Smokefree 2030

Liz Twist Excerpts

Tuesday 26th April 2022 Westminster Hall

[Liz Twist (Blaydon) (Lab)]

It is a pleasure to serve under you as Chair, Ms Nokes. I commend the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing today’s debate. I also wish the hon. Member for Harrow East a very happy birthday.

Smoking, as we have heard, is not a lifestyle choice. It is a lethal addiction entered into by the vast majority of smokers even before they reach adulthood. It is an addiction that is increasingly concentrated among the most disadvantaged in society, fuelled by an industry—the tobacco industry—whose behaviour must be stringently regulated if we are to achieve our smokefree 2030 ambition.

Like my hon. Friend the Member for City of Durham, my constituency of Blaydon falls under Gateshead Council in the north-east, which I regret to say is the most disadvantaged region in the country. Smoking rates in Gateshead are particularly high, bringing disease, death and disability disproportionately to my constituency. In 2019, more than 17% of adults in Gateshead smoked, compared with 15.3% for the north-east as a whole, and far higher than the average for England of 13.9%.

That higher rate of smoking translates to a lower average life expectancy. The average male life expectancy in Gateshead is eight years less than in Westminster, and five years less for women. Smoking costs the NHS in Gateshead £9.3 million, and £5.6 million to local authorities for social care costs that are entirely due to smoking and entirely preventable. Tobacco addiction has been levelling down communities across the country for decades, and will go on doing so until the Government decide to get serious about delivering the smokefree ambition—for all in society.

Smokers in Gateshead spend on average £2,000 a year on smoking. The total spend in Gateshead is £54 million, an eye-watering amount of money that goes up in smoke for no benefit to the local community. Ending smoking will significantly increase disposable income in poorer communities such as those across Gateshead, helping to grow the local economy and to improve health and wellbeing for tens of thousands of people.

In March, I was pleased to be able to attend the event in Parliament marking national No Smoking Day and to reflect on the progress that has been made in tackling smoking over the years. Also, however, the event looked at what more needs to be done. The Minister spoke passionately about the Government’s commitment to making England smokefree by 2030, and said that investment in stop smoking services would be at the heart of the forthcoming tobacco control plan.

I agree wholeheartedly. Smokers need to be motivated and supported to quit. However, the funding for stop smoking services has been cut by a third in real terms since 2015. That funding must be reinstated if the services are to play their vital role in delivering the smokefree 2030 ambition.

That is not the only area that needs extra funding to achieve a smokefree 2030. Smoking during pregnancy is the leading modifiable risk factor for poor birth outcomes, including stillbirth, miscarriage and pre-term birth. The Government’s ambition is to reduce smoking in pregnancy to 6% by 2022, but with rates at 9.6% in 2020-21, that is unlikely to be delivered.

The rate of decline in smoking during pregnancy has been higher in the north-east, and that is because we have invested in specialist interventions. We are delighted to see that initiative being rolled out across the country as part of the NHS long-term plan. Smoking during pregnancy rates remain too high, however, so the north-east has gone further by introducing voucher schemes to provide a financial incentive to pregnant smokers to quit. That is particularly powerful for women on low incomes. In South Tyneside, an area of high deprivation, the proportion of pregnant women who are recorded as being smokers at their time of delivery has dropped by a third in the three years since the scheme was put in place.

Maternal smoking cost the NHS £20 million in 2015-16, with more than 10,000 episodes of admitted patient care. Since smoking is so damaging, incentive schemes are cost-saving, with an estimated return on investment of £4 for every £1 invested. Implementing financial incentives at scale is a vital measure that needs to be part of the forthcoming tobacco control plan, which I hope to see included in the independent review—but it will need funding.

I will touch briefly on mental health. Much more investment is needed to tackle smoking among those with a mental health condition. As many as one in three smokers have a diagnosable mental health condition. The NHS long-term plan tobacco dependency treatment pathway presents a major opportunity to tackle smoking among those with serious mental illness, but many others are not in that category. We need to ensure that much more work is done on pilot projects for IAPT—improving access to psychological therapies—counselling. Counsellors are willing to deliver such support, and they should be given the opportunity to do so.

--- Later in debate ---

[Maggie Throup]

I think the hon. Gentleman must have read the next page of my speech, because I was about to come on to that. He makes a really important point. As has been mentioned by the hon. Gentleman, my hon. Friend the Member for Harrow East and the hon. Member for East Londonderry (Mr Campbell), who is no longer in his place, smoking rates are far higher in poorer areas of the country, among those socioeconomic groups. We see smoking rates of 20% in more deprived areas, compared with 5% in wealthier areas, and nearly one in 10 pregnant women still smokes, which increases the risk of health problems for their baby. Smoking prevalence for people with long-term mental health conditions is over 25%, so the burden of tobacco harm is not shared equally.

We cannot let that continue, so the Government are committed to doing more. Over the past decade we have made significant steps towards making England smokefree—a bold and ambitious target that we committed to in 2019. We continue to enforce high taxation to reduce the affordability of tobacco. As part of the annual Budget process, Her Majesty’s Treasury will continue the policy of using tax to raise revenues and will encourage cessation by continuing with duty increases on tobacco products above the retail prices index. We continue to invest in local stop smoking services and our high-impact marketing campaigns such as Stoptober—I hear it is VApril this month.

Between 2010 and 2021, almost 5 million people set a quit date with stop smoking services, and 2.5 million reported quitting after four weeks. We continue to enforce a strong regulatory framework, and we have introduced policies such as smokefree legislation and standardised packaging. All these measures, and many more, have been instrumental in helping smokers to quit and protecting future generations from starting this lethal habit.

[Liz Twist]

The Minister has spoken about the great progress that has been made in 11 years, but is it not about time that we started expecting the people who caused this problem to pay for the cost of further tobacco control measures and getting people off smoking? Is it not about time that the “polluter pays” principle is adopted?

[Maggie Throup]

If I may, I will come to that later in my speech, but the hon. Lady makes a very good point.

On top of the measures, the NHS has renewed its commitment to tobacco treatment through the NHS long-term plan, delivering NHS-funded tobacco treatment services to all in-patients, pregnant women and people accessing long-term mental health and learning disability services until 2024. The Government also continue to explore ways to move smokers away from smoking and towards alternative nicotine products such as vapes, as highlighted by the hon. Member for North Tyneside (Mary Glindon). We know that the best thing a smoker can do for their health is to quit smoking altogether, but we also know how hard that can be. It remains the Government’s goal to maximise the public health opportunities presented by vapes while ensuring that such products are not appealing to young people and non-smokers. The hon. Member for Denton and Reddish made a very good point on this issue in his speech, and it requires balanced and proportionate regulation.

Despite the progress made so far, the Government acknowledge that we need to go further to achieve our ambition to be smokefree by 2030, which is why the Secretary of State for Health and Social Care asked Javed Khan OBE to lead an independent review into tobacco control in January this year. The Khan review is expected to be published next month and will make a set of recommendations to the Government. The review has two objectives. The first is to identify the most impactful interventions to reduce the uptake of smoking, particularly among young people. The second is to identify how best to support smokers to quit, especially in deprived communities and among priority groups.

Mr Khan has met hon. Members from both the all-party parliamentary group on smoking and health and the all-party parliamentary group for vaping, and he has carefully considered their views and proposals. Quite a number of members of those APPGs have expressed their approval of that route and how Javed Khan is getting into the depth of everything. Once the review is published next month, the Government will consider its recommendations, which will help inform both the upcoming health disparities White Paper and the new tobacco control plan, to be published later this year.