Tobacco and Vapes Bill (First sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Mary Kelly Foy (City of Durham) (Lab)]

I cannot hear everything because of that noise, but I am co-chair of the all-party parliamentary group on smoking and health.

[Jim Dickson (Dartford) (Lab)]

I declare an interest as vice chair of the APPG on smoking and health.

Examination of Witnesses

Professor Sir Chris Whitty, Sir Francis Atherton, Professor Sir Michael McBride and Professor Sir Gregor Ian Smith gave evidence.

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[The Chair]

I am sorry, Sir Chris. Just for the purposes of timekeeping, which is my job, we have about 20 minutes left and five people wish to ask questions, so can we keep the questions as tight as possible, and within reason the answers as well?

Professor Sir Chris Whitty: I wanted to give the exact numbers, which I just found in my notes. Some 75,000 GP appointments a month are caused by smoking—just think of that when you phone up the GP—and 448,000 admissions to the NHS: again, think of that when you look at these areas. So the impact of this is really very substantial.

[Jim Dickson]

Q May I ask a question about some of the arguments from tobacco companies for heated products to be excluded from the tobacco regulations and the Bill—and presumably therefore the age of sale regulations. Would you have a view on whether that is a sensible proposal?

Professor Sir Chris Whitty: I have a very strong view. The tobacco industry is extraordinarily adept at pretending that it is on the side of the angels, and that it is trying to help with the problem. This goes along with slimline cigarettes, filters, low-tar cigarettes—many other marketing things, all of which claim to try and help with the health effects. Tobacco is extraordinarily dangerous, as well as being addictive. The heated tobacco products have probably slightly lower levels—they do have lower levels of the multiple chemicals that are toxic: multiple, not just one or two, but they are way away from safe levels. So heated tobacco products, while arguably being slightly lower in terms of the risk if someone had exactly the same amount, are a long way short of anywhere near safe, and they are still addictive. They also have some side-blow areas where they will have some issues for people around them as well. So the idea that this is some kind of solution only makes sense if you have shares in a company. So I would very strongly argue against trying to exclude these and carve these out.

Sir Francis Atherton: Nicotine is addictive however you take it—whether it is in heated tobacco, in cigarettes, in snus, in chewed tobacco or in shisha pipes—so in terms of protecting the next generation, the great value of this Bill is the flexibility to deal with not just the issues that we see in front of us, but the things that may well come down the pipeline in the future. I believe the Bill is flexible enough to allow us to protect the next generation from these terrible problems that flow from addiction.

[The Chair]

Sir Michael, you were nodding. Did you have any comment to make?

Professor Sir Michael McBride: I simply echo Sir Frank’s comments on the flexibility that the Bill affords us, and again confirm my agreement with Sir Chris’s comments. Let us be clear: there is no other product that causes life-limiting addiction, that kills two thirds—kills two thirds—of the people who use it. It is staggering, and this Bill provides us with an opportunity to address a scourge on our society. There is no safe tobacco product —none.

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[Mr Barros-Curtis]

Q Some of the evidence that has been submitted referred to the gateway effect and how there is perhaps not the evidence to suggest that there is a transition from one to the other. Are your organisations still concerned about the increase in vaping among groups who have not previously smoked cigarettes?

Sarah Sleet: That is a tricky one. We know that a lot of people who use vaping to stop smoking end up dual-using for a while. Some then move on to just vaping, and some eventually move completely away from it. We seriously need a comprehensive programme for nicotine cessation and smoking cessation to support people on that journey and make sure that people who go on that journey do not come back in. We heard earlier from ASH Wales about some really good measures that have been put in place, but without that wider context it is hard to cement the behaviour needed to move completely away from it. We need to think broadly about the whole support structure to help people to get off smoking and eventually to move away from nicotine altogether.

Dr Ian Walker: I agree. The real killer in the room, if you like, is cigarettes and tobacco. There is no safe way of consuming tobacco. The alternative of smoking versus vaping is very clear; even though we do not know the long-term health implications of vapes, we know that you are much better off vaping than smoking. Having said that, of course we do not want young people and never-smokers to vape either.

The power of the legislation is its double-pronged approach: preventing people from ever smoking in the first place by raising the age of sale by one year every year, and putting in place a comprehensive package of measures alongside that to control vaping, particularly the access to vaping and the appeal of vaping for young people, to reduce uptake in those communities. All those things together, alongside—you will forgive me for saying this—the investment that will be required for smoking cessation services and to support enforcement by Border Force, HM Revenue and Customs and retailers, will be important components of the Bill’s ability to drive the change that it can make.

[Jim Dickson]

Q Thank you for all your work to advocate for smoke-free legislation. Can I ask you about differential smoking rates across the country? Which parts of the country are likely to benefit most from this legislation as we see a decline in smoking rates and in tobacco use more generally?

Sarah Sleet: Health inequalities relating to lung disease are profound. The three conditions with the biggest gap in health outcomes between rich and poor are lung conditions: asthma, COPD and lung cancer. All three are profoundly affected by smoking, and smoking is concentrated in socially and economically deprived areas. Those in the poorest part of the country are twice as likely to smoke as those in the richest part of the country.

It is even more profound in certain segments. We heard that young mothers are four times more likely to smoke in poorer parts of the country than in richer parts. If we can drive down smoking, particularly among young people, the impact will be greatest in those areas that are most in need of help and support. This is probably one of the biggest things that can be done to tackle health inequalities. For that reason, I think the Bill is probably the most important public health measure being passed through Parliament in a very, very long time.

Dr Ian Walker: Thank you for the question, which I think is a really critical one. At CRUK, we have done a lot of research and work on cancer inequalities, which are part of broader health inequalities and which generally mirror similar trends. We know that people in the most deprived communities have higher incidences of cancer. They typically present at a later stage, they typically engage less with screening, they typically have worse outcomes and they typically do not get optimal treatment —it is a pretty difficult story right along the pipeline. The reasons behind that can be very complex and involve lots of different things.

Despite all that, the one thing we do know is that higher smoking rates, particularly among children and young people in the most deprived communities, are a really significant contributor to health inequalities. It is very clear from the evidence that the most deprived communities across the UK are the ones that suffer most from the impacts of tobacco.

This Bill is clearly not a magic switch—it will not change those things overnight—but it sets us on the pathway to fundamentally reversing some of those inequalities and to reducing some of the cancer inequalities that we see across the UK. Alongside the important measures in the Bill, a really clear, targeted set of actions around health marketing interventions in those communities and the effective funding of cessation services where we need them most will contribute to reducing health inequalities much more quickly and much more effectively. Again, it is a very positive story in terms of the potential impact on health inequalities.

[The Chair]

Thank you very much. As there are no other questions from Members, let me thank the witnesses, Ian Walker from Cancer Research UK and Sarah Sleet from Asthma and Lung UK.

Ordered, That further consideration be now adjourned. —(Taiwo Owatemi.)