Tobacco and Vapes Bill (First sitting)

Kirsten Oswald Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[The Chair]

Thank you. I will take two more questions, from Kirsten Oswald and Bob Blackman.

[Kirsten Oswald (East Renfrewshire) (SNP)]

Q To expand on a point made earlier, I wonder what more is necessary in terms of promotion and advertising action. I am very concerned about the matter of football strips and, indeed, sports stadiums being sponsored by vaping companies. The messages that that sends to the young people who are taking up vaping in such numbers is hugely problematic. It strikes me that within your areas of expertise there are probably other areas where we could extend what we are seeking to do here, in order that we do the best job possible of trying to close these loopholes.

[Bob Blackman]

All three witnesses have given support for the Bill. You have already suggested one change that could be made in terms of age verification, similar to the system in Scotland. Are there any other changes that you think should be implemented that could make the Bill stronger? One of the concerns that many of us have is that we get only a limited number of chances to deal with this challenge in primary legislation, so we need to get in as much as we can to make sure that we achieve the smoke-free England that we all want to see.

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[The Chair]

We have time for another round of questions, if Members want.

[Kirsten Oswald]

Q I am grateful to you both for your comments so far. Would you say more about your thoughts on groups of people, particularly young people —this is a thing you will hear around the table—who are taking up vaping but have not previously smoked. Do the measures in the Bill go as far as you want in trying to prevent that from being the direction of travel?

Dr Griffiths: If the Committee is minded to strengthen anything that would prohibit people from starting vaping in the first instance, where they are not doing so as a cessation tool—I hope it is really clear that we believe that, as a cessation tool, this is a product that has its place that would help thousands of smokers give up and, ideally, prevent them from losing their quality of life or, tragically, their lives; I hope that is explicitly clear—I think that could have incredible impact. What we are worried about is people using vaping as a start and an entry point to nicotine. Nicotine is so highly addictive. You see that in the number of smokers who desperately want to give up. We have spoken to such people in abundance. Anything that helps us get to that point would be welcome.

Sarah Sleet: Nicotine, we know, is as addictive as heroin and cocaine. It is a terrible addiction. However, in terms of vaping, it is going to be quite tricky to get that balancing act right. We really need to have vaping as a cessation tool. We know it is more effective than just about anything else you can have in terms of cessation. For example, when it comes to flavouring, if you make that too difficult or make it problematic for people to switch, then there is a chance that we may have a real problem in terms of stopping smoking. On the other hand, we really do not want people to be attracted into vaping who have never smoked. I understand that that bit of the legislation is in secondary legislation and can be adapted over time; I think a lot of attention is going to need to be given to how people are actually responding and how they are behaving, and then adjusting that over time.

[Angela Richardson (Guildford) (Con)]

Q You have been quite clear that even though we do not yet have the evidence to understand the impacts of vaping, it is a very important cessation tool. Do you see a world in which it could be prescribed as a cessation tool, as opposed to being available as a retail product?

Sarah Sleet: I believe that is the system in Australia—it is prescribed. I think it is a possibility. It needs to be well researched. Would it still encourage people who need to stop smoking to use it as a tool, or would it put a barrier up to using that tool? Before we move to that system, we would need some really good behavioural evidence that it is not going to be a further barrier for people. If it is not, then that could be a really good option.

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[Dame Andrea Leadsom]

Q Thank you so much for being here, and also particularly for the work that the NASUWT has done in terms of the impact on schools. Could you expand on that a bit further? I have done a couple of visits ahead of this Bill. I met enforcement officers, for example, who gave me anecdotal evidence that teachers say that pupils will return to the classroom with their eyes spinning and unable to concentrate because of the heady nature of whatever it is they have just been vaping or smoking. There was another anecdote about a school where children decided to drink the vape fluid and the school actually had to have a sort of emergency evacuation as a result of that.

Could you therefore expand on that, in terms of the specific health impacts and, at the one end, the ability of children to concentrate on the class when they are spaced out on vapes, and, at the other end, the very real risk to children from doing something stupid with a vape that was entirely unintended, with disastrous consequences?

Patrick Roach: I very much appreciate your remarks about the research that the NASUWT has undertaken. We come at the problem of vaping from the point of view of our members in classrooms, in schools the length and breadth of the country. What do teachers need in order to be able to teach effectively and what do they believe that pupils need in order to learn effectively? They need good order in the classroom.

My perspective is not that of a medical practitioner or of someone wanting to assume that I have the knowledge about the impact of vaping on a child’s physical development. Our concern is the impact on a child’s educational development, participation and achievement. The reality is that everything you have mentioned there is absolutely right, whether it is about the way in which vaping products might be unintentionally used by pupils; or about how they seek to conceal them about their person; or, indeed, the drinking of vaping fluids, as if somehow that will get the high without necessarily being detected; or about the use of vaping products as a stimulant, which impacts not only on concentration but on behaviour and, indeed, on a child’s wellbeing in the classroom.

Matthew has already referenced the difficulty of detecting vapes sometimes, because they can dissipate very quickly; and they can also trigger fire alarms in schools. We have had plenty of examples of teachers and headteachers reporting that their school has had to evacuate the building not just on one or two occasions in a day but multiple times—five or six occasions. That is a loss of learning not just for one pupil or class of pupils but the entire school. We are really concerned about the impact of all that.

Teachers are not just concerned about a child’s educational development, though; they are also concerned about a child’s wellbeing in the round. Teachers are reporting the very damaging impact that vaping can have on a child’s mental and physical development, just as smoking can. That is one of the reasons we have spoken out—and we are pleased that the Government have responded—to say that we need to be doing more to strengthen the enforcement of rules around vaping, access to it and the availability for school-age pupils. We need to do as much as we possibly can to prevent any school-age pupil from getting access to vaping products, whether in or outside school. We are pleased that the Bill seeks to do just that.

Matthew Shanks: I absolutely echo and reinforce what Patrick has said. Also, as school leaders we are looking after teachers, but we are caring for families as well. The Bill will help families to understand that it is not okay for their children to vape. Anecdotally we have parents saying to us that they let children vape at home, because it is better than them smoking or being out on the streets; parents do not see the harm in it. It is really important that that is recognised. The banning of tobacco sale was interesting in terms of the prescription of it; I would posit that at the moment vaping is seen as safe by the general public.

[Kirsten Oswald]

Q I wonder if you can develop some of the points you have made, which have been very useful. I am hearing anecdotally about issues in schools where the addiction of children to these vapes is itself causing a problem, because the children are unable to sit in the classroom and have to go out to vape, with whatever excuse is made, so that they then feel able to come back to the classroom, such is the level of their addiction to these products. If I may go beyond that slightly, what are your views on the way these things are promoted—for instance, on our particular concern about vape companies advertising on sports strips and in sports stadiums, and the impact on the same young people who are so addicted?

Matthew Shanks: I completely agree. The way in which vapes are marketed—the colours, flavours and so on—and the places where they are marketed suggest to people that they are safe. The fact that they are put forward as a “safe” alternative to cigarettes, the fact that parents use them and the fact that there are lots of colourful vape shops open in high streets: all those aspects promote the idea that vaping is okay.

At the same time, getting into a child’s mindset—we have all been there, as children—we like to break the rules and feel like we are pushing at boundaries. We know that it is not okay, but it is made okay. I would suggest that more children engage in vaping than in cigarette smoking, because they are not sure what the harmful effects are. That is the danger in it. I do think it leads on, because the younger children vape, but by the time they are 16 or 17, vaping might not be cool any more, so they go on to cigarettes or other things.

Anecdotally, we have heard of schools down in the south-west where people are putting cannabis into the vapes, so the addiction grows from that point of view as well. It leads to children coming out of lessons agitated. If I did not have three coffees in the morning, my agitation would be quite high. If children are not getting nicotine, as well as going through all the other things they are going through, they really do present as confrontational to staff, which makes it difficult to deal with them in classrooms and engage them in their learning. At the same time, to repeat a point I made earlier, you have parents at home who are saying, “Well, it’s okay to do.” I absolutely concur about the way it is marketed and so on.

Patrick Roach: To add to that, because those are important points: vape producers and manufacturers, and indeed those supplying vapes, are advertising freely in ways that make their products increasingly attractive to children and young people, with the way vapes are advertised and the marketing descriptors used for them. All the evidence we have, and certainly what our members tell us—our survey was of 4,000 teachers, so this is not anecdotal; it has an impact right across the system— suggests that the way those products are marketed and described deliberately seeks to entice young people to make use of them.

We believe that this is a strong Bill that very clearly sets out the societal expectations in this space, but as with any legislation, there is always scope for loopholes. If there are areas in the Bill where there is potential to further strengthen the legislation, I think the enticing way products are described, before an individual understands what they are getting themselves into, is something that needs to be considered and addressed.

From our point of view, it is about advertising, but it is also about access to these products. With the best will in the world, and no matter how they are advertised, if the products are easily available at the point of sale it makes things incredibly difficult. I remember that when I was bringing up my own children I worried about going to the supermarket with them, because they would be surrounded by candy and sweet products at the checkouts. You could not navigate your way through the checkouts. Thankfully, things have moved on: that has changed, and many parents are benefiting from those changes.

Young people are very much interacting with many of these products at the point of sale. They are in the shops that are in the vicinity of or on the route to and from school. They are being marketed in places that young people will frequent, whether that be a local café, the hairdressers or the barbers. They are in places where young people will be. They are also immediately available. The more we can do to stop the immediacy of marketing of these products and that easy availability, no matter how they are described, the better.

[Dr Cameron]

Q I have been hearing from parents and schools in my constituency that they are very concerned that children are going out at lunchtime and spending their lunch money on vapes, so they are not having anything nutritious during the day. Is there any evidence that indicates that there might be a pattern developing in that respect that will have an impact on children’s physical health and wellbeing?

Matthew Shanks: Absolutely: children will find any which way they can to do what they want to do. At the moment, while this is not illegal, they will gather more people to follow the crowd and go out. In my experience, the majority of children want to do as they are instructed—probably about 85%, anecdotally, over the years—but they will follow the herd. At the moment, there is a greater herd growing because of all the things we have talked about, with the marketing and colour of vapes. I can absolutely see children going out at lunchtime and spending their money on that, instead of on food. There is peer pressure to do that as well—it is taking more people with them. As Patrick said, you can see these products in the barbers, in the shops and so on.

Patrick Roach: To add to that, there are also bullying behaviours that manifest themselves. Whether a pupil is making the choice to go out at lunchtime to acquire vapes or is feeling coerced to do so, there is an issue either way. The availability of those products in the proximity of schools needs to be considered. That is a point that we would make.

Increasingly, schools have introduced systems to seek to ensure that children are being fed at lunch times, for example. We should not lose sight of that, but in some instances these products—particularly disposable vapes —are cheap as chips. I know that that is an issue of concern to the Government, and it is of concern to us and our members.

It is really important that we look at how we can ban the sale of disposable vapes entirely, because frankly no one knows what is in them, and they are incredibly cheap to acquire. Even if your parent can see what you had on Tuesday lunchtime because it comes up on their phone, how will they know if you have spent 10 minutes popping out to the local shop to acquire some vapes, particularly if they are of the disposable variety? More can be done not only to limit appeal, but to reduce the availability and accessibility of those products to young people. The more that can be done on that, the better.

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[Dame Andrea Leadsom]

Q Thank you. Would that older person suffering those consequences say: “Yes, it was all a matter of free choice”?

Paul Farmer: I think different people will have different opinions about choice, and whether it was as a result of choice. I think what many older people have been telling us is that if they had known about the damaging consequences of smoking, they would not have started in the first place and would certainly have considered it in a greater way.

I want to pay huge tribute to colleagues at British Heart Foundation, who I know you have just heard from, who I think have taken the best way of trying to campaign over a long term on this issue. This is a long-term issue. Sadly today’s generation of older people is seeing the consequences of what has not happened.

[Kirsten Oswald]

Q Could you explain who “older people” are? Sadly, I recently recognised that that might include more of us than we might like to believe. We need to take that on board. What I am really interested in are the different demographic groups, and where you think there might be disproportionate levels of harm from tobacco and vaping within the groups of older people that you support.

Paul Farmer: We work with people over the age of 50, which may be news to some of you here. One of the reasons why we have recently chosen to drop the age group that we increasingly work with is precisely for prevention and early intervention.

This is not the earliest intervention; you can, of course, argue that many health interventions need to take place among children and younger people. However, from an Age UK point of view, we know that there is potential to intervene in people’s lives and support them to live healthier lives—it is not just about health, but in this context it is mainly about health—which means that your healthy life expectancy can improve and, as I mentioned earlier, you can fulfil some of the ambitions of your later life. The burden on the NHS of unhealthy life expectancy is a big issue.

The bulk of our direct work is with people over pensionable age, if you like. In each of those generations, you see the differences in experiences of smoking. Somebody now in their 80s or 90s almost certainly will not be alive if they are a heavier smoker, because they probably will not have benefited from any of the public health information that has taken place under previous Governments, so that is obviously the major difference.

In terms of the different health conditions, we know that certain health conditions will increase with age. Dementia is the greatest example of that, where we know that the older you are, the more likely you are to develop dementia. In a sense, as our population as a whole has gotten healthier and lived longer, it has become increasingly apparent where those health inequalities are at their most acute.

[The Chair]

I will attempt one final question from Dr Lisa Cameron. I simply make the point that the briefer the question, the more possibility there is that she will get an answer.