Tobacco and Vapes Bill (Third sitting) Debate

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Department: Department of Health and Social Care
Nickie Aiken Portrait Nickie Aiken (Cities of London and Westminster) (Con)
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Q I want to go back to the vapes point. As we have all agreed and you have highlighted, vaping was, for all intents and purposes, a product to help people off tobacco, but it has become a product marketed in its own right. What are your personal and professional views on the Bill as it stands? It would stop people selling vapes to under-18s and stop members of the public or family members buying them on behalf of under-18s. Should we ban under-18s from using vapes full stop? Also, should we move vapes on to a prescription basis to ensure that they are aimed at people who want to give up smoking?

Professor Sir Gregor Ian Smith: My view on the Bill as it stands is that it is a starting point for how we take this work forward. It is adequate in that sense because this is a really important area. For me, the absolute priority has to be to remove young people’s ability to access vapes and so begin the journey to nicotine addiction.

I am not in favour of criminalising the possession of these products, but I am certainly in favour of banning their sale to younger people. If we can achieve that at this stage, and, as Sir Michael said in his previous answer, if we can begin to shift the culture so that people do not start to use vapes and begin to become addicted—potentially also by using other nicotine and tobacco products—for me that will be a good job done.

If we do things that way, it will allow us to protect the useful use of vapes: where people with a lifelong addiction to tobacco can use them as way to help them stop. That is the only justification that I can see now for the way we have set this up and for continuing to use vapes in society: as a useful tool for those with a pre-existing addiction to tobacco, so that they can reduce the harm and gradually stop using tobacco—through formal cessation services, as well.

Professor Sir Chris Whitty: I agree with Sir Gregor. To reiterate, the Minister wanted to get a balance and most people would agree that criminalising people for individual possession is a step further than anyone would want and is needed. I do not think there is a clamour for that from anybody, and I think it would not help the Bill.

On prescription vapes, I would like to see those available for use at the moment. So far—I will go into the reasons for this on another occasion—no products are available that we can prescribe. We would all very much like those products to be there so that people can prescribe them. That is different from saying that they should be only on prescription; at this point, we do not even have any products to prescribe at all. If we did, that would be a very firm step in the right direction, but it depends on the industry coming forward with products.

Speaking directly to the industry, I should say that I do think there is a very important niche for prescription vapes. They would be very useful for some people, particularly those on low incomes who, for other health reasons, have free prescriptions. I encourage anyone from the industry who is listening to think seriously about bringing forward a prescription vaping product appropriate for aiding people to quit.

Bob Blackman Portrait Bob Blackman (Harrow East) (Con)
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Q I think the whole panel have said they are 100% behind the Bill. It is great that the whole medical fraternity is going together, but are there any tweaks that you would like to see in the Bill that could make it stronger—for example, making age verification the same in England as it is in Scotland? One of our concerns is that we have a chance to get primary legislation in only once every 10 years or so, and doing it now would be far better than waiting.

Professor Sir Chris Whitty: I have had the privilege of being more heavily involved in this Bill than the other CMOs, so I am going to ask them to answer it. My short answer is that this is a fantastic Bill. What I do not want is for the Bill to be delayed and therefore to not get through in the parliamentary time available. There is always a danger with these things, particularly when we are up against the clock, of the best being the enemy of the good. This is more than good; this is an outstanding Bill, to be clear, in terms of the Prime Minister’s bravery in putting it forward and, I think, the huge support from the general public and massive support from those working in healthcare. Really, what we want to do is get this through. I fully accept the points you are making, but that is my real concern about proposing any additions. Maybe you can start with Sir Michael, then Sir Gregor and then Sir Frank.

Professor Sir Michael McBride: I think this is a situation where perfection risks snatching victory from us. The most important thing, having looked at the Bill closely, is that this is an excellent Bill. I think we have all indicated that this is a once-in-a-generation opportunity, as your question suggests. We need to seize this opportunity. I and my colleagues fully support this Bill. I think this is a point that we will look back on five or 10 years from now and we will say that we were on the right side of history in supporting the Bill. This will make a fundamental difference to the next generation and generations to follow. Again, it is entirely consistent with the commitment in the Northern Ireland Executive to gradually phase out tobacco smoking. I fully support the Bill as it stands.

Professor Sir Gregor Ian Smith: I have nothing much more to add. In my view, this is a momentous point in time when we have the ability to really safeguard the future health of generations of people who will not be exposed to the regretful, harmful addiction to tobacco that they might have encountered. I am very satisfied with the content of the Bill as it is just now. The point Sir Michael makes about perfection being the enemy of good is a really important one. This is an opportunity that, to be honest, I really did not anticipate seeing in my career, yet here we are discussing a potential piece of legislation that will allow us to improve the health of people in our country for years and generations to come. This is an opportunity that we cannot afford to miss.

Sir Francis Atherton: There are no changes to the primary legislation that I would recommend at the moment. One thing I would say is that in Wales, we were very impressed with the Khan review, which gave us a really good steer. Many of the Khan review recommendations will be dealt with through the Bill, while a couple will not. I think the Bill as it stands has enough flexibility, particularly around vaping, to allow secondary legislation to keep up with the industry as it adapts and as it tries to find ways around the barriers to getting young people addicted to nicotine.

If I had a wish from the Khan review, it would be around the industry making a contribution to those costs I was talking earlier—the cost to the NHS—so sort of a levy on the industry to correct the damage, or a polluter pays thing, as is being introduced for the gambling industry. However, I do not think that would fit at all with the current Bill.

Bob Blackman Portrait Bob Blackman
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Q The other issue is that the medical evidence is very clear on the damage that tobacco smoking does to people’s health, but on vaping, medical evidence is emerging. Sir Chris, could you lay out your concerns about vaping, the delivery mechanism and the chemicals in vapes?

Professor Sir Chris Whitty: I reiterate at the beginning that we think it is safer to vape than smoke—I always have to say that first. All of us, including the other CMOs—what I am about to say is a pretty central view in the medical profession—would say that there are many things in vapes that we know cause harm, but we do not know the extent of the harm because they are relatively new products, or we would say we do not know whether they cause harm, but they might well do. We know from work on air pollution that there are large numbers of chemicals that if you breathe them in in reasonable concentrations are highly damaging not just to lungs but to brains, the liver and many other things, but are not damaging if you eat them.

The fact that something is non-toxic—a food additive, say—does not necessarily mean that it is non-toxic if you inhale it. So all of us are very cautious about the long-term effects of vaping and very concerned that we do not see a large expansion of vaping in people who were not smokers. That is particularly true for children. Within that, there are things available in legal vapes—multiple things—and every time a new flavour is brought in, new chemicals are introduced for which we often do not have a good evidence base. In my view, the onus should be on the industry to prove it is safe when inhaled, and not on us to prove 20 years later that it was dangerous. There is a very serious concern about that. Additionally, there is a significant additional risk from illegal vapes, of which there are many, which contain really very dangerous chemicals—heavy metals of various sorts.

None of us would want you to go away with the idea that we think vapes are safe and that we would encourage their use, except in the narrow context of someone who was a smoker, where we definitely think they are safer. But that, as I said earlier, is setting the bar very low.

None Portrait The Chair
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I inform Committee members that we have 14 minutes to go and three people who have not yet spoken and would like to. I want to bring in the Minister and the shadow Minister at the end. I notice that there is huge unanimity among our panel members. Could I also ask you to be brief and perhaps get one of your number to answer a question so that we get everybody in? Bambos Charalambous is next.