, so it is much easier for determined individuals to bypass age-of-sale restrictions and, crucially, to undertake proxy purchases on behalf of individuals under 18 because there is a much lower chance of their being challenged about such a purchase. Additionally, by their very presence vending machines advertise their contents and the Bill will ban the advertising of vapes. We need to ensure that children are protected from harmful and addictive products. Ensuring that we remove the ability of children to access age-restricted products is an essential part of that approach.

I turn to amendment 96, regarding the exempting of mental health units from the vending machine prohibition. I am grateful to the hon. Member for South Northamptonshire for bringing this important issue before the Committee today for discussion. Her amendment would allow vape and nicotine product vending machines to be available for use in specialised mental health units in England and Wales.

I am very sympathetic to the needs of adult smokers and vapers in mental health facilities, and I know that this topic came up during the evidence session. However, we do not currently believe that there is a need to exempt mental health settings or other healthcare settings from these requirements. Scotland did not exempt mental health units from its vape vending machine ban, and it has had no issues. I want to be clear, because it is really important that I make this point: we are not banning the sale of vapes and nicotine products in mental health settings. We are only prohibiting their sale from automatic machines that provide no means to prevent proxy purchasing. Facilities that contain shops will still be able to sell vapes to patients and staff. Additionally, patients in mental health settings may be able to benefit from stop smoking services and the swap to stop scheme.

The majority of in-patient trusts, both acute and mental health, successfully deliver stop smoking support to smokers. As part of the swap to stop scheme, localities can request free vaping starter kits to provide to adults engaging with their local stop smoking services. Awards have now been made to individual services in a range of settings, including NHS and mental health settings, and to specific populations. It will still be legal and possible for vending machines to dispense medicinally licensed nicotine replacement therapies such as gums, patches and inhalers. These important medicines will still be available to patients who are looking to quit smoking or who are struggling with their nicotine addiction.

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

I thank my hon. Friend for making the arguments on vending machines. From a public health consultant point of view, I have listened and think there is a reasonable debate to be had. I am convinced by the arguments that my hon. Friend the Minister has given, but I would ask that following the debate the conversation continues as the Bill progresses and that the Department of Health and Social Care continues to have these conversations.

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.