Tobacco Control Plan

Ian Paisley Excerpts

Tuesday 16th November 2021 Westminster Hall

[Bob Blackman]

My hon. Friend is quite right. Nicotine is one of the most addictive drugs on the market, if not the most addictive, and perfectly legal to consume. The issue is whether someone, once addicted to nicotine, can quit. The damage is done not necessary by the nicotine, but by the delivery mechanism by which someone gets the nicotine.

Anything that reduces the risk of cancer or other related diseases has got to be good news. We can migrate people and encourage them to quit. Ideally, they give up completely. However, because it is so addictive they may need help and assistance to do that. Vaping and non-heated tobacco are ways of migrating people to safer means of delivering the nicotine they desire.

Taking up the point made by my right hon. Friend the Member for South West Wiltshire (Dr Murrison), ending smoking is essential if we are to level up the nation’s health after the pandemic. We need to reduce health inequalities between rich and poor, and increase healthy life expectancy by five years by 2035, in line with the Government’s manifesto commitments.

As well as being necessary, tobacco control measures are popular with voters for every main party, including the Conservative party, which both my hon. Friend the Minister and I represent. Results from the annual YouGov survey of over 10,000 adults in England, funded by Action on Smoking and Health, show that more than three quarters of the public support the Government’s smoke-free 2030 ambition, and eight out of 10 members of the public support Government intervention to limit smoking.

The Government have the full support of the APPG in delivering the smoke-free 2030 ambition. However, as the Government stated in the 2019 prevention Green Paper, achieving that ambition will require “bold action.” Inequalities in smoking rates have grown in recent years, not shrunk. In order to be smoke-free by 2030, we need to reduce smoking by two thirds in just a decade—we have only nine years left to achieve that—and by three quarters for smokers in routine and manual occupations. At current rates of decline, Cancer Research UK has estimated we will miss the target by seven years, and double that for the poorest in society.

There are still nearly 6 million smokers in England. We will only achieve a smoke-free 2030 by motivating more smokers to make quit attempts, using the most effective quitting aids, while also reducing the number of children and young adults who start smoking each year. With 1,500 people dying from smoking-related diseases every week and less than a decade to achieve a smoke-free 2030, there is no time to waste.

Disappointingly, with the end of the year in sight, there is still no sign of the tobacco control plan that was promised this year. My first question to my hon. Friend the Minister, therefore, is whether she can she set out a timeline for the publication of the next tobacco control plan. But the tobacco control plan is only as strong as the measures it includes. That is why the APPG was disappointed that the Government rejected the amendments to the Health and Care Bill tabled by my friend the hon. Member for City of Durham (Mary Kelly Foy), and supported by myself and other officers of the APPG, in Committee.

Those amendments would have closed the loopholes in the regulations that expose children to the insidious marketing tactics of the tobacco industry, provided funding for tobacco control and strengthened the regulation of tobacco. As it stands, the Bill fails to include a single mention of smoking or tobacco and represents a major missed opportunity to introduce key policies for achieving a smoke-free 2030. That is why we have retabled the amendments on Report. I hope the Government will look at them sympathetically, because the Bill is the ideal opportunity for them to deliver their 2019 commitment to finish the job and introduce the legislation that is needed if we are to achieve a smoke-free 2030. My second question is whether the Minister will commit to considering the adoption of tobacco amendments to the Health and Care Bill on Report.

My next area is the “polluter pays” levy. The bold action that the Government acknowledge is needed cannot be taken without investment. The Health Foundation estimates that a minimum £1 billion is needed to restore public health funding to its 2015 levels, with more needed to level up public health across the country. While there was some positive news on tobacco taxation in the recent spending review, which we welcomed, unfortunately the Government opted not to increase the public health grant to local authorities. As a consequence, we need to establish new sources of funding.

The Government promised to consider a US-style “polluter pays” levy on tobacco manufacturers in the 2019 prevention Green Paper. This scheme would mirror the approach taken in the United States, where user fee legislation raises $711 million annually from the tobacco manufacturers, with the funds then used to cover the cost of stop smoking campaigns, tobacco control policy development, implementation and enforcement.

[Ian Paisley (North Antrim) (DUP)]

I must say that I am opposed to punitive taxation policies, because I do not think they work. Does the hon. Member accept that tobacco companies already pay the Government £13 billion? An additional levy could lead—and most likely would lead, as the evidence shows—to a significant increase in criminality, because instead of paying for taxable product, people will buy smuggled product. Is that not a huge worry that he has about introducing a levy?

[Bob Blackman]

I will come to some of these issues in a few moments, if the hon. Gentleman will be patient and let me build the case. Obviously, it has been estimated by ASH that the funding needed for a comprehensive tobacco control plan to deliver a smoke-free 2030 would cost around £266 million for England and £315 million in total for the UK. A levy could raise around £700 million from the tobacco manufacturers, to be spent on tobacco control and other public health initiatives. The devolved Governments would also have the ability to opt into the scheme, should they so wish.

Such a scheme is more than justified in response to market failure that allows an industry, whose products kill consumers when used as intended, to make exorbitant profits. While net operating profits for most consumer staples, such as food, beverages and household goods, stands at 12% to 20%, Imperial Brands in the UK enjoyed net operating profits of 71% in 2019. That is £71 in profit for every £100 in sales. In 2018, it is estimated that tobacco manufacturers made over £900 million in profits in the UK alone.

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[Ian Paisley (North Antrim) (DUP)]

I declare an interest as the chair of The Gallaher Trust, which was set up half a dozen years ago in the wake of the closure of tobacco production in Northern Ireland. It was named after Tom Gallaher, a huge industrialist in Northern Ireland who created tens of thousands of jobs. Although the charity has absolutely nothing to do with the promotion, sale or development of tobacco—it is a skills development charity, of which I am an honorary and unremunerated chairman—I think it is important to put my interest on record, because of the association that people may draw from that.

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing the debate. He has presented the arguments in the way that he always does, very persuasively. It is important that we have had a very good, healthy debate. It has showed that we are probably all on the same page. We want to get to the same finish line, but there are differences in nuance and in how we get there. I think it is important that we explore those differences and we try to get there in the best, most efficient and effective way.

Any tobacco control plan must be evidence-based, not based on emotions. Evidence is key. Innovations to support quitting smoking are crucial to the plan. We have heard something of the detail from the hon. Member for Rugby (Mark Pawsey) and others who are very keen that we develop innovation to ensure a systematic quitting of smoking. The evidence shows that high punitive taxation policies simply do not work. For someone growing up in a deprived society, whose parents have low wages, and where cigarettes—a lawful product in the local shops—are nearly £15 a pack, the temptation to purchase a pack for a fiver from someone round the local pub is huge and significant. The real thrust of any tobacco control plan must go hand in hand with a plan that addresses criminality. Aside from one or two vague mentions of criminality, that is what is absent from the plan.

We have to focus on criminality. We can tax this product until it squeaks even more, but unless we address the criminality that lies behind illegal product and illegal product sales across the United Kingdom, I am afraid that consumption rates will stay at a very high, stubborn level. I do not believe that there are fewer than 10 million smokers in the United Kingdom. I think that anyone who believes that is in cloud cuckoo land. Walk down any street in this city and count the first 100 people. I would say that in excess of 20 people on average are smoking. That is a rudimentary calculation. In other places it is considerably higher—in night culture, for instance. Let us face the fact that smoking consumption is probably at a much higher rate than the figures suggest. Therefore, all the punitive taxation policies that have been adopted by the United Kingdom—and they are the highest in the world—are not addressing the stubborn fact that people are continuing to smoke.

Let us pivot and get on to other counteracting measures. Where do those other measures rest? I believe there is a role for partnership with experts. Three things need to be done. We need to explore, develop and ensure that new products are brought to the market expeditiously. We need to engage a huge amount of effort in education, especially for young people and women. We need to make sure there is adequate, sensible and robust enforcement against criminality.

As has been mentioned today, there is a full range of new products already on the market to ensure that less harmful products are available to smokers, helping them to reduce their habit and get away from smoking. I applaud companies that have created e-cigarettes, nicotine patches, heated products and vaping, to encourage people away from the very harmful addiction to tobacco and nicotine. Those less harmful alternatives must be pursued and we must encourage their use, not discourage it. Indeed, the points that were made earlier regarding misinformation about those products should be addressed sensibly by central Government. There must be co-operation with responsible companies that want to make their lawful product and pay tax on it. That co-operation should allow research and development to happen, to enable them to get away from manufacturing the single product that they currently produce.

Some mention has been made today of the levy, and it was suggested that there should be a new levy on tobacco manufacturing companies. As I said earlier, we in the United Kingdom pay the highest taxes in the world on a pack of cigarettes—I think that 90% of what we pay for cigarettes goes to the Government—but that high tax has not solved the problem by reducing consumption. What happens is that people are driven towards buying unlawful products, thinking that that is a harmless activity. Many people who purchase cheap cigarettes think that they come over from mainland Europe in a white van and do no one any harm, but of course most of those products are illegally made. They are not made by the tobacco companies. What is inside those products is beyond tobacco and therefore, incredibly, they are even more harmful than cigarettes. People do not necessarily realise it, but selling those products is a huge and significant crime in our kingdom.

In the last number of years, over £1 billion-worth of illicit cigarettes have been sold in the United Kingdom. This is not a problem exclusive to Northern Ireland; in fact, we are the minority. This is a multi-million pound problem across the whole United Kingdom, and we have to get to grips with it as soon as we can. That multi-million pound crime syndicate needs to be broken up and destroyed.

Regarding taxation, in 2019-20 tobacco alone accounted for £11.25 billion of the Government’s revenues. However, if we set against that the criminal sales of tobacco, we see that the Government lost almost £3 billion in tobacco revenue. There is a huge gap that could be made up. On the point about a levy, if there was proper enforcement against the criminals, an extra £3 billion would be available—legitimately raised from legitimate sales—for things such as the promotion of education, research and development. Imposing another levy on the tobacco companies is lazy and would not address the problem of crime; indeed, that problem would continue to grow. Until we face up to that, we will keep coming back to this House—year in and year out, decade in and decade out—and inflating taxation but seeing consumption remain stubbornly high.

Let us address the real issue of properly attacking the criminals. In 2020, HMRC gathered an additional £1.4 billion through its border control activities. That was an untapped source of new revenue, which came about largely as a result of Brexit and having more control of our borders, but also because of the pandemic and the inability to travel to and from the continent to bring illegal products in. The Government were able to raise revenue under those circumstances. With a little bit of ingenuity, they could continue to raise that additional £1.4 billion in previously untapped sources by clamping down on gangs and gathering the revenue that the public are entitled to have gathered on their behalf; that is something that HMRC should do proudly.

As Members know, there is a £10,000 on-the-spot fine for criminals engaged in evasion of tax on tobacco. People might say that that is a very high fine, but it is not. A case of illicit cigarettes is worth hundreds of thousands of pounds in illicit sales to a criminal, and a van full is worth over £1 million. Why is the on-the-spot fine not something like £50,000 or £100,000, in view of the sums that the criminals make? For every van that HMRC captures, at least 20 or 30 get through, so let us make sure that we have proper enforcement. The high price of a pack of cigarettes simply encourages people, especially those with less disposable income, to purchase illicit products.

I understand the point that was made about the age limit, but if we are going to change the age limit for smoking, we have to look at the whole panoply of age limits across the United Kingdom—for alcohol consumption, driving, betting and smoking. It would be incredibly difficult to enforce different age limits rather than having a standardised one. If a 20-year-old tells a shopkeeper that they are 21 and they want to buy a pack of cigarettes, that would be incredibly difficult to enforce. Shopkeepers already find it hard to tell an 18-year-old from a 14-year-old in some circumstances.

Let us make sure that we have a standardised age for sales rather than different ages for different products. I do not think the Government are looking at that point, but it will no doubt gather momentum, because it seems to be an easy solution. None of these easy solutions work. Hard attacks against criminal enterprises are where we will make a significant difference.

We need to avoid the danger of virtue signalling—I am not saying any of that has gone on today; we have had a good, positive and practical debate—and move towards evidence-based solutions, including by encouraging companies to make less harmful product available to the public, by enforcing and controlling the legitimate enterprises of business and by ensuring that criminals are not allowed to get away with their multibillion-pound criminal enterprise. Otherwise, we should really go the whole hog and ban tobacco altogether in the United Kingdom. To achieve some of the goals that have been set out, that is where this debate has to be taken. It is not being taken there at present, but we need to get real on this.

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[Maggie Throup]

I could not agree more with my hon. Friend. The burden of tobacco harms is not shared equally: smoking rates are far higher in poorer areas of the country, and among the lowest socioeconomic groups. Alongside the tragedy created by illness and early deaths, the NHS bears the heavy financial burden of £2.5 billion every year from smoking. In 2019-20, smoking was responsible for nearly half a million hospital admissions and around 64,000 deaths.

The Government have set the bold ambition for England to be smoke free by 2030. To support that ambition, we have been building on the successes of our current tobacco control plan. We will soon publish a new plan with an even sharper focus on tackling health disparities. That new plan will form a vital part of the Government’s levelling-up agenda and will set out a comprehensive package of new policy proposals and regulatory changes, to enable us to meet our smoke-free 2030 ambition.

We are, of course, carefully considering the recommendations of the all-party parliamentary group on smoking and health. Our new tobacco control plan will look to further strengthen our regulatory framework. We are exploring various regulatory proposals, including those put forward as amendments to the Health and Care Bill. We will conduct further research and build a robust evidence base in support of such measures, and will include the strongest proposals in the new plan.

One continuing concern is that one in 10 pregnant women are still smokers at the time of delivery, which is something that the Government are determined to tackle. The maternity transformation programme contains some important measures, and we have made a commitment under our NHS long-term plan that pregnant mothers and their partners will be offered NHS-funded treatment to help them to quit. I know that issue is close to the heart of my hon. Friend the Member for Harrow East. Our new plan will continue to have a strong focus on pregnancy and will encourage more innovation and new approaches to help mothers to quit.

The evidence is clear that e-cigarettes are less harmful to health than smoking. It remains the goal of the Government to maximise the opportunities presented by e-cigarettes to reduce smoking while managing any risks. Our regulatory framework enables smokers to use e-cigarettes to help them to quit, but we do not want to encourage non-smokers and young people to take up those products. In the current tobacco control plan we have actioned the MHRA to help bring medicinal e-cigarettes to the UK market. On 29 October, the MHRA published updated guidance to encourage manufacturers to do so.

Stop-smoking services remain at the heart of our tobacco control strategy, producing high quit rates of 59% after four weeks. Since 2000, they have helped nearly 5 million people to quit. We have protected the public health grant over the course of the spending review, to ensure that local authorities can continue to invest in stop-smoking services and campaigns specific to their areas. We will continue to support local authorities to prioritise those services.

The UK has been recognised as a global leader in tobacco control. We are proud to be a member of the World Health Organisation framework convention on tobacco control. My officials played an active role in the ninth conference of the parties—COP9—last week, and reaffirmed our commitment to deal with the global tobacco pandemic. It was a robust meeting, with more people attending than ever. In my video statement to COP9, I set out the UK commitment to having comprehensive tobacco control policies, including a strong regulatory framework for e-cigarettes. Our commitment to the WHO FCTC is further demonstrated through the overseas development funding we contribute to the FCTC 2030 project, which is now entering its sixth year. That project directly supports the implementation of the WHO FCTC in 31 low and middle-income countries, helping to reduce the burden of death and disease from tobacco.

I will now address some of the issues raised by right hon. and hon. Members. My right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about restrictions imposed during covid. Covid has highlighted the health disparities across the country. Our ambition to be smoke free by 2030 will play a major role in tackling those disparities. I would like to reassure my hon. Friend the Member for Harrow East that I am conscious of the urgency of the publication of the tobacco control plan. However, I am determined that the plan will have robust and effective measures. He also highlighted measures that the APPG would like to see included. Along with my officials, I am looking carefully at each measure put forward.

Tobacco taxation was raised by my hon. Friends the Members for Harrow East and for Broxbourne (Sir Charles Walker), as well as the hon. Member for North Antrim (Ian Paisley). That is a matter for Her Majesty’s Treasury. However, the Department continues to work with HMT to assess the most effective regulatory means to support the Government’s smoke-free 2030 ambition, which includes exploring a potential future levy.

[Ian Paisley]

Will the Minister give way?

[Maggie Throup]

I am a bit short of time.

On raising the age from 18 to 21, we know how important the period between the ages of 18 and 21 is for those who may experiment with tobacco. We will include a focus on protecting young people and adults from the harms of tobacco within our tobacco control plan. As I have already indicated, I am ambitious for our new plan.

On the Health and Care Bill, at this stage we do not feel that it is the right Bill for the suggested measures without a full assessment. Members should rest assured that they will be fully considered as the tobacco control plan is finalised.

The hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Rugby (Mark Pawsey) asked about the post-implementation reviews. The Department will publish its response in the coming months. I make no excuse for the delay. We had more than 5,000 responses to that review, and that was coupled with the pressures that my Department has experienced on covid-19. I reassure colleagues that it is on our agenda and we will publish in due course.

The hon. Member for City of Durham also asked about the investigations into menthol. The Office for Health Improvement and Disparities is investigating a range of cigarettes to determine if the flavour of menthol is noticeable. Once that study is complete, we will explore whether further action is needed against companies that have breached regulations.

My hon. Friend the Member for Rugby asked a number of questions. I understand that the ONS will publish smoking prevalence data for 2020 next month.

As I have already said, COP9 was one of the best attended conferences of the parties so far. I understand that there was a real buzz and an appetite to address the harms from tobacco and implement the framework convention on tobacco control, which I am sure will be welcomed by everybody in the room.

My hon. Friends the Members for Rugby and for Northampton South (Andrew Lewer) spoke about e-cigarettes. The Government are clear that we only support the use of e-cigarettes as a tool for smokers who are trying to quit, not as a route for people to take up smoking by another means. Our approach to e-cigarettes has been and will remain pragmatic and evidence-based.

My hon. Friend the Member for Northampton South talked about the environment that those who are attempting to quit find themselves in. Vaping is not covered by the smoke-free legislation. It is down to individual businesses to determine how they consider the guidelines.

I extend my thanks to hon. Members for their participation in today’s debate. It has been very constructive and there is clearly cross-party support. I reiterate the Government’s commitment to a smoke-free 2030. As we build back better from the pandemic, our aim is to make smoking truly a thing of the past and level up society.