Tobacco and Vapes Bill

Danny Chambers Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Simon Hoare]

My hon. Friend makes an important point, and I readily accept that it has a huge intellectual underpinning, but we have had public health campaigns for years on the dangers of smoking tobacco. In some instances, it has worked. We have also used taxation and the pricing mechanism. My late father told my mother that he would give up when cigarettes reached 10 shillings a packet. He eventually gave up when smoking was banned in public buildings and the like. The question that remains is: do we allow unfettered freedom if it harms only the individual who is exercising it, and step in when the exercise of that unfettered freedom has negative impacts on society?

The Secretary of State and others have dilated, perfectly correctly, on the impact on demand and supply in the national health service. A disproportionate amount of resource goes to dealing with smoking-related diseases, illnesses and conditions. We can do something about that. We know full well the negative impact of passive smoking on other people’s health, so the impact of the exercise of that liberty is not limited to the individual. I suggest respectfully that my hon. Friend the Member for Romford (Andrew Rosindell) would have a stronger point if it was limited to the individual. Then we could say, “Provide the information and let the individual take the decision.” However, that decision impacts many other people. It affects the productivity of the nation and the national health service, and the health of family and society.

I suggest to my hon. Friend that it is an entirely Conservative instinct to say, when all the levers have been pulled and buttons pushed—when there has been public information, education and some forms of prohibition—“It has worked up to a point, but not enough and not at the right speed. We will have to do something else.” I accept that not everybody who describes themselves as a Conservative, as my hon. Friend and I both do, will make the same analysis and arrive at the same position as me. I voted for the Bill in its last iteration, and I will vote for it again today, because I think it is the next lever that we need to pull and the next button that we have to push.

[Dr Danny Chambers (Winchester) (LD)]

Does the hon. Gentleman agree that we have an NHS and a Government who are expected to provide and pay for treatment when people are ill, so there is a duty and an onus on the Government to try to keep people healthy, and to provide information about well-known dangers to people’s health? This is not about having a nanny state, but about nudging people to make the right choices, because it costs money to treat people, and we want to save money as well.

[Simon Hoare]

The hon. Gentleman makes a valid point. One can nudge, prod, push and exhort as much as one can, but the Bill is probably the final stepping stone in quite a long line of stepping stones to try to wean people off their dependency on tobacco.

The House has been generous with its time, as have you with your patience, Madam Deputy Speaker. In closing, I echo and endorse the point made by the Secretary of State and other contributors from the Government Benches: people who have an addiction are not free. They are trapped by their addiction, and that affects many areas of their life. If someone is terribly well off, they can afford the addiction to tobacco, and it will make not a jot or tittle of difference to the household budget or income, or to their standard of life—

Tobacco and Vapes Bill (Second sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Euan Stainbank (Falkirk) (Lab)]

Q Do you believe that the generational smoking ban might cause an increase in the use of other nicotine products such as vapes, smoke-free tobacco or even illicit products?

Alison Challenger: We are ultimately trying to reduce the harm caused by smoking—that is the big killer, and we really would not want to lose sight of that. The Bill also brings in elements around the second-hand smoke agenda. It is important to recognise that there are many vulnerable people who would potentially be harmed by breathing in second-hand smoke, so we welcome the fact that the Bill includes that element. As for whether it will increase vaping, it is really hard to know at the moment how that will work out. Potentially more people might switch to vaping, but ultimately, the Bill brings in a progressive approach to taking out smoking tobacco, which is to be welcomed.

[Dr Danny Chambers (Winchester) (LD)]

Q You might not have the answer here, but do you have a rough estimate of what it costs the NHS financially to deal with passive smoking and second-hand smoking every year?

Alison Challenger: I do not have the actual figure, but it is significant. One of the early benefits of the Bill going through will be the impact on children, particularly around asthma. Obviously, second-hand smoke will be exacerbating some of those respiratory illnesses, particularly for children. There is a considerable burden on the NHS as a result of breathing in second-hand smoke. We must also consider those who have cardiovascular disease and those who have existing respiratory illness. It is not always evident that somebody is vulnerable, so it is really important that the measures in the Bill serve to protect those who are vulnerable from inhaling second- hand smoke.

[Dr Chambers]

Q I am assuming that from a public health point of view, looking at the epidemiology, certain communities and demographics will be more greatly affected by this. Is that something that you are mindful of? How do you see the Bill changing health inequalities?

Alison Challenger: We are very mindful of that. Some of the statistics we give around smoking prevalence are an average smoking prevalence for often quite large geographical areas. For my own area in west Sussex, our local survey suggests there is a variance of 4.3% in our most affluent area compared with 16% in our least affluent area. Those are still averages. We also know that in households in the most deprived part of our area, 40% of children are exposed to cigarette smoking from a parent or carer. That is through our own survey.

The point I am trying to make is that there is very much a health gradient, and in those who are most disadvantaged and living in our most disadvantaged areas, we see both higher rates of smoking and more children exposed to that smoking. Those children are more likely to take up smoking if they have been exposed to it.

[Jim Dickson (Dartford) (Lab)]

Q This is to Councillor Fothergill. Are there any circumstances you can envisage where local enforcement would not be enough and the Secretary of State would need to utilise the powers granted in the Bill under clauses 130 and 131 to intervene?

David Fothergill: We have discussed this outside the room, and I think the area we would be most concerned about is illegal sales online. Our local teams could not get into those, and therefore we might need more national resources to break into how people are bringing illegal substances into the UK.

--- Later in debate ---

[Dr Chambers]

Q Dr Ahmed asked almost word for word what I was going to ask, but from a population medicine point of view, do you have a rough estimate of how much smoking is costing the NHS and how much would be saved if the measure was implemented properly?

Professor Linda Bauld: I do not have in front of me the cost to the NHS—other witnesses will probably have it at the tip of their tongue—but it is substantial. If you look at the number of admissions to hospital from smoking, there are over 500,000 every year in England, and we still have over 75,000 deaths. By reducing smoking prevalence, you are going to see very significant impacts and cost savings.

The other thing we know from our research, as previous witnesses have said, is the effect on productivity and workplace absence. As you all know from your constituencies, smoking is also driving some of the loss of people from the workforce in their 50s, early 60s or even younger that we have seen recently. I think that you will see cost savings and an impact on productivity.

The final thing that I would say on that, despite not having the figures in front of me, is that this is an area that causes such a burden to the NHS. One of the things that our CMOs did not make clear earlier, although they said it indirectly, is that if you look at non-communicable diseases in the UK, smoking is the only risk factor that is linked to all four of our NCDs—respiratory conditions, cancer, diabetes and heart disease. It is the only one that is directly linked to all of those. If you think about all of those diseases, and the burden of disease that Sir Gregor mentioned, of a 21% increase by 2040 in my own nation of Scotland, we are going to make an impact on that, and that will achieve cost savings for the NHS—and, importantly, for social care.

[Dr Chambers]

That is well articulated. Thank you.

[Dr Cooper]

Q Thank you for coming along this afternoon. You mentioned the New Zealand case. Could you talk briefly, in case anybody does not know, about what happened and why the standards were dropped? What learnings might we take from that for our legislation?

Professor Linda Bauld: I think there are political aspects to that, which I will not comment on, but obviously the understanding was that it was a very comprehensive and ambitious set of measures that was introduced. Like this Bill, it was about not just the smoke-free generation but other measures as well, including, interestingly, on the density of retail outlets, which might be something for another day or another, potential future measure. A new Government came in and decided not to take it forward.

The learning that we need to take from that, from my understanding and from speaking to colleagues there, goes back to the CMOs’ evidence about the lobbying that is going to occur. The tobacco industry and partners around the industry are very powerful, so persuading colleagues that this is undermining choice and that it will be a burden in terms of regulation, cost to retailers and so on—those were the arguments that were used in New Zealand.

We need to keep a watchful eye, as we think ahead to the regulations and the next steps for the legislation, that we do not open that door too widely and allow those arguments to become too powerful. As you heard earlier, that industry is continually looking for new recruits to replenish those it loses through morbidity and mortality, and that will happen in the UK as well unless we get this right.

--- Later in debate ---

[Andrew Gwynne]

Q The Bill seeks to reduce youth vaping. How do you think we can best achieve that while not deterring adult smokers from quitting?

Professor Steve Turner: That is a really good question. I think that the balance in this Bill—between supporting the 6 million smokers to quit and not engaging children in nicotine addiction—is the right balance. Going back to what I was saying earlier, getting the message across to young people is a multifaceted intervention that requires education as well as legislation. It is a really difficult balance, but I do believe that the Bill, as it is, has that balance just right.

[Dr Chambers]

Q Thank you for coming all the way down from Aberdeen; I worked there for a few years, so I know it is a long way. We have been trying to ask some panellists approximately what this issue is costing the NHS. As a consultant, in your clinic, doing respiratory paediatrics, what proportion of your patients are in some way involved with smoking or second-hand smoking?

Professor Steve Turner: The impact on the whole of society of second-hand smoking in children is complex, but there are various pieces of the jigsaw. First of all, children come to the clinic, are admitted to hospital, come to the emergency department, or go and see the GP, so there is that healthcare side. If any of you have children, however, when your child is off school, that has implications for you as a family; there are some difficult discussions over breakfast about who is going to work and who is not. Therefore, there are a number of different impacts on us as a society, economically and to the NHS from second-hand smoking.

I am not clever enough to put a number on it, but it is a lot bigger than I think people know. I do know that £46 billion is the number cited as the direct health cost to the NHS of smoking—it is almost too big to consider—but I suspect that the wider societal cost will probably be a magnitude greater than that.

[Dr Chambers]

Q Is there a ballpark figure for a general day? When you have a list of paediatric respiratory cases, are maybe 10% or 20% due to this?

Professor Steve Turner: The children who are exposed to second-hand smoke in the home are over-represented among children with respiratory symptoms. Parents do not want their children to smoke, so they feel torn. They are conflicted: they are addicted to nicotine, but they do not want their children to smoke, and having a smoke-free generation will address that almost impossible parental conflict.

[John Whitby]

Q The Bill makes it illegal to sell vaping products to under-18s, and to proxy-buy vapes for children, but it does not make it illegal for under-18s to buy vapes. What is your view on that?

Professor Steve Turner: I support the Bill as it stands. I think that the onus has to be on the vendor not to sell, not on criminalising the customer or the child.

Tobacco and Vapes Bill (Third sitting)

Danny Chambers Excerpts

Committee stage
Thursday 9th January 2025 Public Bill Committees

[Dr Johnson]

Wisdom or age, but I shall be cautious not to answer too closely.

[Dr Danny Chambers (Winchester) (LD)]

I accept the view that having to provide ID will be inconvenient and frustrating for some people, but all the expert witnesses on Tuesday pointed out that many smokers do not wish the younger generation to continue smoking. I think that most of them would probably be of that view that the slight infringement of their civil liberties in having to carry ID is a small price to pay for the knowledge that they are preventing smoking from being taken up.

[Dr Johnson]

The hon. Gentleman is right that the measures have broad support. Certainly, the pollsters who have investigated people’s views of this legislation—that proposed by the previous Government and the legislation as it is now, with some tweaks to it—have found the public to be overwhelmingly positive. We legislate because we are elected by those people. On the basis of their opinions and given that policing in this country is done by consent—

Tobacco and Vapes Bill (Fifth sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[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.

[Dr Danny Chambers (Winchester) (LD)]

I am reticent to extend the discussion about cigarette papers; I was unaware it was possible to discuss something to such an extent. I am not legally trained, so I ask this for my own understanding as someone who is not a learned Member. If the exact same product was renamed and rebranded as model paper or musical instrument paper, would this law still apply to it?

[Andrew Gwynne]

That is a good question. Of course, if it was to be used for the consumption of tobacco, it would come within the scope of the Bill. We have to be clear that many of these products have dual uses, as we have heard. I am as guilty as anybody of making pipe-cleaner characters for my children and grandchildren—grandchild, rather, because I have only one so far.

We want to make sure that those who want to continue smoking are able to do so, but that obvious restrictions and boundaries are put in place regarding the accessibility of these products, so that no child born after 1 January 2009 will ever legally be sold them.

Tobacco and Vapes Bill (Sixth sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[Dr Johnson]

I thank my hon. Friend for his intervention. Last Tuesday, we heard in evidence from various medical sources, and both the Select Committee and our processor Bill Committee heard in evidence that nicotine is, of itself, harmful, and that the chemicals added to vapes are harmful. In some cases, they are extremely harmful. I will talk more about vaping chemicals later. Indeed, sometimes the products do not contain what they are expected to contain, and that can be worse still. I will return to that subject later, too.

Nicotine is highly addictive and can permanently affect the development of the adolescent brain. We have heard how the industry targets young people, and that is because the adolescent brain is particularly vulnerable. Nicotine can permanently affect its development. Nicotine also fulfils all the criteria for drug dependence. Giving it up is very difficult, and withdrawal symptoms can include cravings, irritability, anxiety, trouble concentrating, headaches and other mental symptoms. Symptoms associated with nicotine and dependence are often not recognised by novice smokers, particularly if they are young.

[Dr Danny Chambers (Winchester) (LD)]

On the subject of how nicotine affects the brain and brain development, one thing we have not really touched on—and we have touched on many physical health issues—is the incidence of smoking among people with mental health issues. One submission was from the Mental Health and Smoking Partnership, which said that 45% of people with a serious mental health issue smoke, and around 25% of people with clinical anxiety. It would stand to reason that the impact on a young person’s brain could also start to lead to serious mental health issues, as well as all the physical health and development issues.

[Dr Johnson]

The hon. Gentleman is right to raise the importance of managing nicotine dependence for those with mental health conditions. We know that smoking, in particular, is more likely to take place among people with mental health conditions or those who are in mental health in-patient units. I am sure we will go on to discuss the issue of vending machines.

Last May, in the previous Bill Committee, we heard evidence from the Mental Health Foundation about the myth that tobacco helps with anxiety, and how that myth needed busting. We also heard about the importance of giving extra support to people with mental health conditions to enable them to kick the habit of nicotine—whether that habit is smoking or vaping—because it will help both their physical and mental health. However, it can be more challenging for them to complete. I am grateful to the hon. Gentleman for raising that important issue.

Returning to clause 10, a study considering the effects in adolescents of nicotine dependence after the initiation of smoking cigarettes found that the symptoms of nicotine dependence can appear only a few days after initiation. Given that oral nicotine pouches contain similar or higher levels of nicotine, similar symptoms may appear following initiation of oral nicotine pouch use, which is why it is particularly important for children that we pass clause 10 and ensure that children are protected from these nicotine products.