COP10: WHO Framework Convention on Tobacco Control

David Jones Excerpts

Thursday 18th January 2024 Westminster Hall

[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.

--- Later in debate ---

[Karin Smyth (Bristol South) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Vickers. I understand that this is the third debate this week about tobacco and vaping, so the subject is getting a good airing. I confess that I was not expecting to have a debate about sovereignty and taking back control this Thursday when talking about smoking, but one always has to be prepared to be taken back, as the Minister says. Like colleagues, I thank the hon. Member for Northampton South (Andrew Lewer) for securing this debate, and I thank the right hon. Member for Clwyd West (Mr Jones), my hon. Friend the Member for Ealing, Southall (Mr Sharma) and the hon. Member for Christchurch (Sir Christopher Chope) for their contributions and the work they do in this area.

As we have heard, the convention on tobacco control was adopted in 2003 and came into force in 2005. It has since become one of the most rapidly and widely embraced treaties in UN history. It was developed in response to the globalisation of the tobacco epidemic, and a quick glance at the statistics tells us why. Tobacco kills up to half its long-term users. It is responsible globally for an estimated 8 million deaths per year, 1.2 million of which are of non-smokers exposed to second-hand smoke, yet the global market is still worth more than £800 billion a year. Tobacco remains the largest cause of health inequalities, accounting for as much as half the difference in amenable mortality between the most and least deprived communities in the country.

My hon. Friend the Member for Ealing, Southall highlighted the work that he has done, particularly on reducing smoking among minority and ethnic communities. In my constituency, the tobacco industry has historically employed many thousands of people and there is a long legacy of tobacco, which can be seen in the higher rates of chronic obstructive pulmonary disease and other smoking-related conditions in Bristol South. Tobacco costs the taxpayer tens of billions every year, putting increased pressure on the NHS and care system, as well as contributing to the productivity crisis through lost earnings, unemployment and, sadly, early deaths.

That is why the Labour party is committed to building a smoke-free future. It is why we have said that we will support the Government’s measures to raise the legal smoking age by a year every year, so that a 14-year-old today will never legally be able to buy a pack of cigarettes. It is also why we would make sure that all hospital trusts integrate opt-out smoking interventions into routine care, so that every interaction with the NHS encourages quitting. Unlike the hon. Member for Linlithgow and East Falkirk (Martyn Day), I am a former smoker who did have to quit. I pay tribute to the people who do it: it is a very hard thing to do.

This is a global issue, which is why we have to tackle it globally. We have seen the tactics of the tobacco industry over many years. Hugely profitable multinational companies will use their muscle in individual states—we have seen in Uruguay, Vietnam and elsewhere how they will behave —so working together seems to be the way forward. The establishment of the WHO framework two decades ago is an important milestone in tackling a public health hazard. It encourages parties to implement common-sense policies that have strong public support, such as protecting public health policies from commercial and vested interests; protecting people from secondary smoke; and bans on advertising and on so on. Those have been developed over many decades.

As we have heard, the next conference of the parties will be the 10th since the convention entered into force and will take place in Panama. Agenda items up for discussion will be articles 9 and 10 of the convention, on the regulation of the contents and disclosure of tobacco products, which is addressed by the UK’s Tobacco and Related Products Regulations 2016. We all seem very keen to send the Minister to Panama—the right hon. Member for Clwyd West suggested a boat, which would take her some length of time—so we are all interested in whether she is going, and, more specifically, how she will be instructing the UK delegation to approach these really important discussions.

Does the Minister have any plans to bring other nicotine products, such as nicotine pouches, into the regulatory process as part of the Government's forthcoming legislation? Many colleagues will have received letters from constituents about e-cigarettes and vaping, which will be discussed at COP10. We hear what they are saying. E-cigarettes are an important tool for stopping smoking. Evidence indicates that they are less harmful than cigarettes, and that their use shows a positive association with quitting smoking, as we have heard so eloquently from colleagues today—something we would support. Particularly in this month, January, many smokers are grappling with their new year's resolutions, and we fully support them in that journey however we can. We must acknowledge, however, that vaping is not risk free, particularly for people who have never smoked, and that there is a lack of evidence on the long-term health impacts.

As we have said many times in this House, we are particularly concerned about the rise in youth vaping. In just the past two years, the number of children aged 11 to 17 who vape regularly has more than trebled. Over 140,000 more children have taken up vaping since the Government voted down Labour’s proposed measures in 2021 to crack down on companies that brand and advertise vapes to appeal to kids. We want tougher regulation of those products and for a strong message to be sent to those companies trying to make a profit at the expense of our children’s health. I hope that Ministers, via their role in the WHO, will push harder for stronger and clearer messages, based on the latest data and evidence, and seek to regulate this market in a way that promotes quality and safety and, crucially, that protects young people.

Will the Minister use the forthcoming tobacco and vapes Bill to close loopholes that allow nicotine-free vapes to be sold to under-18s, and free samples of even addictive nicotine products to be given to children? Is she considering strengthening the powers of the regulator, the Medicines and Healthcare products Regulatory Agency, to deal with the number of illegal vaping products circulating on the UK market today? She is welcome to our policy—will she back our proposal to ban companies from branding and advertising vaping products in a way that is appealing to children?

Just as the last Labour Government led the way on tobacco control, so will the next, with a road map to a smoke-free Britain. We want to make sure that hospital trusts integrate opt-out smoking cessation interventions into routine care, making every clinical consultation count. We will legislate to require tobacco companies to include information in tobacco products that dispels the myth that smoking reduces stress and anxiety, and tackle the rapid rise in youth vaping, on which the Government have failed to act so far. To tackle health inequalities and rescue the NHS from 14 years of decline, we need bold measures to tackle smoking and improve public health.

[Mr David Jones]

Could the hon. Lady say what measures she proposes to put in place to tackle the issue of youth vaping?

[Karin Smyth]

I am sure the right hon. Gentleman took great notice of the Labour party conference, where we announced a ban on targeting, and advertising and marketing to, young people. We think that where there is a will, there is a way. The ban on smoking, which I remember very well from when I was part of an NHS trust, was an incredibly difficult thing to do and enforce. But when the Government make clear that the targeting of young people is completely unacceptable, the market will react. We want to work with companies to make sure that happens. That is our plan for doing that and for getting the NHS back on its feet and making it fit for the future.

--- Later in debate ---

[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.

[Mr David Jones]

Does my right hon. Friend know why the WHO exhibits such hostility to the harm reduction measures that the United Kingdom Government are putting in place?