London Health Commission: Smoking

Earl Howe Excerpts

Thursday 15th January 2015 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, I thank the noble Lord, Lord Darzi, for securing this important debate. As we have heard, the Mayor of London set up the London Health Commission in September 2013, with the noble Lord, Lord Darzi, as chairman, to review the health of the capital, from the provision of services to what Londoners themselves can do to help make London the healthiest major global city. In October, the London Health Commission published its report, Better Health for London, with a range of recommendations for the Mayor of London to consider. I congratulate the noble Lord, Lord Darzi, and the members of the London Health Commission on their well considered and thought-provoking report.

Local government has responsibility for improving health and well-being in its communities, including reducing rates of tobacco use. Noble Lords will understand that it is not for me as Health Minister to respond to the London Health Commission’s report. That is for the Mayor of London, for whom the London Health Commission prepared its report. I will, however, be very interested to see how the mayor progresses the recommendations that have been made.

Nevertheless, given the Government’s commitment to tobacco control, I particularly welcome this opportunity to tell your Lordships more about the work we are doing to tackle tobacco use. Tobacco remains one of our most significant public health challenges. Smoking is a leading cause of cancer, cardiovascular and respiratory disease; smoking is the primary preventable cause of morbidity and premature death; smoking is a significant driver of health inequalities and remains the biggest cause of inequalities in death rates between the richest and poorest in our communities; and smoking places an enormous strain on the NHS, while the overall economic burden of tobacco use to society is estimated at more than £13 billion a year. We must also remember that tobacco use is harmful not only to individual smokers, but to others around them.

Reducing smoking rates is a public health priority for this Government. In early 2011, we published the Tobacco Control Plan for England, which set out a comprehensive package of evidence-based action to be implemented at national level to support local areas in driving down rates of tobacco use. We also set out in the plan the importance of our efforts to reshape social norms around tobacco use to promote health and well-being. The noble Lord, Lord Faulkner, and the noble Baroness, Lady Finlay, asked what our plans were for refreshing the tobacco control plan. As they said, the plan sets out action until the end of this year. Like both noble Lords, I, too, hope that whoever are in government after the election continue to take comprehensive and effective action on smoking. However, it will be, essentially, for the next Government to take that decision.

From the outset, we ought to reflect the enormous amount of progress that we have made over the past decade. Smoking rates in England are at their lowest since records began. Today, around 18 per cent of adults are smokers, down from around half of adults smoking in the 1970s. Almost 2 million fewer people in England are smokers compared to a decade ago, and London has some of the lowest smoking rates in the country. We know that the majority of smokers take up smoking when they are teenagers. Most smokers were regularly smoking before turning 18 years of age—before they were able to make informed, adult decisions about tobacco use.

The good news is that rates of regular smoking by children in England between the ages of 11 and 15 years have declined by some 70 per cent since 2000. However, I want to be clear that continuing to reduce the uptake of smoking by children is essential. Research published in 2013 shows that every day around 600 children aged between 11 and 15 years start smoking in the United Kingdom.

The Government have taken action to protect young people from tobacco and nicotine addiction and a range of new powers relating to smoking were introduced through the Children and Families Act 2014. We have laid regulations to end smoking in private vehicles carrying children in England, which shortly will be considered in your Lordships’ House and in the other place. New legislation will stop adults buying tobacco on behalf of children.

The Department of Health is currently consulting on proposed regulations to bring the same age-of-sale requirements into place for electronic cigarettes that exist for tobacco. I would just say, on electronic cigarettes—mentioned by the noble Baroness, Lady Finlay—that while there is emerging evidence that e-cigarettes may be helpful to some people wishing to quit smoking, the quality of products on the market remains highly variable. We continue to work towards a regulatory framework that ensures for those smokers who want to use e-cigarettes to cut down or quit that they meet quality standards and are accompanied by sufficient information to enable informed choices. However, e-cigarettes are not risk free. We do not know enough about the long-term health effects of adults, let alone children, using e-cigarettes. Furthermore, as there have been no long-term studies to examine whether e-cigarettes serve as a gateway to tobacco use, we cannot be certain at this stage about whether there is a gateway effect from the use of e-cigarettes into tobacco smoking, so further research is needed to answer that question definitively.

The display of tobacco products in shops can promote smoking by young people and undermine the resolve of adult smokers trying to quit. Legislation to end tobacco displays has already been implemented for large shops such as supermarkets. All other shops selling tobacco, including corner shops, will need to end their displays of tobacco on 6 April.

The issue of standardised packaging for tobacco has been raised by almost every Peer who has spoken. I want to be clear that the Government have not made a final decision on whether to introduce legislation for standardised packaging. We held a final, short consultation that closed in August and the results are informing decision-making. It is important that the Government have time to carefully consider all issues relevant to the policy. I assure noble Lords that a decision will be made in due course. However, in saying that, I reassure your Lordships that we in the Department of Health are, as I speak, very actively working towards a decision. The draft regulations for standardised packaging were notified to the European Commission under the technical standards directive on 29 August. We have received detailed opinions from 11 member states, which extends the “standstill” period to six months. This will expire on 2 March 2015 and until then we are unable to make regulations, although I hear what the noble Baroness, Lady Finlay, says about laying regulations.

As regards evidence from Australia—

[Lord Faulkner of Worcester]

Before the noble Earl moves on, will he confirm that Sir Cyril Chantler’s report, which he commissioned, is helpful to him in coming to a view as to whether or not standardised packaging should be introduced? Does he accept the report and its conclusions?

[Earl Howe]

Undoubtedly it is extremely helpful although I am sure that the noble Lord would be the first to acknowledge that there are considerations that Sir Cyril did not address, which we obviously have to do across government before taking a final decision.

[Lord Naseby]

Can my noble friend assure those of us who take a detailed interest in this that the decision will be based on the independent evidence from Australia after two years of implementation against the yardsticks that that Government set?

[Earl Howe]

I am grateful to my noble friend. I was about to answer the question posed by the noble Lord, Lord Faulkner, on exactly that point. Evidence and experience continue to emerge from Australia, as my noble friend rightly said. I can reassure noble Lords that my department is looking very carefully at the evidence as it emerges. We will introduce standardised tobacco packaging if, having considered the evidence both here and around the world and other relevant information, we are satisfied—I emphasise “satisfied”—that there are sufficient grounds to do so.

The UK leads the world in supporting smokers to quit, and local authorities are now responsible for providing “stop smoking” services in their communities. The Government have continued to invest in tobacco marketing campaigns to encourage smokers to quit. Your Lordships may have seen Public Health England’s latest campaign that is currently running. Our “Stoptober” campaign has become hugely successful, encouraging smokers to quit for a whole month, giving them a significantly better chance of remaining smoke-free for good. Today, we offer smokers information and support through a range of media, including through the internet and mobile telephone applications.

A new European tobacco products directive has been agreed and will come into force in 2016. The new measures cover labelling, ingredients, tracking and tracing, e-cigarettes, cross-border distance sales and herbal products for smoking.

Making tobacco less affordable is proven to be an effective way of reducing smoking prevalence. The Government continue to follow a policy of using tax to maintain the high price of tobacco at levels that have an impact on smoking prevalence. In the Autumn Statement, my right honourable friend the Chancellor of the Exchequer announced that the Government will consult on whether to introduce a levy on tobacco manufacturers and importers. That consultation is now under way.

The Government have taken sustained action to reduce levels of illicit tobacco, and over the past decade, the illicit market has declined significantly. In the past two years, nearly 3.6 billion illicit cigarettes and 1,050 tonnes of rolling tobacco have been seized. Local authorities continue to take their own action against illicit tobacco, which is to be welcomed.

Smoke-free legislation, implemented in 2007, has had beneficial impacts on health. I would say to my noble friend Lord Naseby, who mentioned this, that the legislation has been highly successful in terms of public health and it continues to be popular and well complied-with, on the whole. The Government have no intention of amending this important legislation along the lines suggested by my noble friend. As I said, levels of compliance and public support for the law are high. While smoke-free legislation covers enclosed work and public places, local authorities may wish to take action to limit smoking in open-area environments. That is a recommendation in the London Health Commission’s report. However, I do not believe that changes to smoke-free legislation would be needed to achieve this. I commend local authorities across England for the commitment they have shown to reducing tobacco use; for example, more than 80 councils have signed the Smokefree Action Coalition’s Local Government Declaration on Tobacco Control.

My time is up. I will finish by saying that the Department of Health has worked actively to support the implementation of the World Health Organization’s Framework Convention on Tobacco Control, including protecting tobacco control from vested interests, and is today regarded as a global leader in the implementation of effective tobacco control policies. The UK deserves that reputation and I am proud to be able to share with your Lordships the news that the Department of Health has just been named as the winner of the American Cancer Society’s prestigious Luther L Terry Award for exemplary leadership by a government ministry in the field of tobacco control.

[Noble Lords]

Hear, hear!

[Earl Howe]

With that, my Lords, I end by thanking the noble Lord, Lord Darzi, once again for this debate.

Committee adjourned at 5.57 pm.