Tobacco and Vapes Bill (Seventh sitting)

Jim Dickson Excerpts

Committee stage
Thursday 16th January 2025 Public Bill Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to serve under your chairmanship, Sir Roger. May I start by not only thanking the shadow Minister for her support, but congratulating my hon. Friend the Member for Dartford on his birthday? [Hon. Members: “Hear, hear!”] It is a real pleasure that we are able to provide him with a full day’s entertainment—better than Netflix.

[Jim Dickson (Dartford) (Lab)]

I thank the Minister very much for his birthday felicitations. There is nowhere I would rather be than here.

[The Chair]

I only hope that is not open to challenge.

Tobacco and Vapes Bill (Sixth sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

Moving forward, nothing much changed until 1927 when a man called Joseph Robinson in New York filed a patent for a device he called a medical butane ignition vaporiser. That never really made it off the drawing board, but it shows how the early idea of an e-cigarette first came into play as an alternative to smoking. Numerous patents for nicotine inhaler devices were filed throughout the 20th century and early 2000s by tobacco companies and individual vendors, with a flurry of activity in the 1990s. But the first commercially successful e-cigarette was invented by a smoker who wanted to quit, so it was initially conceived as a device in that regard. In 2004, a pharmacist in China called Hon Lik invented—

[Jim Dickson (Dartford) (Lab)]

I applaud the hon. Lady for her admirable history lesson on the background of vaping. Can I ask how it is relevant to what we are discussing in terms of the penalties and the sale of products?

[Dr Johnson]

It is relevant because we are discussing a product in the UK that we are considering essentially doing away with, and banning completely for children. The hon. Gentleman may note that we discussed the history of tobacco when we debated clause 1, on tobacco, and no less than two Members of the hon. Gentleman’s own party talked about how interesting and relevant that was—[Interruption.] At least one of those individuals appeared very genuine.

Let me go back to Hon Lik, who invented the first e-cigarette as a way to cure his own smoking addiction and to try to prevent deaths such as his father’s from lung cancer—and we have talked much about the potential for smoking to cause lung cancer. The basic concept of mimicking smoking via vaporising liquids remains the same. The company he started was later bought as a subsidiary of Imperial Tobacco, which again demonstrates that the industry will continue to try, where it can, to be involved in nicotine addiction.

The World Health Organisation proclaims that it does not consider electronic cigarettes a legitimate smoking cessation aid. It demands that marketers immediately remove from their material any suggestion that it considers electronic cigarettes to be safe and effective. In 2011, the WHO released a report on e-cigarettes recommending that they be regulated in the same way as tobacco products. Clause 10 will do some of that, inasmuch as it will bring e-cigarettes in line with the legislation on tobacco products so that they cannot be sold to under-18s. However, it does not go so far as to bring it in line with the new smoke-free generation legislation. The Minister may wish to comment on why he has not done so.

In the last Bill, the hon. Member for York Central (Rachael Maskell) tabled an amendment that would have included nicotine products in the smoke-free generation legislation, banning them for those born after 1 January 2009 rather than just for under-18s. Her concern, as I understand it, was that the industry would pivot to other forms of nicotine that did not contain tobacco, hook a new generation on them and use similar marketing techniques to hook them on a lifetime of nicotine addiction, as it once did with tobacco. The Minister could seek to avoid that by preventing non-medicinal products containing nicotine from being used by anyone born after 1 January 2009. That power is within his grasp. On a personal level—this is not necessarily my party’s view—I would like him to seize that power.

The sale of vaping products to under-18s is addressed in clause 10. One of the reasons for restricting the sale is the range of pulmonary and coronary conditions—lung and heart conditions—that can occur for people who vape. To help us to understand why they are so damaging, it is important to understand what is in vapes per se. This is not just about nicotine products; it is also about vaping products.

As I say, nicotine is an extremely addictive substance that disrupts brain development in adolescence. Because adolescence is a critical time for neural development, it makes young people particularly vulnerable to the negative effects of nicotine. Adolescence is marked by substantial neurodevelopment, including synaptic pruning and the maturing of the pre-frontal cortex, the part of the brain that governs decision making, impulse control and emotional regulation. Nicotine exposure during this period can disrupt those processes, leading to lasting cognitive and behavioural impairment. Research indicates that nicotine alters the neurotransmitter systems, noticeably those using acetylcholine and glutamate receptors, affecting the neural pathways essential for learning and memory development. Nicotine exposure during adolescence has been linked to deficits in attention, learning and impulse control. Studies have shown that adolescents using nicotine products exhibit diminished cognitive performance and are more prone to mood disorders, including depression and anxiety.

Another reason to get rid of these products, which relates to the point made by the hon. Member for Winchester, is that they can lead, in and of themselves, to problems with mental health. As hon. Members will know, these issues can adversely affect academic achievement—as we have heard from teachers’ evidence in the past and evidence to this Committee—and social interactions, potentially leading to broader physical challenges.

Hospice and Palliative Care

Jim Dickson Excerpts

Monday 13th January 2025 Commons Chamber

[Gregory Stafford (Farnham and Bordon) (Con)]

Hospices provide vital care for adults and children with life-limiting conditions, offering end of life care, pain management and bereavement support to families, but despite being this essential part of healthcare, the hospice sector has challenges due to inadequate Government funding and the taxes that they are putting on it, and to workforce shortages. That is all compounded by rising costs and economic uncertainty.

Before I became a Member of Parliament, I have to confess that I had, perhaps fortunately, very little contact with the hospice sector, despite having worked in health and social care for the majority of my career and being a local government councillor for 17 years. During the election campaign, I was invited to the Shooting Star children’s hospice, which has been mentioned by numerous Members across the House. I visited Christopher’s, which is its in-house care facility in Guildford. I think it is actually in the constituency of my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt)—I am sure that the hon. Member for Guildford (Zöe Franklin) will correct me if I am wrong. There I saw the true meaning of selfless day-to-day acts of kindness and care, with people looking after some of the most vulnerable children and their families. They are the absolute exemplar of people providing dying well.

I also have the Phyllis Tuckwell hospice in my constituency, which is currently going through a multimillion-pound rebuild funded by donations from people who have either used or care for our hospice in Farnham. When it is open—hopefully by the end of the year—it will provide 18 new palliative care beds alongside rehabilitation and services for the families as well, along with therapy sessions. Both are shining examples of what dying well should look like.

As other hon. Members have mentioned, the one good thing to come out of the assisted dying debate has been a much greater focus in this House, and indeed across the country, on what it means to die well. I echo some of the comments we have heard: let us get palliative care and hospice care right first, before we start thinking about whether or not we should be allowing people to kill themselves.

Despite the Government’s announcement just after Christmas, which I would be churlish not to welcome, the reality is that adult hospices and children’s hospices are almost totally reliant on charitable donations. The rest comes through the integrated care boards and, as the hon. Member for Scarborough and Whitby (Alison Hume) just mentioned, it is a complete postcode lottery.

I am grateful to the hon. Member for Wimbledon (Mr Kohler) for securing the debate, and he mentioned the significant variation in per person funding depending on where they are in the country and at which hospice they are being treated. The children’s hospice sector is the starkest example, with some places funding just under £30 a head, whereas others fund over £500 a head. This inequity in care clearly leaves some families worse off.

The Government really have not made it easy for the hospice sector. It is still not clear to me that the Health Secretary and the Department of Health had any clue that the national insurance contribution changes were coming down the line. If they were aware, had they allocated this funding beforehand? Was this in their plan, or have they been scrabbling to try to make up the difference since they heard this announcement? Despite asking questions, I have not heard an answer.

We also have not heard whether the Government will cover the costs of the national insurance contribution rise. My personal view is that they must, because the hospice sector, alongside so much of the care sector, is vital not just to the people who use it, but to the wider health economy. Underfunding and taking money from hospice care will have a significant cost impact on other parts of the health service.

[Jim Dickson (Dartford) (Lab)]

The hon. Member seems to welcome the additional £100 million for the hospice sector and, indeed, the additional investment in the NHS that have come out of the Budget, but he seems not to welcome the way in which that revenue is being raised. How would his party raise the revenue needed for the NHS and the hospice sector?

[Gregory Stafford]

Well, the simple fact is that what the hon. Members and his Front-Bench team are doing is ensuring that the NHS is worse off, because raising the money will have a greater impact on the rest of the service. [Interruption.] The Minister for Care is shouting at me from the Front Bench, and I am sure that, in his response to the debate, he can outline whether he and his team knew about the national insurance contribution rises and whether they planned for them.

The other part of this is the workforce, who have been touched on briefly. There is a real shortage of qualified healthcare professionals. Vacancy rates for hospice nurses have risen to nearly 19%, and the corollary is that staff morale is low. Again, the Government need to make sure that the long-term workforce plan that they and the NHS are rolling out includes how we will ensure that hospice staff are part of the long-term funding. Hospice UK has warned, seriously, that without urgent action, some, indeed many, hospices may be forced to close their doors in the next 12 months.

I have some requests of the Government. First, as the hon. Member for Birmingham Erdington (Paulette Hamilton) said, we need them to commit to a long-term sustainable funding model for hospices. That is not to say that hospices should be brought into the central NHS—I personally believe that the innovation of the hospice sector is down to its independence from the NHS—but they need multi-year funding to understand where they stand.

Secondly, as has been mentioned, we need to scrap the postcode lottery that comes from the integrated care boards. Some kind of ringfenced funding, particularly for children’s hospice grants, would prevent a lot of the delays and inequities in the service. As I said, we need to make sure that hospice staff are integrated into the NHS long-term workforce plan and are paid in parity with similar NHS roles.

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[Jim Dickson (Dartford) (Lab)]

I thank the hon. Member for Wimbledon (Mr Kohler) for securing this debate and for his excellent and moving opening speech. Hospices across the country care for hundreds of thousands of people living with conditions that limit their lives or mean they face their lives coming to an end.

I wish to put on record my thanks to two hospices that provide crucial services for people in my area. Ellenor is a specialist palliative care provider for adults and children based in the constituency of my hon. Friend the Member for Gravesham (Dr Sullivan). Since 1985 it has been providing hospice care for those who need it most, and it recently opened a new wellbeing centre, which is a hugely welcome addition to its facilities. I also pay tribute to Demelza, which has children’s hospices in the constituencies of my hon. Friends the Members for Sittingbourne and Sheppey (Kevin McKenna) and for Eltham and Chislehurst (Clive Efford). Demelza supports families who are going through what I can only imagine are some of the most difficult circumstances I can possibly think of, where children are facing serious or life-limiting conditions.

Given the importance of such services, I understand the high degree of concern from the sector before the Government’s announcement of further funding last month, with the NHS England children’s hospice grant not having been confirmed at that point for 2024-25. I therefore join hon. Members who have welcomed the 19 December announcement by the Secretary of State for Health and Social Care of £100 million in funding improvements for hospices, such as updated IT and improved facilities for patients and visitors. I also very much welcome the news that hospices for children and young people will receive £26 million in revenue funding for the next financial year. Hospice UK has welcomed that funding, saying that it will

“bring clarity to critically important services for children with life-limiting illnesses.”

[Mr Angus MacDonald]

What does the hon. Member think about the many hospices that do not need the capital but are desperate for the income? I would be interested in his answer.

[Jim Dickson]

I thank the hon. Gentleman for his question. The capital funding will be of immense help to a wide variety of hospices in ensuring that they can upgrade their operation so that they are less reliant on revenue funding from the charity sector and from the NHS. We need a sustainable funding model, and I know the Minister will come back on that at the end of the debate. Finally, let us wish Hospice UK, individual hospices, and our NHS every success with their amazing care for all who need their services, and hope that they will be able to find a sustainable financial future as a result of the Government’s work.

Tobacco and Vapes Bill (Third sitting)

Jim Dickson Excerpts

Committee stage
Thursday 9th January 2025 Public Bill Committees

[Dr Johnson]

I merely make the point that ID is used for purposes other than to buy cigarettes and tobacco, Sir Roger.

I want to return to a point raised in an earlier intervention about the group of people who would be asked to carry ID. If somebody’s birthday is, like mine, in 1977, it is sadly unlikely that anyone will think that I was born in or after 2009. The cohort affected will be those born around 2006 or 2012. I do not see this as an ID for old people through the back door, because, as I view it, there will be a cohort of people within five or even 10 years on either side of the 2009 boundary who will find themselves required to carry ID if they wish to smoke. If they do not wish to smoke or use any tobacco, cigarettes or smoking products, they will not be affected.

[Jim Dickson (Dartford) (Lab)]

Will the right hon. Lady give way?

[Dr Johnson]

I keep getting promoted—that is fine.

[Jim Dickson]

Sorry. Does the hon. Lady accept that the changes that have resulted in significant decreases in smoking prevalence over the last 20 years have all been about imposing additional burdens on those who wish to smoke, such as on where they can smoke and how they can buy the products, which are now in lockable cupboards rather than out on display in shops? Asking someone who wishes to smoke to carry ID is an increased burden—a very small one, but an increased burden none the less—and it is all part of the policy family that has enabled us to reduce smoking prevalence from between 25% and 30% 20 or 30 years ago to 12% now, and that will hopefully help us reduce it to 5% or 0% in the future.

[Dr Johnson]

It is certainly the case, as I am sure we will come to when we discuss clause 1 itself in more detail, that where tobacco control measures have been brought in—on place, price, display or age group—they have led to a fall in smoking, which is a welcome and intended outcome.

I have been lumbered with a lot of interventions and I did not get to answer one point in full, which was on the issue of adult consistency. Amendment 17 would create two groups of adults—those aged between 18 and 25, who would be unable to smoke or use tobacco products, and those over 25, who would. The previous Government sought to say, “This is when you become an adult—when you turn 18. Before that, you are a child, and we will use child protection and safeguarding measures, so you cannot get married or buy a lottery ticket.” We sought to create consistency across the board, because consistency helps people to understand what the law is, which makes it easier for them to follow it and give a greater level of consent to it.

Let me turn back to the amendments. I cannot speak directly for the hon. Member for Epsom and Ewell, who tabled the amendments, but one of the reasons that has been given to me for increasing the age to 25 is that people normally begin smoking when they are young. Most people begin before they are 16, and many more before they are 21. That means that in principle, if we raised the age to 25, we would find that people did not start smoking in any great numbers, because their brain and their thinking process would be more mature, so they would be less likely to start. It is also the case that if someone starts smoking at a younger age, they are more vulnerable to the addictive properties of nicotine, as we heard in the impact assessment and in medical evidence.

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[Jim Dickson]

On the point made the hon. Member for South Northamptonshire, a common maxim applied to our public policy on harmful substances is that we permit. Even having a permission to smoke and buy cigarettes after the age of 25 means that society is effectively saying that that is fine to do, albeit harmful. We do not do that with very many other harmful substances, so it would seem odd to do it with cigarettes.

[Dr Johnson]

I think this comes down to the libertarian argument. Someone can be an adult either because they are over the age of 25, as per amendment 17, or because they are born before 1 January 2009, as per clause 1, unamended by amendment 17. Essentially, whichever type of adult someone is, we would normally say, “If you are an adult, you make an informed choice about which substances to take and what risks you want to take with your life.” But two thirds of people who take cigarettes will die as a result.

There are other substances that we do ban, and there is a scale. There is the libertarian who would have us make all drugs—whether cannabis, cocaine or heroin—free for everyone to use and to buy as they choose. That is not a position I subscribe to, but it is a position that some subscribe to. There are also those who would go further and ban many more substances, such as certain foods that are particularly sweet or fatty but otherwise enjoyable. There is a spectrum, and I think—society probably agrees—that the judgment is that tobacco is very harmful to those who consume it, and potentially to those around them, in a way that does not offer them any significant benefit. I am a doctor, and when we prescribe medication, we look at the risk balance between the benefits of the substance that we are giving somebody and its potential harm. However, with smoking, as far as I can tell, there are no real benefits, other than an emptier pocket—because an individual has spent so much money—worse lungs and worse health.

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.)

Tobacco and Vapes Bill (Second sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[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.

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[The Chair]

I call Jim Dickson.

[Jim Dickson]

I am fine, Sir Mark.

[The Chair]

If there are no further questions, I thank the witness, Professor Bauld, for her contribution. We will move on to the sixth panel of witnesses.

Examination of Witnesses

Lord Michael Bichard and Wendy Martin gave evidence.

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[The Chair]

One final quick question from Jim Dickson, before we have to go on to the next panel.

[Jim Dickson]

Q Tobacco companies, as we know, collect a pretty rich dataset on their sales. Do you think that requesting, or placing in legislation an obligation on them to publish, that sales data would be a useful tool for trading standards?

Lord Michael Bichard: I cannot see that it would not be useful, but it is not something that has come across my desk.

Wendy Martin: Mine neither, but intelligence-led enforcement means the more that intelligence is available, the better one is able to target. I do not know exactly what tobacco companies collect, but generally any intelligence is useful.

[The Chair]

I thank both panellists for their evidence. We will move on to the next panel.

Examination of Witness

Inga Becker-Hansen gave evidence.

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[Mary Kelly Foy]

Q As we know, we have very high levels of child poverty in this country. Much of that poverty is in the areas where there is high smoking prevalence, as well as many other health issues. How important do you think the Bill is for the health of children as they grow into adulthood, for the impact that it will have on the communities they live in, and for addressing inequality?

Professor Steve Turner: Touching on what I have said before, there are communities, invariably the poorer communities, in something called the tobacco map. If you look at the areas where tobacco use is greatest, it maps totally on top of deprivation. We have an opportunity to break that generational social norm of, “It’s okay to smoke.” The people who come to the greatest harm from cigarette smoking and nicotine addiction are invariably the poorest. What is proposed here will be a good step towards narrowing the divide we see in this country in health outcomes, which is totally determined by poverty.

Professor Sanjay Agrawal: We estimate that around 350 children a day start to smoke. A lot of those will be from the most deprived communities. In addition, smoking in the UK brings around a quarter of a million families into poverty, and those families have children. The Bill will go a long way to not only reducing the health harms to individuals, but reducing poverty and hopefully smoking-related deprivation.

To answer one of the questions earlier about the cost of smoking to the NHS, it is estimated that it costs secondary care about £1 billion a year. With primary care in addition, that is a total cost of £2.6 billion to the NHS, around £20 billion a year to social care, and about £50 billion a year in lost productivity. That is the overall cost of smoking to our society, whether at the level of the individual, poverty, deprivation, social care or workforce productivity, and that is why the Bill is so important.

[Jim Dickson]

Q Some other countries, notably Australia and Canada, have introduced mandatory health warnings for manufacturers to place on individual cigarettes and filters, because quite often, young people in particular are accepting cigarettes away from the packaging. Do you see that as a useful way of increasing the saliency of health warnings?

Professor Sanjay Agrawal: These additional measures warn people away from smoking—those who might be looking at the packaging or the individual cigarette. Remember, an individual cigarette—every time someone takes out a cigarette—is an advertisement for cigarettes. Lots of times, children are sold cigarettes on a per-cigarette basis, and they have never actually seen the packet; they have only seen the cigarettes. Therefore, having on-cigarette warnings is another measure that we can introduce to warn people off the harms of smoking. It would be great to see that.

[The Chair]

I was incorrect; we have until 5 o’clock, rather than 4.50 pm, which is now. Do we have any more questions from Members? No. In that case, I thank Professor Turner and Professor Agrawal for giving evidence, which I am sure will be useful to the Committee in its deliberations. The next panellist happens to be the Minister. Instead of asking questions, he will come under fire from his own Committee.

Examination of Witness

Andrew Gwynne MP gave evidence.

Tobacco and Vapes Bill

Jim Dickson Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

It is a privilege to speak in this debate on a Bill that delivers on our manifesto commitment to finish the job started by the right hon. Member for Richmond and Northallerton (Rishi Sunak) at the back end of the last Parliament. We should be proud that, once the Bill receives Royal Assent, it will be the most advanced legislation of its kind in the world.

I should declare at the outset that I was a smoker, and that experience gives me particular clarity on the need for change. I am also honoured to be vice-chair of the all-party parliamentary group on smoking and health. I will use my six minutes to say a little about why this Bill is so necessary and—I hope the Minister does not mind —to gently set out where I think it could go further.

We often hear that smoking is about choice. The only choices I made were to have my first cigarette at the age of 15 and then, almost 15 years and thousands of cigarettes later, the much more difficult choice to finally give up.

According to the wonderful Action on Smoking and Health, which has been quoted widely in this debate, the majority of smokers wish they had never started, and it takes, on average, 30 attempts to quit. This legislation will ensure that future generations in this country, including in Dartford, will not have their freedom to choose stolen by a deadly addiction.

The latest figures, before their collection was interrupted by the pandemic, show that in Kent, nearly 6,000 people died from smoking between 2017 and 2019, with 10,000 hospital admissions due to smoking during 2019 and 2020 alone. Before being elected to this place, I was, for many years, a local councillor working on public health issues, and I saw at first hand the burden that smoking places on my local community. Now that I have the great honour of representing the wonderful constituency of Dartford, I see smoking taking a similar toll.

No matter where we are in the country, we will hear the same stories of loved ones lost too soon, of people becoming addicted as children and of the most disadvantaged groups bearing the heaviest burden. We cannot, and must not, accept a situation in which more than 74,000 deaths a year are attributable to smoking. We now know, with more clarity than ever, the damage that smoking causes. Smoking can lead to at least 16 different types of cancer, and it cost England £21.8 billion in 2023, mainly in lost economic productivity.

We have a chance to change this. Modelling by the Department of Health and Social Care estimates that raising the age of sale by one year every year will prevent almost 500,000 cases of stroke, heart disease, lung cancer and other lung diseases by the end of the century. It will save tens of thousands of lives and help untold numbers of people to lead healthier and more enjoyable lives.

An issue that often comes up when discussing measures of this nature is how we make them enforceable. The legislation enjoys widespread public support, with 69% of the public in favour of the measures, according to polling undertaken by YouGov for ASH earlier this year, and even a slim majority of smokers in favour, which indicates that many smokers recognise that we do not want the next generation to grow up addicted to smoking. The measures command high levels of public support, and when such policies are done with and not to people, compliance is self-enforcing and high.

Turning to where the Bill might go a little further, I welcome the additional powers to create smokefree outdoor spaces and to designate smokefree places as vape-free. However, I admit slight disappointment that the Government seem to have ruled out hospitality premises from the scope of the regulations, rather than setting out options via a consultation about how we might proceed. I hope the Minister will recognise that there are options other than an outright ban.

As the number of smokers in the UK continues to decline, there are discussions to be had about how we use public spaces and protect individuals from second-hand smoke, particularly children and those with health conditions. From my time in local government, I know that councils can play a vital role in improving the health of their communities. Councils across the country have used the pavement licensing system to create smokefree outdoor spaces. That has proved popular with businesses and customers, particularly families with children. I gently urge the Minister to consider whether the Bill might be amended to allow local authorities to decide which additional spaces, beyond those regulated nationally, they might like to make smokefree in the best interests of communities.

My final point, which reflects those made by other hon. Members, is about the “polluter pays” principle. We all know that public finances are under significant strain. If the funding we desperately need to create a smokefree country cannot be found in our existing budgets, I would urge Ministers to consider the imposition of a “polluter pays” levy on tobacco manufacturers.

National Insurance Contributions: Healthcare

Jim Dickson Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

The right hon. Gentleman tempts me to go into my previous career working with GPs and their employment and contractual status, but I will not do that now, Mr Speaker, as you would rightly curtail me. GPs have a complicated contractual status that has been long in the process. We understand the precariousness of primary care. GPs are crucial to our plans for developing the health service, and we will discuss with them, in the normal process, the allocations for the following year.

[Jim Dickson (Dartford) (Lab)]

Last month’s Budget finally gave my constituents hope that there will be an NHS that works for them. Will my hon. Friend assure me that this Government will avoid the sticking-plaster, piecemeal approach of the last Government, and bring forward a long-term plan to fix the NHS for the future?

Oral Answers to Questions

Jim Dickson Excerpts

Tuesday 15th October 2024 Commons Chamber

[Andrew Gwynne]

I absolutely do, and I pay tribute to Abbi, a beautiful woman whom I was privileged to meet after the Westminster Hall debate last week. Although care after sepsis will vary hugely on a case-by-case basis, we need to make sure that the needs of each individual are met. In this case, it sounds like they have not been met. If the hon. Gentleman wants to meet me to discuss this issue further, I am more than happy to do so.

[Jim Dickson (Dartford) (Lab)]

Given that last month was Sepsis Awareness Month, will the Minister join me in paying tribute to the courage of John Snow and his family in my Dartford constituency? Tragically, he has just experienced a quadruple amputation due to sepsis. He has received amazing support from the Dartford community, who have rallied around to help fund support for his family. Will the Minister use that as a spur to improve treatment for sepsis more generally across the country?

[Andrew Gwynne]

I pay tribute to John Snow and, indeed, my hon. Friend’s constituents, who have rallied around him at his time of need. This matter highlights the need to have better joined-up care to ensure that people who have sepsis receive the best care possible, that those who tragically lose limbs as a consequence of sepsis are able to have good-quality aftercare, and that we continue to raise awareness of sepsis and the risks it poses.