Vaping Products: Usage by Children

Lord Bethell Excerpts

Monday 2nd September 2024 Lords Chamber

[Lord Bethell (Con)]

The noble Lord, Lord Winston, may be right that vaping has been around for longer than we think, but the current boom came out of a deliberate exercise by two academics at Stanford University, Adam Bowen and James Monsees, in 2005, to find a medical technology that would give people a route out of smoking which would give them the same social interaction—the smoking, the fiddling and the what have you. They deliberately sought to find a device that would help people give up smoking. In this endeavour they succeeded fantastically well. The business that span out of their work in Stanford became Juul, the big success story in the American vape industry, sold in 2017 for billions. In that respect, it is a wonderful success story of how medical technology can be used to crack one of the big, difficult knots in our medical challenges.

We should be honest with ourselves. In the UK, smoking cessation has completely stalled. There are still 50 million cigarettes smoked every day by around 15% of the country. There is no way that we will hit the 2030 smoke-free objective that we have set for ourselves on the current trajectory. In some demographics—the poorer demographics—we will not get there until 2050, if at all.

Vapes are a really promising opportunity—a way out. This is innovation at its best. However, vapes also present us with a classic but horrible public health dilemma: in seeking to forestall one deadly epidemic, we might accidentally be creating another one. Clearly, the vape companies, now largely owned by the tobacco companies, are targeting children. My noble friend Lord Storey put it really well. The statistics are plain. They have created a £1.5 billion nicotine addiction industry here in the UK, which is mostly made up of young people who have never smoked and never intended to smoke. I find that extremely uncomfortable.

As noble Lords have pointed out, current regulation is completely failing to prevent young people taking up vaping. I say this with due consideration of and respect for the efforts of those concerned, but the truth is that trading standards officers, HMRC inspectors, MHRA officials and local authorities are tripping over each other to try to find a way to control this. But the business moves more quickly than regulators can adapt, and, frankly, it is a bit of a mess. I have little hope that the various piecemeal ideas that are being proffered will be an effective answer.

This state of confusion is compounded, as the noble Lord, Lord Winston, quite rightly pointed out, by the ambiguity around the long-term health implications of vaping. I am a lay person, not a clinician, but I think I would be right to summarise by saying that although there is not conclusive evidence today that vaping is bad for you, there is enough on the books to make us worry that there is a fair chance of significant consequences sometime in the future.

What we end up with is a debate around whether we should have flavours, but we should be honest: the debate around flavours is a bit of a legislative displacement exercise. Flavours are intrinsic to the attraction of vapes, both to adults and to children, but the real dilemma facing us as legislators is how comfortable we feel about this industry growing in size. Are we comfortable with the number of vapers in the UK rising from 5% of the country to 15% or 25%? Are we comfortable with the industry being worth £3 billion or £5 billion, or maybe more? Are we comfortable with it attracting largely a poorer consumer group, for vapes to be used largely by young people and children, and for it to store up a potentially massive healthcare liability for the future? Those are the key questions. Or are we so worried that our smoking cessation tool may become a backdoor for another nicotine addiction sector that has dangerous health effects that cost our society another fortune, just like the tobacco industry did, that we should close the whole thing down, as many other countries have done or are trying to do? Is there a way of using regulation to walk the line between these two vivid and quite different choices?

This is the dilemma facing many areas of consumer medical advance. There is a wonderful revolution in the world of medicinal innovation. We must work much harder on the edge cases to make this bountiful for our taxpayers and our patients. This is true in nutrition, medtech, social media and many other fields. Let me give three quick examples.

There is mounting evidence that hallucinogenics might offer treatment for the horrible effects of PTSD. We should probably be encouraging more investment and research, but we will need a regulatory regime that prevents misuse of these potent drugs. After 10 years at the Ministry of Sound, I can testify that they can have both wonderful and devastating effects on one’s psyche.

Ketamine technology is being offered as a new treatment for unlocking psychological challenges, and I know many people who swear by it. However, I read with anger, as other noble Lords might have, about the death of Matthew Perry, the “Friends” star who died when his cynical doctor overprescribed the drug in exchange for hundreds of thousands of dollars in fees.

Cannabinoid medicines are another case. They offer treatment for those with epilepsy. Campaigners have argued very persuasively for more investment and research, and that they have been held back by arcane attitudes and laws about drug control. Recreational users of cannabinoids argue that edible highs are a healthy alternative to booze. I have grave concerns about the legalisation of cannabis, but, with global attitudes changing quickly, it is surely a possibility that this could happen here in the UK. Too many countries have already legalised marijuana without enough thought; they have not done the boring but important regulatory work around taxation, packaging, sanctions and transparency that encourages responsible behaviours.

We used to live in a binary world where medicines were for doctors, narcotics were for the police and there was a duty for the taxman to collect. But now we are in a more complex world of vapes, hallucinogenic treatments and cannabinoid edibles, where there is a leisure industry, a cosmetics industry and a nutrition industry all with one foot squarely in the medical world and aggressively trying to bend the rules to their advantage. Quite rightly, these industries are making claims that their products can help promote healthiness and fight disease. They have a point: we cannot rely on hospital treatment of disease alone to make Britain healthy. But this shambles around vaping flavours demonstrates what happens if the regulators are fragmented and decision-making does not keep up with innovation. That is why I encourage the Minister to really get stuck into the detail; to bring the various regulators together; to assign responsibility; to insist on much clearer data and reporting from the industry; to set deadlines for changes; to timetable reviews; to move quickly to close gaps; and to identify ingredients—as the noble Lord, Lord Winston, rightly pointed out.

We have a huge opportunity to apply exciting innovations to help the health of the nation and to build valuable businesses, but that is not going to work if our regulators are heavy-handed and move so slowly. Thesequasi-medical industries depend on an unremittingly activist approach to regulation and I ask the Minister to commit to more agile supervision than we have shown around vapes to date; to be prepared to close down bad behaviours when they are explicit; to put in place strict descriptions of what vapes can contain; to look very seriously at the licensing regime, as the noble Lord, Lord Storey, recommended; to look closely at advertising restrictions that get round many of the restrictions that we have on tobacco; and, if necessary, to act firmly in order to protect the vulnerable.