E-cigarettes

Lord Bellingham Excerpts

Thursday 31st October 2019 Westminster Hall

[Jane Dodds (Brecon and Radnorshire) (LD)]

I have not put my name forward to speak, but I would like to say a few words.

[Sir Henry Bellingham (in the Chair)]

Yes, indeed. I call Jane Dodds.

[Jane Dodds]

Thank you, Sir Henry. I wanted to draw attention to the correlation between people who have mental health difficulties and the propensity to smoke. I pay tribute to my right hon. Friend the Member for North Norfolk (Norman Lamb), who has championed the cause of mental health throughout his time in Parliament. I hope that Committee members will not mind my thanking him for everything he has done.

This debate relates specifically to England, and I am a Welsh MP, but I draw attention to the issue of cross-border healthcare. Many people in Wales who need to attend a residential mental health unit have to travel to England, and of course there is complete disparity between the practice in Wales and that in residential units in England. I realise that this is not totally within the Committee’s brief, but I would like it to consider how the policy for mental health units in England, which have particular rules and regulations around access to e-cigarettes, could be married up with the policy in Wales. There are significant differences between them. We talked earlier about learning from international bodies and countries around the world, but there is also a need to look at the whole UK, and consider how we can get parity between the nations. Thank you, Sir Henry, for allowing me to speak. Diolch.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Henry. I apologise if I sound a bit croaky; I have a cold that is going round. Hopefully I will get rid of it soon, given what is to come over the next few weeks.

I thank the right hon. Member for North Norfolk (Norman Lamb) for introducing this debate, and for his characteristically well-informed speech. It is sad to think that it could very well be his last speech in what has been an illustrious career as an MP. I am sure that it will not be his last speech as a campaigner or activist. I also congratulate him on his work chairing the Science and Technology Committee, and on the excellent report that we are considering.

I thank all the other right hon. and hon. Members who have spoken, including the hon. Member for Ayr, Carrick and Cumnock (Bill Grant), and my right hon. Friend the Member for Rother Valley (Sir Kevin Barron), who I have enjoyed working with for many years. He has also had an illustrious career, and was an excellent Chair of the Health Committee for a number of years; he will be sorely missed in this place. There were also speeches by the hon. Member for Dartford (Gareth Johnson) and by the hon. Lady who has just spoken; I did not catch the name of her constituency.

[Sir Henry Bellingham (in the Chair)]

Brecon and Radnorshire—by-election win.

[Mrs Hodgson]

Excellent. Thank you.

As we have heard, there is still some uncertainty about the use of e-cigarettes. They entered the UK market only 12 years ago, and because this technology is still so young, we do not know for certain what its long-term impacts on health will be. What we do know is that e-cigarettes are around 95% less harmful than conventional cigarettes, and because of that, an estimated 2.9 million people in the UK are using them to stop smoking. Each year, tens of thousands of people successfully use e-cigarettes to quit. A randomised controlled trial, published in the New England Journal of Medicine earlier this year, found e-cigarettes used in a stop smoking service to be nearly twice as effective as licensed nicotine replacement therapies, such as patches and gum.

The importance of e-cigarettes as a smoking cessation tool should therefore not be dismissed. However, that must come with the caveat—I think everyone has made this point—that using an e-cigarette is not completely risk-free. There has been a recent outbreak of serious lung injury in the US linked to vaping, although that has not been replicated in the UK. Currently, 3.6 million people vape in the UK, yet the number of cases of severe respiratory pathology associated with vaping is low and diverse, with reports over a long period.

I agree with ASH’s recommendation that e-cigarette users should buy vaping products, including e-liquid, only from mainstream suppliers that sell regulated products, because using black market products may carry lethal risks. They should report any adverse effects from e-cigarettes to the Medicines and Healthcare Products Regulatory Agency using the yellow card scheme. If they experience serious adverse effects that they think are due to vaping, they should immediately stop vaping and get advice from their doctor.

Has the Minister considered launching an e-cigarette safety education programme that will ensure that e-cigarette users know the risks, and what to do if anything goes wrong and they manifest any such symptoms? That may lessen the possibility of manifesting the same patterns that we have seen in the US of lung injuries linked to e-cigarettes.

The Committee’s recommendation 4 says that NHS England should issue e-cigarette guidance to all NHS mental health trusts, and the default should be to allow e-cigarette use by patients. As we have heard, people with mental health issues smoke significantly more than the rest of the population, and could therefore benefit significantly from using e-cigarettes to stop smoking. Encouraging and allowing patients in mental health units who are smokers to switch to e-cigarettes as a means of smoking cessation would allow them to engage with their treatment sessions in the facilities without the interruption of smoking breaks.

A third of the 50 NHS trusts that responded to the Committee’s survey ban the use of e-cigarettes. The Government have agreed to issue guidance to NHS trusts about e-cigarettes. Will the Minister please tell us when she anticipates that it will be published? I know that she might have to rush it out in the next couple of days, but she might have a magic wand and be able to do that. Doing so could allow patients in mental health units to engage more fully with their treatment, which could improve outcomes.

As the Committee has found, e-cigarettes have a role to play in our society and in the Government’s commitment to achieving a smoke-free generation. However, we must ensure that advice on the safety of e-cigarettes, both short and long term, is updated regularly and publicly, so that users have the most relevant and up-to-date information available to them. The Government must also consider the role that e-cigarettes play in mental health services and improving patient outcomes across the NHS.

Every contact counts, especially when it comes to smoking cessation, and none should be missed. However, due to the Government’s public health budget cuts since 2013, which I know the Minister is not personally responsible for, smoking cessation services have suffered, leaving the most vulnerable smokers behind, without any support to quit smoking. That must change. Again, I ask the Government to reverse those public health budget cuts, so that local authorities can provide the smoking cessation services that their local communities need and deserve. I look forward to the Minister’s response.