Electronic Cigarettes

Caroline Johnson Excerpts

Thursday 29th June 2023 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I beg to move,

That this House has considered electronic cigarette use.

E-cigarettes were introduced as a stop-smoking device, but in my opinion they have moved from being a stop- smoking device to an alternative addiction. Indeed, they are attracting many non-smokers. In 2007, there were around 10.6 million smokers, according to official figures. The number fell to 6.6 million in 2022, so 4 million smokers had stopped. Sadly, it is estimated that around 1 million of those people died, which means that around 3 million quit smoking. That is undoubtedly a huge success, although it cannot be attributed entirely to vapes.

In the Health and Social Care Committee yesterday, we heard from the industry that it estimates that around 5 million people currently vape in the UK, which means that, even by the most generous estimates, 2 million of them were not smokers beforehand—a significant proportion of the vaping market. With the market estimated to be worth £4 billion a year, these products clearly have huge profit margins. Vapes have been available for a long time, but if they are genuinely safe, healthy devices that save lives by stopping people smoking, why does the NHS not provide any on prescription? I wonder whether it is because they are not safe and the NHS has been unable to develop the safety profile as well as it might wish.

The idea that e-cigarettes are 95% safer than smoking was quantified by Public Health England. Members will no doubt have heard the figure before, because the vaping lobby never tires of repeating it, but if we look into its origins, its veracity seems to suddenly disappear. The figure originated in a 2014 paper in a journal called European Addiction Research, but it comes with some important caveats. The study was partly funded by the Italian Anti-Smoking League, and one of its authors was a member of that organisation and served as a consultant to an e-cigarette distributor at the time. That blatant potential conflict of interest did not escape the journal’s editors, who added a warning note at the end of the paper, but it certainly escaped subsequent reporting of the figure.

The scientific journal The Lancet was even more excoriating of the original article, accusing it of having

“an almost total absence of evidence”

and of being based on

“the opinions of a small groups of individuals with no prespecified expertise in tobacco control”.

Furthermore, it is worth noting that the paper is seriously outdated. Since 2014, a plethora of evidence has emerged about the negative effects of these novel and fast-evolving devices, in studies that were never considered when the figure of 95% was reached. I am concerned that the statistic will age about as well as the claims made to past generations about the health benefits of smoking.

As we delve deeper into the topic, it becomes evident that a growing body of evidence links vaping to severe complications. Chronic bronchitis, emphysema, increased blood pressure and significantly worse physical performance are just some of the adverse effects associated with vaping that scientists have found. Furthermore, the high nicotine content, which some say is roughly equivalent to between 40 and 50 cigarettes in a disposable vape, poses a grave risk to the health and wellbeing of young people. We heard yesterday in the Health and Social Care Committee from Dr Helen Stewart of the Royal College of Paediatrics and Child Health—I should declare my interest as a member of that college and a consultant paediatrician—who told us about the difficulties that children are facing. Some of them are not going to the toilet during school time because the clouds of vapour they experience there trigger their asthma and make them unwell. We heard about children collapsing, too.

The number of children vaping is increasing. The evidence submitted to the Health and Social Care Committee by the vaping industry suggests that over 83% of children have never vaped or are unaware of vaping, but that flies in the face of the experience of most of the children, teachers and doctors I have spoken to. Indeed, a report on Blackpool published by Healthwatch in May found that a staggering 31% of children and young people claim to vape or sometimes vape. More disturbingly still, when I asked Healthwatch if it could break down its figures by age, it said that one in ten 10 and 11-year-olds vapes. These are children in year 6. That rises to nearly one in five 12 to 13-year-olds, while for 16 to 17-year-olds the figure was almost one in two. We have also noticed that the number of children vaping is rising extremely quickly.

I would like share a distressing incident from my constituency. In just one school, St George’s Academy in Sleaford, there have been eight reported cases of children collapsing after vaping. Those incidents occurred at different times with different children. I was deeply troubled to hear about this, so I went to visit them and met with one of the intelligence officers from Lincolnshire police, who had collected five vapes from another school.

In just those five vapes they found Velvana Fridex Eko, a modern non-toxic coolant intended for cooling cast iron and aluminium engines, as well as Avanti coolant antifreeze, Steol-M, which is designed for filling hydraulic devices, and Rauvolfia serpentina, or Indian snakeroot. Also found was Agip antifreeze, trichloro- ethylene, and poster and watercolour varnish—1-methoxy-2-propanol—along with diethylene glycol diacetate and 2-methoxyethyl acetate, a substance that may damage fertility and unborn children and is harmful to the skin if inhaled or swallowed. They also found aviptadil, a synthetic vasoactive intestinal peptide that is used to treat certain medical conditions.

These vapes do not contain what the children think they do, and they can be very dangerous. The police found that some children had significant health issues. The eight children who collapsed in Sleaford were taken to hospital. Thankfully, they have all recovered, but in one description given to me, a child taken to hospital in the back of a car had one side of his face drooped down as if he had had a stroke. His mother was clearly terrified by this. Another young boy said that he thought he was walking along through the marketplace in Sleaford when he realised that people were gathered around someone who had collapsed. Then he realised, as if looking from above, that that person was him. We have heard some really scary stories about what has been going on.

We hear that vaping is a good route to quitting, but we should balance the fact that it may help adults to quit with the need to keep these devices away from children. One of the things that makes vapes attractive to children is how inexpensive they are. We have seen them at £4 each, three for a tenner and those sorts of prices, which is clearly within pocket money range. When children can get disposables so cheaply, they are easy to discard. If a child finds that mum or dad is coming down the corridor or up to the bedroom, they can dispose of them quite quickly. When teachers come into the toilet, they can be disposed of, including in sanitary waste bins, which poses other hazards, too.

How much nicotine is in vapes? The average disposable contains 2 ml of e-liquid at 20 mg/ml nicotine strength, which I am told is the equivalent of 40 to 50 cigarettes. The reason for that is that people only take about 10% of the nicotine from cigarettes into their lungs—the rest of the time it just goes into the air—so vapes are stronger in many cases than cigarettes.

The other issue I want to raise with the Minister today is marketing tactics. We heard yesterday from the chief executive of Totally Wicked, who I challenged on his marketing techniques. Totally Wicked sponsors Blackburn Rovers and a rugby team as well, so the stadium is called Totally Wicked. The young men on the pitch—the heroes, as he called them, who those young men and women admire so much—are running around with T-shirts emblazoned with “Totally Wicked”. He said that the young people’s ones do not have that logo on. I checked this morning and found no evidence of them selling any junior shirts, which begs the question of what happened to them all. The suspicion might be that they have disappeared off sale—we do not know.

The Online Safety Bill offers an opportunity to ensure that vapes are not advertised on platforms such as TikTok. Vapes have bright, attractive packaging, with colours and flavours such as bubble gum. Why does an adult smoker need a unicorn milkshake-flavoured vape to quit? My 12-year-old daughter is too old for unicorns, she would tell me now, so why an adult would need a unicorn, I do not know. These vapes have become fashion accessories, and are being matched to outfits. Walk into any corner shop and we can see a whole rainbow from which to choose. There are understandable concerns that some manufacturers are deliberately doing that. They would all deny it, of course, and I hope that it is not the case, but with flavours such as unicorn milkshake, bubble gum, candy floss and green Gummy Bear, it is clear that these things are far too attractive to children. I ask the Minister to consider whether, if these are truly stop-smoking devices and not lifestyle products that are attractive to children, they really need to be coloured and flavoured. I do not think they do.

The environmental impact of disposable vapes has been highlighted by a number of my colleagues in the House on a number of occasions. Some 1.3 million disposable vapes are discarded in the UK every week. The vast majority are not recycled. Their complex construction and high nicotine concentration make proper disposal challenging. They also contain lithium batteries, a precious and vital resource in our transition away from fossil fuels that is being discarded willy-nilly, sometimes into rivers and water courses. That further exacerbates the environmental consequences.

Vapes have also been known to cause fires in bins, bin lorries and recycling centres. They pose a danger. I am also advised that the plastic, because the nicotine salts leak into it, becomes hazardous waste and is non-recyclable in any case. I urge the Government to back my ten-minute rule Bill and to ban these devices. A ban has been backed by the Royal College of Paediatrics and Child Health, and by the Royal Society for the Prevention of Cruelty to Animals. It is a widely supported measure.

As well as the issue with colours and flavours, we need tougher regulations on the advertising and marketing of vaping products. Health warnings should cover 65% of the front and back of the pack, in the same way as for tobacco. Sports club sponsorships should be banned. I cannot see why these products need to be advertised on sporting shirts; there is also the worry that that will make them more attractive to children.

When the former Government brought in bans on where people could smoke and where cigarettes could be displayed, the number of smokers dropped dramatically. I appreciate that that is a nanny state measure and, as Conservatives, we are reluctant to bring in nanny state measures. Nevertheless, it did work. If we were to ask people now whether we should reverse that measure, I do not think that many, if any, would agree. I suggest that as a sensible step forward.

At the moment, we are banning sweeties at the till because we think that will help to stop people becoming obese, but I have been into shops where those sweeties have been replaced with vapes. I am sure most people would much prefer that their child had a packet of Rolos than a vape.

My third point is about regulation. The industry is actually quite positive on this issue, and is keen for regulation—at least, that is what they say. At the moment, anyone can sell a vape. When I take my son for a haircut, we could get three lemon-flavoured vapes for £1 while we are there. He is only eight, so he will not be getting any, but we could. If we go to the sweetie shops on Oxford Street, we can buy them along with the candy.

Having the same sort of regulations as for tobacco or alcohol would mean that people would have to be licensed and would be challenged to make sure that vapes did not get into the hands of children, and there would be bigger fines. I saw an example of someone being fined £200 for selling these things to children. That is clearly no disincentive. A proper regulatory framework, where people lose their ability to sell these fairly lucrative products in the event that they break the regulations, will reduce the supply to children.

I also wanted to raise taxation. I appreciate that it is not the Minister’s responsibility, but he can raise it with the Chancellor and other colleagues. This measure was supported by Action on Smoking and Health in the Health Committee yesterday. If vapes are around £4 and a packet of cigarettes is £12, we could add considerable amounts—ASH is asking for a £5 tax on every disposable vape—as a way of taking them out of the range of children’s pocket money, while making sure that they are still cheaper than a packet of cigarettes for those adults who genuinely are smokers who wish to quit. Children are very price-sensitive and we need to deter them from this harmful habit.

My final point is about education. We heard from the headteacher of St George’s Academy yesterday in the Health Committee. Children need to know about vapes, and understand that they are not lifestyle products for them to use but aids for adults to stop smoking. The relationships, sex and health education curriculum review that is being done at the moment offers Ministers an opportunity to ensure that that happens. I am interested to hear what the Minister has to say.

--- Later in debate ---

[Dr Caroline Johnson]

I thank everyone who has contributed to this debate. It was interesting to hear that my right hon. Friend the Member for Calder Valley (Craig Whittaker) has given up smoking, on which I congratulate him. I hope he will soon be able to give up heated tobacco as well; I am sure his health will benefit.

I also thank the SNP spokesperson, the hon. Member for Paisley and Renfrewshire North (Gavin Newlands), and the Opposition spokesperson, the hon. Member for Ilford North (Wes Streeting), for their support. I think I am correct in saying that there was support from all corners of the House for doing everything possible to ensure that children cannot get their hands on vapes.

I welcome the measures in the Minister’s speech, particularly those on education, preventing the distribution of free vapes, the introduction of the enforcement team and nicotine-free vapes. I also welcome the consultation, but we need to be quick about this because more children are vaping every day. That means that every day more children are becoming addicted and developing a nicotine habit that they will find difficult to break.

One of the challenges of quitting smoking is giving up nicotine, and giving up the nicotine in vapes is no different; in fact, it may be more difficult. I urge the Minister to look very closely at banning disposables and at marketing. He did not mention this in his speech, but I do not think that vapes should be advertised on the kits of any sports team. In shops, vapes are often positioned in the front of display cabinets where children can see them. I have seen advertisements for vapes on taxis and things like that—they should not be there.

The Minister’s review should look closely at flavours and colours, because I do not think they are necessary for stop-smoking devices. He should regulate where they can be sold and increase the penalties for those that break the rules. The Minister did not mention tax. I appreciate that that is a matter for the Treasury, but vaping companies should be taxed heavily to lift their pocket money. That is the right way to go.

As well as education, children need support. A huge number of children are already addicted to vaping products, and they need support. When they realise and are educated about the harms and wish to quit, they will need support and help to do so.

Perhaps my most important ask of the Minister is for him to look at the latest evidence. The 95% safer approach was predicated on evidence that is not terribly robust and on a study that is nearly 10 years old. It was based on an apparent absence of evidence of harm, but we are now seeing evidence of harm. I urge him to review the evidence. We are in a situation in which our headteachers are telling us that children must be able to vape so that they can discuss the flavours to fit in with their peer group, and we must get away from that. This issue is urgent and I urge the Minister to act quickly.

Question put and agreed to.

Resolved,

That this House has considered electronic cigarette use.