COP10: WHO Framework Convention on Tobacco Control

Christopher Chope Excerpts

Thursday 18th January 2024 Westminster Hall

[Andrew Lewer (Northampton South) (Con)]

I beg to move,

That this House has considered COP10 to the WHO Framework Convention on Tobacco Control.

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank the co-sponsors of today’s debate, the hon. Members for Ealing, Southall (Mr Sharma), and for Linlithgow and East Falkirk (Martyn Day). I also thank all colleagues who have requested to speak, and the Backbench Business Committee for giving this application the urgent consideration that was asked for. The fact that Members wished to contribute to this debate, and to many others on similar topics of late, demonstrates how important this issue is across our United Kingdom.

I am pleased to see my right hon. Friend the Minister in her place, and of course I welcome her back to Government. I say that with no small amount of friendly bias, as she and I are constituency neighbours in Northamptonshire and have known each other for a very long time. We look forward to hearing from her later. I also welcome the shadow Minister, the hon. Member for Bristol South (Karin Smyth); I am keen for her to share her perspective on today’s proceedings. I state for the record that I have served as a vice-chair of the all-party parliamentary group for vaping.

I beg your indulgence, Mr Vickers, as I set the scene for why we are here today and outline the importance of what we are discussing. My co-sponsors and I were clear that this debate is not yet another opportunity to opine generally about smoking and vaping, or to merely rehash some of the well-known talking points that arise when we talk about these issues. Hopefully, it will not be a debate in which each side of the political divide claims to be cloaked in unique righteousness. I was pleased to have tripartite support for the debate application, and even more pleased that colleagues from a wide array of political parties, and from all four parts of the UK, have expressed a desire to speak in this and related debates.

It has been a stressful few days in Parliament. In some senses, the timing of this debate is very important, as it comes ahead of the 10th conference of the parties, but in other senses it is less fortunate, coming as it does straight after what we have been through over the past two or three days. Nevertheless, the debate is an opportunity for this mother of Parliaments to show our democracy at its best. We in the legislature can come together on a non-party basis to question the Executive and hold the Government to account. We should be conscious that many people from around the world will be watching these proceedings, given that the debate relates to international agreements and has a global perspective.

To the best of my knowledge, this debate is one of a kind. It is the only substantive discussion on next month’s meeting of the framework convention on tobacco control, COP10, taking place in any parliamentary democracy. It is my hope that we can shine a light on the World Health Organisation’s sometimes less than ideal proceedings.

I thank my hon. Friend the Member for Harrow East (Bob Blackman) for having secured the debate in this place on the WHO framework convention on tobacco control in March 2020. We all share a dislike, to put it mildly, of smoking. I pay tribute to the work that he and his colleagues do on the all-party parliamentary group on smoking and health to drive smoking cessation. Who in Parliament does not hate smoking? I do, and where we have differences, they are only on how best to drive it out. Since that debate nearly four years ago, we had one subsequent conference of the parties to the WHO: FCTC COP9, which took place in Geneva in November ’21. Today, of course, we are discussing COP10, which will be held in Panama in just over a fortnight.

We all know the term “COP”; it has become something of a household name, thanks to the United Nations climate change conference, which concluded its COP28 meeting in the United Arab Emirates last year, and which is heralded as a beacon of openness, transparency and engagement. The UK hosted COP26 in Glasgow in November 2021, which was expertly presided over by my right hon. Friend the Member for Reading West (Sir Alok Sharma). Ministers from Governments from all over the world attend these meetings. Indeed, our own Minister for Energy Security and Net Zero, my right hon. Friend the Member for Beverley and Holderness (Graham Stuart), was so enthusiastic about COP28 that he went to it twice. The conference sessions are open to the media, to civil society and to other interested stakeholders to participate in.

What a contrast that is with the FCTC and COP10. Despite smoking being one of the leading causes of death in the UK, killing about 80,000 people every year and causing one in four cancer deaths, there is likely to be no ministerial representation from the Government in Panama. It is unfortunate that such an important area of health policy is left to officials. Unlike the climate change COP, the FCTC COP meets and takes decisions behind closed doors, away from the scrutiny of Parliament and the press. The decisions taken in Panama next month will have wide-ranging influence over the UK Government’s approach to smoking cessation and the regulation of tobacco harm reduction products, which many smokers use to quit combustible tobacco.

For nearly a year, I have been asking the Department of Health and Social Care who will be in the UK’s delegation to COP10 in Panama. I have been asking what positions that delegation will take, and whether we will continue to stand up for Britain’s world-leading and evidence-based approach to tobacco control and smoking cessation. I know that a great many Members from across the House have made similar representations to the DHSC. Despite repeated oral and written parliamentary questions on the subject, Ministers have not yet set out the UK Government’s approach to COP10 in any detail. Clearly, none of us wants our Government to be as opaque as the World Health Organisation is on this and many other issues.

My first request of the Minister is that she asks my right hon. Friend the Minister for Energy Security and Net Zero to give serious consideration to attending COP10 in Panama next month. Members may ask why that is so important. The UK is one of the largest financial contributors to the FCTC, with millions of pounds of taxpayers’ money being shipped off to the WHO in recent years to support this agenda. That is whole streets-worth of residents of my constituency’s total contribution to the Exchequer. Every penny of tax that street after street of them pay goes to funding the WHO. We have an obligation to our constituents to ensure that the money is well spent, so we need to know who will be standing up in Panama on their behalf, and what policy positions will be supported or opposed.

What we do know is that the WHO takes a highly sceptical view of tobacco harm reduction products, including vapes, heated tobacco and oral nicotine pouches, arguing that they pose a risk to health. As I have mentioned, that is in direct contrast to the UK’s world-leading approach to tobacco control. It really is world leading, and we should be proud of what we have accomplished in recent years in driving down smoking rates and saving lives. Public Health England, which is now the Office for Health Improvement and Disparities, has been clear that vaping is at least 95% less harmful than smoking, and that heated tobacco products are considerably less harmful than conventional combusted tobacco cigarettes. That is independent, peer-reviewed evidence from a glittering array of public health experts, clinicians and scientists, not funded by players in the tobacco industry. Not only has it formed the bedrock of the UK Government’s approach to smoking cessation in recent years, but our model has been heralded by public health experts in countries and universities across the world as a beacon to follow. I therefore pay tribute to the Minister’s predecessor, my hon. Friend the Member for Harborough (Neil O'Brien), for the groundbreaking “swap to stop” scheme, which he announced early last year. For many of my constituents, vaping is a vital alternative that helps them to curb their smoking habits and quit, and the “swap to stop” scheme, which offers free vape starter kits to smokers, is a welcome tool in the arsenal.

When the Minister unveils her legislation later this year, we will have the opportunity to debate some of the fundamentals, including ensuring that children do not access nicotine products, and giving trading standards the enforcement powers that they need to tackle rogue traders who sell to minors or sell illegal products. However, we must not throw the baby out with the bathwater by introducing draconian measures that discourage adult smokers, whether deliberately or not, from making the switch to vaping. That is a fundamental point. Over-regulation and blanket bans are not the safe option; they could cost lives.

I agree with the Minister’s remarks in the debate last week that we must clamp down on packaging with cartoon characters, and vapes shaped like toys, but I discourage the misconception that flavoured vapes are not designed for 60-year-old smokers. There is very clear research on this: in a 2003 opinion poll by OnePoll, 83% of smokers stated that flavours helped them to quit smoking, and there is a definitive and widely available study on this matter by the University of Pennsylvania. Constituents tell me that it is precisely the availability of a wide range of non-tobacco flavours that enables them to make the switch away from harmful cigarettes. I oppose the suggestion from the hon. Member for Walthamstow (Stella Creasy) that adults are not interested in fruit-flavoured vapes. Why should adult smokers be discouraged from switching away from smoking, which will cost them their life, by a vaping market that is reduced to tobacco-only flavours that constantly remind them of smoking, and trigger their desire to smoke a cigarette?

There is also a danger that over-regulation will exacerbate the black market. In fact, as colleagues pointed out in the Westminster Hall debate on illegal vapes on Tuesday, the black market has flourished in recent years. Between 2020 and 2023, more than 2.5 million illicit vapes were seized by trading standards across 125 local authorities, and the enforcement agency warns that that is just the tip of the iceberg. Do we want to grow that iceberg, or reduce it as much as possible?

There is a tendency for us politicians to pass legislation or produce guidance from Whitehall so that we can say that we are taking robust action on an issue, without having regard to how it might be implemented. The UK already has stringent restrictions in place via the Tobacco Advertising and Promotion Act 2002, so much of the issue is really about enforcing the many existing laws, rather than a need for new ones. Speaking as a long-standing local government man—and I am still vice president of the Local Government Association—underpinning this issue is the new burdens doctrine, which this Government have signed up to and adhered to for many years. That doctrine states that all new burdens on local authorities must be fully assessed and funded. It is a cornerstone of Whitehall Departments’ preparatory work before they pass responsibilities on to local authorities, and I urge the Minister and her officials to keep that broader point in mind for discussions at the conference.

The real risk is that at COP10, the WHO will, as is expected, call for regulatory equivalence for tobacco harm reduction products, so that they are treated in exactly the same way as combustible tobacco products. That is not only counter to the UK Government’s position; if successful, it will significantly harm public health goals, not just in this country but across the world. Some countries have already banned vapes but not cigarettes, and that will cost huge numbers of their citizens’ lives.

Additionally, why bother to “swap to stop” at all if cigarettes and vapes are taxed in the same way and there is no price differential or flavour incentive to quit? That said, I am conscious that the Minister is still compiling her response to the recent consultation on smoking and vaping ahead of new legislation, which we await with interest.

There is one occasionally repeated fallacy that must be nailed and not repeated, given its harmful potential. It is not nicotine that causes lung cancer, and nor does nicotine itself kill its long-term users; rather, it is the constituent chemicals inherent in the combustion of tobacco within cigarettes that causes harm. Nicotine vapes, oral nicotine pouches, and indeed heated tobacco products—which are sometimes known as “heat not burn”, given that there is no combustion involved—are all essential in giving adult smokers a range of solutions for their smoking cessation journey. For the avoidance of doubt, I quote Cancer Research UK, which says that nicotine

“is not responsible for the harmful effects of smoking, and nicotine does not cause cancer.”

Tackling misinformation is at the heart of this debate, as we consider some of the measures that the WHO is proposing to enact at next month’s COP10 meeting, and the harmful effects they will have on public policy here at home.

As ever, the devil is in the detail, so I ask colleagues to forgive me if I take a few minutes to speak to some of the specific policies under consideration in Panama, and why the UK delegation must stand firm against them. The words of the Chief Medical Officer for England are ringing in my ears:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.

We need to consider how our public health bodies can effectively communicate that to adults who currently smoke.

One of the most worrisome proposals being put forward by the WHO is item 6.2 on the agenda, which covers tobacco advertising, promotion and sponsorship. It is widely understood that the WHO will push for an expansion of article 13 of the FCTC to include reduced-risk products—vapes, “heat not burn”, and oral nicotine pouches —within the restrictions on advertising, as if they were the same as combustible tobacco, when, as I hope I have already illustrated, they are not.

Like everyone else in this room—I cannot stress the importance of this enough—we have to ensure that children are not targeted by nicotine products, but successful uptake by adult smokers of these reduced-risk products as part of the UK Government’s strategy of tobacco harm reduction relies on the ability of responsible manufacturers and retailers to provide important and accurate information about the products’ health benefits when set against traditional combustible cigarettes. There are still 6.4 million smokers in the UK, and they are our constituents, our neighbours, our families, and—I am very sorry to say—for many of us, our friends.

Misinformation on this issue is not only dangerous; it is lethal. The best must not be the enemy of the good. The extent of misinformation is such that, according to Action on Smoking and Health, four in 10 smokers believe that vaping is as harmful or more harmful than smoking. That figure increased by a third last year. A recent YouGov poll also found that over 50% of people thought that vaping was more harmful or as harmful as smoking. Whenever there is an online newspaper article about this subject, to which I have obviously been paying particular attention in the last week or so, I am amazed by the extreme, contradictory and occasionally potentially dangerous views expressed.

The proposals under discussion at COP10 would limit the ability to tackle misinformation on relative harms, while simultaneously restricting the promotion of reduced-risk products to adult smokers. As I alluded to earlier, the UK delegation must challenge any attempt to bring about regulatory equivalence between combustible tobacco and reduced-risk products—in particular “heat not burn” products, which the Office for Health Improvement and Disparities has made clear are substantially less harmful than smoking.

There is a risk through item 6.3 on COP10’s agenda that the WHO will seek to do just that: to push Governments around the world to regulate vapes and other reduced-risk products in the same way as combustible cigarettes, leading to the concern that that could extend to proposals on taxation and price points. If the WHO is successful, any financial incentive to switch away from cigarettes will be removed. That point has been made by many colleagues on many occasions, and I know from our work together on the APPG for vaping that the hon. Member for North Tyneside (Mary Glindon)—my colleague and co-author of an article on the issue—has spoken passionately about it and her own personal experiences. Such measures would send the wrong message, and would only perpetuate the dangerous myth, believed by 40% of smokers, that vaping is as harmful as smoking, and would therefore obviously discourage them from switching in the first place.

Will the Minister undertake to confirm that the UK delegation will block any measures to restrict the ability to effectively communicate with adult smokers on the health benefits of switching away from combustible cigarettes? Will the UK delegation oppose any move towards regulatory equivalence, including on taxation and price points?

I am conscious that other colleagues wish to speak. Thank you, Mr Vickers, for indulging me in setting the scene more generally and outlining some of the concerns as the Government head into COP10.

[Sir Christopher Chope (Christchurch) (Con)]

My hon. Friend is making a brilliant speech, and I am grateful to him. Can he explain why we would be required to follow any recommendations that come out of COP10? As a sovereign country, surely we would be able to decide whether we wished to accept the recommendations.

[Andrew Lewer]

I will develop my hon. Friend’s point in my closing remark.

If the UK delegation attends COP10 and goes along with international agreements, even if they are not legally binding, there will be a mood music and atmosphere, as we have heard in recent days, that because we are a signatory and have agreed to go along with them, we therefore need to follow along. My hon. Friend the Member for Christchurch (Sir Christopher Chope), possibly more than anyone else, has been robust about the limitations of international bodies with respect to this Parliament and this country. However, as we discovered this week, their prevailing influence is great, and not standing up to proposals at such events therefore leads inexorably to their proposals being absorbed into British policy and lawmaking.

It would be hugely beneficial if the Minister attended COP10 in Panama and flew the flag for our world-leading public health strategies for smoking cessation. She is someone who passionately championed, when she stood astride that Wembley stage back in 2016, Britain’s great future as an independent, free-trading and outward-looking nation, having taken back control of our laws, borders and money. I do not believe for one moment that she wishes to see responsibility for our public health policy abrogated to another supernatural—sorry, supernational: a Freudian moment there—unelected body of bureaucrats. To assist in setting out the UK position, perhaps my hon. Friend the Member for Winchester (Steve Brine), in his capacity as Chair of the Health and Social Care Committee, might have the UK delegation appear before him and his colleagues to answer questions before COP10 gets away on 5 February, as well as afterwards.

Our constituents, many of whom have written to us about this in recent days, have the right to know what the UK delegation will or will not be doing on their behalf, let alone who is in it. I am sure that I speak for many Members when I say that we would welcome clarity on that point. I am grateful to the Minister for coming to respond to the debate. I am sure that she will use the opportunity to provide us with some of the answers we seek, and will undertake to keep the House and colleagues fully informed. I hope she will make a statement from the Dispatch Box at her earliest convenience after the conclusion of COP10 to update us on the outcomes from Panama.

I look forward to the contributions of colleagues from all parts of the House, and to the response from the shadow Minister, the SNP, and the Minister, who I know shares my passion for ensuring that our Parliament retains its status as the sovereign decision-making body.

--- Later in debate ---

[Mr David Jones (Clwyd West) (Con)]

May I say what a pleasure it is to serve under your chairmanship, Mr Vickers? I congratulate my hon. Friend the Member for Northampton South (Andrew Lewer) and the hon. Members for Ealing, Southall (Mr Sharma) and for Linlithgow and East Falkirk (Martyn Day) for securing the debate, and I thank the Backbench Business Committee for facilitating it. At the outset, I declare an interest as an honorary life governor of Cancer Research UK.

I agree entirely with my hon. Friend the Member for Northampton South that the stance the UK adopts at COP10 next month will be crucial to the future of tobacco harm reduction in this country. To their great credit, the Government have pursued a distinctive and very successful UK-made policy on smoking that has significantly reduced its prevalence in this country. Nevertheless, as we heard from my hon. Friend, 6.4 million people still smoke—around 12.9% of the UK’s adult population.

To help reduce smoking rates, the UK is taking a world-leading approach, supporting the principle of tobacco harm reduction. In particular, the UK takes the view that vapes can have an important role in reducing the prevalence of cigarette smoking. The Government have allowed vaping to develop on a market basis, and that has gradually taken 1.5 million people off smoking altogether.

As we have heard, the smoke produced by combustible tobacco represents the greatest threat to the health of smokers. The UK has therefore been keen to point smokers to alternatives to combustible cigarettes. As we heard from my hon. Friend, in April the Department of Health and Social Care announced that a pioneering “swap to stop” strategy would be rolled out across England, providing a million smokers with a vape starter kit, alongside behavioural support to help them quit. That approach has a history of success. The largest such programme to date was conducted in Salford in 2018, and it resulted in over 60% of participants being smoke-free after just four weeks.

While no one route can be said to be the only one to help smokers to quit, the fact is that, for many, vaping does work. I repeat the quote my hon. Friend mentioned from the chief medical officer for England, who said:

“If you smoke, vaping is much safer”.

However, he went on to say:

“if you don’t smoke, don’t vape.”

The 2022 Khan review made it clear that the Government should

“embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco.”

However, one solution does not suit all smokers. It is important that the Government, and indeed the devolved Administrations, which have responsibility for healthcare in their areas, keep as many options open as possible to have the highest chance of success in reaching smoke-free status by 2030. That is the Government’s highly commendable ambition, and it must not be thwarted by the likely stance of the World Health Organisation in Panama.

The WHO opposes reduced-risk products, including vapes, heated tobacco and oral nicotine pouches, arguing that there is insufficient data to understand their effects. The WHO, to be entirely blunt, is being stubbornly backward. It does not accept any harm-reduction approach to smoking. It does not accept that smokers switching to vapes is a better choice. It does not accept British scientific consensus—for example, the Public Health England report stating:

“While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals that are present pose limited danger”

and that

“best estimates show e-cigarettes are 95% less harmful to your health than normal cigarettes”.

The WHO’s stance, therefore, runs counter to the UK Government’s successful, evidence-based approach to tobacco harm reduction through the use of reduced-risk products to help to cut smoking rates. We must remember that the United Kingdom is one of the largest financial contributors to the FCTC, and the Government should not be afraid to remind the WHO of that. British taxpayers have in recent years provided millions of pounds to support WHO policies that are contrary to those operated by the United Kingdom.

The WHO’s approach is that nicotine products pose a risk to health and that the safest approach is not to use them at all. Well, of course—that is self-evidently the case. Non-smokers should never start using nicotine, but it is counterproductive to prevent adult smokers from accessing reduced-risk products in a world in which 1.1 billion people still smoke. That makes no sense at all.

As my hon. Friend the Member for Northampton South said, some of the proposals in the provisional agenda for COP10, published on its website, are a serious cause for concern. For example, item 6.2 aims to impose the same restrictions on the advertisement, promotion and sponsorship of reduced-risk products as on conventional tobacco products. That would limit the ability of the UK Government, the devolved Administrations and public health bodies to promote to adult smokers less harmful alternatives as part of a smoking cessation strategy. It should be noted that, in contrast, Sweden is set to become the world’s first smoke-free country, after seeing substantial reductions in smoking rates through the use of a wide range of reduced-risk products.

Item 6.3 on the agenda threatens to establish regulatory equivalence between combustible tobacco and reduced-risk products. That sends a dangerous, misinformed message that reduced-risk products are as harmful as, or more harmful than, combustible cigarettes.

[Sir Christopher Chope]

Is that not exactly what has happened in China? China is regulating vapes in the same way as tobacco, and we know that the WHO is controlled by Chinese interests. Should that not make us really alarmed?

[Mr Jones]

Yes, it certainly should, and it is another reason why the United Kingdom, which has significant influence within the WHO, should actually exert that influence, and I propose to discuss that a little later in this speech.

Misinformation about vaping is already an important and worrying issue. According to Action on Smoking and Health, four in 10 smokers in the UK now believe that vaping is as risky as, or riskier than, smoking. That is the consequence of the misinformation, and the WHO’s position simply compounds the misinformation.

In the teeth of this hostility on the part of the WHO, the Government should confirm what policy positions the UK delegation to COP10 will take, especially on the agenda items that I just mentioned. I hope my right hon. Friend the Minister, in her winding-up speech, will be able to assure us that the Government will challenge the WHO on the science head-on. Will she say, as my hon. Friend the Member for Northampton South has asked, whether a Minister will attend COP? I believe that a Minister should be there—I think she should take a slow boat to Panama. We need ministerial involvement at this conference. Will my right hon. Friend also say what policy positions she will be instructing officials to take, and will she undertake to provide a further statement to the House on the key outcomes—particularly where there may be an impact on health policy and smoking cessation strategies—after the closure of the conference? Critically, will she confirm that the UK delegation will oppose, and if necessary veto, any proposals that would impact on the UK’s world-leading and evidence-based approach to tobacco control through the successful use of reduced-risk products?

I repeat that we are a major funder of this organisation. If we are to meet our goal of being smoke-free by 2030, the Government, working with devolved Administrations, must ensure that adult smokers are provided with a wide range of reduced-risk products to help them to quit, such as vapes, including single-use vapes; heat-not-burn and heated tobacco products; and oral nicotine pouches. Different solutions will work better for different people. Japan, with heated tobacco, and Sweden, with snus, the organic form of nicotine pouches, have had even more success in reducing smoking than the UK, so vapes should not be the only solution. Indeed, these products have been even more successful in their home markets than vapes have been here. We should be learning from other countries’ experiences.

At this COP, there will be an attempt on the part of the WHO to create a global norm of treating harm reduction products, including vapes and heated tobacco, exactly like combustible cigarettes, as if they were equally dangerous, including by raising their excise duties to the same level. That would be a colossal disincentive to any smoker who might consider switching to a less dangerous choice. I hope my right hon. Friend the Minister can confirm that the UK will stand against what would be a reactionary and profoundly dangerous error.

The WHO should not be allowed to undermine the UK’s evidence-based and science-led approach to tobacco harm reduction. The UK’s successful use of vapes to reduce smoking rates is rightly seen as a model of success around the world. The UK delegation at COP10 must do all it can to oppose measures that may threaten that.

[Sir Christopher Chope (Christchurch) (Con)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I had not expected to speak in this debate, but I think it is worth re-emphasising the point that the WHO is controlled by China in very dubious circumstances. The chairman and director general of the WHO were appointed under Chinese influence. We have debated several times in Westminster Hall the influence of China when it comes to other areas of activity with the World Health Organisation. Here we have a specific example of how Chinese leadership is trying to persuade this WHO body to introduce the same policies and regulations that it has already introduced in China.

We should be the world leaders in this. We should be out there explaining why tobacco harm reduction products are really well suited to the consumer and the battle against the harms caused by smoking, but we do not seem to be in a leadership role. I urge my right hon. Friend the Minister to show that leadership by leading the UK delegation in Panama. Otherwise it will seem as though we are diffident. There is even a danger that what we believe in this country and the pioneering work that has been done, to which reference has already been made, will count for nothing when it comes to the debates in Panama.

We know the extent of Chinese influence across the world. The next stage may well be that what is advisory for this WHO body will become mandatory. That is the Chinese agenda. They are trying to take over the these international bodies and get their way. What should we be doing? We should be fighting back robustly. We should not be naive about this. I fear that we are far too diffident.

I am disappointed that despite the number of constituents who have written to me and on whose behalf I have written to the Government, we have still not had clear answers about exactly what our position will be when the discussion takes place in February. My right hon. Friend the Minister has always been a champion of national sovereignty, but I urge her to demonstrate that by leading the way and telling the Whips that we can manage without her for a few days, while she raises the flag in Panama on behalf of the United Kingdom and all we are doing to improve our public health and reduce the harm that comes from smoking.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

It is a real pleasure to serve under your chairmanship today, Mr Vickers. I thank all colleagues who have taken part in this Backbench debate, especially my hon. Friend the Member for Northampton South (Andrew Lewer) for his leadership in organising it. It has been very interesting, and I can absolutely assure colleagues that I have learned some new things myself today.

To tackle the very first question, I do not intend to go to Panama for COP10. That is because I am preparing flat out for our smoke-free generation Bill, including the response to the consultation and the measures. I just do not think it would be a good use of my time to travel on 5 February. However, the Government will be represented by our excellent colleague from the civil service, Dr Jeanelle de Gruchy, who has done fantastic work representing the UK’s position.

I will give a rough overview of the UK’s position. There will be discussion about global progress on tobacco control. Of course, the UK is an outlier on the topic of vapes, and we will be putting forward our position that vapes are a very important tool for helping adults to quit. There will be some discussion on advertising and sponsorship. The UK has no plans to implement further restrictions on advertising and sponsorship, particularly in the COP’s desire to see further restrictions implemented. On novel and emerging tobacco products, different parties take different approaches. At the moment, the UK is still looking at issues around heated tobacco, so the UK delegation will be in listening mode. In terms of parties going further on tobacco control, certainly the UK Government would welcome other parties going further to protect people, but we will be monitoring the negotiations to ensure that nothing becomes mandatory. Finally, there will be discussions on whether there should be an increase in assessed contributions. The UK intends to press for contributions to stay where they are now. I am very happy to provide a statement to the House after COP10, giving feedback on exactly what happened. I think that covers a lot of the issues raised by colleagues. I hope that was clear, and I would like to again thank everyone for attending.

As has been pointed out, the framework convention on tobacco control was the first treaty negotiated through the World Health Organisation. However, as colleagues will appreciate, I am not one to get misty-eyed about international conventions, or indeed international regulatory frameworks. I am not terribly romantically attached to this, and I feel that the UK’s sovereignty is actually the most important aspect. My priority as the Minister will be to help us in the UK protect our citizens from harm. Is there not a song that goes, “I did it my way”? The UK has a world-leading approach to reducing harms from tobacco and nicotine, and we will continue to do that.

The conference of the parties has, however, been a helpful way of keeping strong tobacco controls at the top of the global health agenda. It is also, as I hope I have just illustrated, a very useful forum for sharing best practice. All papers are presented and all decisions made are published online via the dedicated COP10 website. The UK remains committed to the convention, because we are a world leader in tobacco control. Like many friends around the world, we want to see a tobacco- free future. Next month’s conference will be a fantastic opportunity for us to showcase the UK’s strength, being at the cutting edge of a smoke-free generation. As I have said, our deputy chief medical officer, Dr Jeanelle de Gruchy, is the chief delegate. I have every confidence that our team will encourage other countries to follow in our example.

Now, my hon. Friend the Member for Northampton South is a big fan of common sense, and so am I. I want to reassure everybody that our delegation will be bound by common sense, and not by conference decisions that run contrary to common sense, or indeed to decisions that run counter to our national interest. That includes the decisions we take in helping smokers to quit through quit aids such as vapes and nicotine replacement products. We are a sovereign nation, and it is not within the WHO’s remit to intervene in our internal affairs.

Last week, I was given a couple of opportunities to update the House on our progress towards a smoke-free generation. With permission, I would like to reiterate a few of the points I made then. Our new tobacco and vapes Bill will save lives. Unlike other consumer products, there is no safe level of smoking: it is a product that kills up to two thirds of its long-term users, causes 70% of lung cancer cases, and massively increases the risk of stillbirth. It causes asthma in children; dementia, stroke and heart failure in old age; disability and early death. Almost every minute of every day, someone is admitted to hospital because of smoking, and up to 75,000 GP appointments every month can be attributed to smoking. It takes a massive toll on both our health and our NHS.

Smoking also takes its toll on our economy. Detractors will say, “But what about the £10 billion a year the Treasury gets from taxes on tobacco—how will the Chancellor do without that?” But independent analysis shows that the overall cost of tobacco to society totals £17 billion a year, completely offsetting—and then some—whatever we receive in taxes. The cost of smoking is equivalent to the annual salaries of more than half a million nurses, almost 400,000 GPs, 400,000 police officers or 400 million GP appointments. Reducing smoking rates will bring down those costs and help our economy to become more productive. Our modelling suggests that the smoke-free generation policy we are looking to introduce will reduce smoking rates in England among 14 to 30-year-olds to close to zero by as early as 2040, and will provide cumulative productivity benefits of up to a staggering £85 billion over the next 50 years. That is why bold action is necessary. We are making history with this Bill.

I took up smoking at 14 and gave it up as my 21st birthday present to myself. It was not easy. To this day, I hate talking about smoking because I sometimes think, “I’d quite like a cigarette”, but I shall never be tempted. It is so hard to quit. To those hon. Members who mentioned that nicotine is not bad in itself—yes, it is; it is desperately addictive. When people try to give up nicotine, they suffer cravings and get irritable. It is really difficult to give up nicotine, no matter how it is consumed. Combustible tobacco certainly has all sorts of other horrendous health issues, but nicotine itself is not a harmless product by any means. There is no safe level of nicotine consumption.

Like so many smokers, I desperately wanted to give up this lethal addiction. We want to help more smokers than ever to quit through significant new funding and support. All smokers deserve our support to quit and lead a healthier, longer life, which is why we have announced we are doubling the funding to stop smoking services across England to a total of £138 million a year, to help around 360,000 people quit every year. We are also backing these efforts with substantial new money to support marketing campaigns. As my right hon. Friend the Member for Clwyd West (Mr Jones) and my hon. Friend the Member for Northampton South both pointed out, four in 10 smokers think vaping is as bad as, if not worse than, smoking cigarettes. With this substantial marketing support, the stop smoking campaigns will be common sense and easy to use, setting out the facts to help smokers to be able to quit. We will also provide vapes as a quit aid to those who want to stop smoking.

As colleagues will know, I am passionate about helping mums, mums-to-be and new families, which is why I have asked officials to redouble our efforts to tackle smoking in pregnancy. Women who smoke during pregnancy are two and a half times more likely to give birth prematurely. Smoking is also a significant driver of stillbirth. I want to do everything I can to spare parents the heartbreaking tragedy of losing a baby. One in 10 mothers smokes at the time of delivery; this figure rises to one in five in some parts of the country. Pregnant women who receive financial incentives are twice as likely to successfully quit in pregnancy as those who do not. We must also protect pregnant women and their babies from second-hand smoke. We are working to roll out a financial incentive scheme by the end of 2024 to help all pregnant smokers—and, crucially, their partners— to quit.

As I have said, vapes can be an effective tool to help smokers quit. That is why we have committed to providing 1 million vapes to smokers through our “swap to stop” programme. That is a different approach from that taken in the WHO proposals; we are proud to take it, because we know it works.

Along with millions of parents across the country, I am alarmed by the number of children using vapes, a device that should be used only by adult smokers who want to quit smoking. Youth vaping has tripled in the last three years, and one in five children has used a vape. We have a duty to protect children from under-age vaping while their lungs and brains are still developing, so we are taking decisive action to reduce the appeal and availability of vapes.

In our recent public consultation, we sought views on restricting flavours, point-of-sale displays and packaging, and on restrictions on disposable vapes. We will take tough new action to reduce the appeal and availability of vapes to children through the tobacco and vapes Bill.

I totally get the point that my hon. Friend the Member for Northampton South made about flavours. These are all areas that are being carefully looked at, but he will appreciate that Cherryade, Yazoo and bubble-gum flavours are not really designed for him and me. Packages that look like a little Coke bottle, or are brightly coloured, like a bubble-gum package, are marketed not at him, but at children. Of course we see the vape stand right next to the sweets stand, and vapes are sold, conveniently, at pocket-money price, so let us not be naive about this. A lot of the flavours and colours are specifically designed to appeal to children, and that has to stop. A strong approach to enforcement is a crucial part of making sure that it has a real-world effect.

Under-age and illicit sales of tobacco, and more recently vapes, are undermining the Government’s work to regulate the industry and protect public health. We are cracking down on this appalling illicit trade by backing enforcement agencies, including Border Force, His Majesty’s Revenue and Customs and trading standards, with £30 million extra per year. In the tobacco and vapes Bill, we will introduce powers to give on-the-spot fines, to tackle under-age sales.

[Sir Christopher Chope]

Will my right hon. Friend comment on the undue influence of China on the WHO, as exemplified in my remarks? China is trying to ensure that its policies are adopted by the WHO, and it seems to be funding the WHO and controlling it. Should we not be concerned about that?

[Dame Andrea Leadsom]

I will look into my hon. Friend’s concerns and respond to him in writing. That is probably the most helpful I can be, because that is not something that I have been briefed on. I am, as are all hon. colleagues across the House, concerned about the undue influence of China on public policy that finds its way into national policies. I am grateful to him for raising the issue.