(1 year, 7 months ago)
Public Bill CommitteesI 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.
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
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.
Mr Barros-Curtis
Q
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
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.)
(1 year, 8 months ago)
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.
(1 year, 9 months ago)
Commons ChamberThe 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?
(1 year, 10 months ago)
Commons ChamberI 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?
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.