London Health Commission: Smoking

Lord Faulkner of Worcester Excerpts

Thursday 15th January 2015 Grand Committee

[Lord Faulkner of Worcester (Lab)]

My Lords, I think that the noble Lord, Lord Naseby, will find that he is a lone voice in this debate. I will not attempt to counter all the points, but when he comes to reply, perhaps the Minister will have something to say about the so-called evidence adduced from Australia, which so far as I am aware has been produced only by the tobacco industry itself. It funded the research. Perhaps the Minister will be able to confirm that.

I shall start by congratulating my noble friend Lord Darzi on securing the debate and on contributing to a brilliant report which, if it is implemented, will help London set the lead for all of us to lead healthier lives in the future. I agree with absolutely everything he said in his speech.

As a direct result of the measures taken by Parliament, and particularly in this House, the UK is now a world leader in tobacco control legislation. Smoking by people aged 16 years and over has reduced over the past decade by more than a fifth, from 26% to under 20%. As a result, there are almost 2 million fewer smokers than a decade ago. Your Lordships will recall that all the tobacco control measures contained in the Children and Families Act 2014 began their lives not in the House of Commons but in this Committee Room, and were the subject of amendments proposed by Members from all parties. Three of them are here today, and I am delighted to see that the noble Baroness, Lady Finlay of Llandaff, is to speak and that the noble Baroness, Lady Tyler of Enfield, has joined the debate. It was to the Minister’s great credit that he accepted the principle for adopting standard packaging for tobacco products here, and he graciously responded to the defeat in the House on smoking in cars when children are present by ensuring that the House of Commons was given the opportunity to vote on it too. I understand that the regulations to give effect to that will be with us shortly.

However, like my noble friend Lord Darzi, I am concerned that there seems to be some doubt about the Government’s resolve on standard packs. My understanding is that to ensure that Parliament is allowed its say before the general election, the Government must ensure that regulations are laid this month so that they can go through parliamentary scrutiny by the Joint Committee on Statutory Instruments and the Secondary Legislation Scrutiny Committee in time. I really hope that the Minister will be able to confirm today that this is their intention. To delay a vote on standard packaging until after the election would be seen by the tobacco industry as a significant victory and would seriously damage the Government’s credibility on health issues.

The case for standard packs is simple. Cigarettes are the only legal products sold in the UK that kill their consumers when used exactly as the manufacturer intends. No company should be allowed to promote such a product through advertising and marketing. Thanks to our efforts here and those of the public health community, packaging is the tobacco industry’s last remaining avenue to lure vulnerable children into starting to smoke. It must therefore be made as unattractive as possible. Contrary to what the noble Lord, Lord Naseby, says, it is a policy that works. Recent evidence from Australia, which was the first country to introduce standardised packaging, shows that soon after standard packs began to appear in shops, smokers reported finding cigarettes in these packs less appealing or satisfying. Research has also shown that smokers consuming cigarettes from standard packs were 81% more likely to have thought about quitting at least once a day during the previous week.

Standardised packaging is intended to protect children and young people from starting to smoke. Young people are a vital market for the tobacco industry, particularly young women. The marketing message is this: smoking is cool, glamorous, and constitutes adult behaviour. Some two-thirds of smokers start before they are 18 and the vast majority while still teenagers. Every day, hundreds of children in the UK start smoking. Standardised packaging would remove the existing attractive promotional aspects and require the appearance of all tobacco packs to be uniform, including the colour of the pack. They are not going to be plain packs, as the noble Lord, Lord Naseby, says; they will allow for the promotion of strong anti-smoking and health messages. Studies from around the world show that plain, standardised packs are less appealing, make health warnings more effectively, and reduce the ability of the packaging to mislead customers about the harm caused by smoking. In April this year, Sir Cyril Chantler’s government-commissioned independent and comprehensive review of evidence reported that there is a strong public health case for the policy, concluding that,

“the body of evidence shows that standardised packaging … is very likely to lead to a modest but important reduction over time on the uptake and prevalence of smoking and thus have a positive impact on public health”.

If I had a little more time, I would widen the debate and talk about the tobacco control plan for England, which expires at the end of the year, and ask the Minister to give an assurance that it is his intention that it will be taken forward after it expires. I also hope that he will be able to say positive things about the measures contained in the London Health Commission’s report, including the licensing of retailers for tobacco.

I will finish with the comment of the Chief Medical Officer, Professor Sally Davies, who supports the smoke-free park plan, saying that it will stop,

“role modelling in front of children”.

It is children and young people that this policy must be directed towards.

--- Later in debate ---

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, I thank the noble Lord, Lord Darzi, for securing this important debate. As we have heard, the Mayor of London set up the London Health Commission in September 2013, with the noble Lord, Lord Darzi, as chairman, to review the health of the capital, from the provision of services to what Londoners themselves can do to help make London the healthiest major global city. In October, the London Health Commission published its report, Better Health for London, with a range of recommendations for the Mayor of London to consider. I congratulate the noble Lord, Lord Darzi, and the members of the London Health Commission on their well considered and thought-provoking report.

Local government has responsibility for improving health and well-being in its communities, including reducing rates of tobacco use. Noble Lords will understand that it is not for me as Health Minister to respond to the London Health Commission’s report. That is for the Mayor of London, for whom the London Health Commission prepared its report. I will, however, be very interested to see how the mayor progresses the recommendations that have been made.

Nevertheless, given the Government’s commitment to tobacco control, I particularly welcome this opportunity to tell your Lordships more about the work we are doing to tackle tobacco use. Tobacco remains one of our most significant public health challenges. Smoking is a leading cause of cancer, cardiovascular and respiratory disease; smoking is the primary preventable cause of morbidity and premature death; smoking is a significant driver of health inequalities and remains the biggest cause of inequalities in death rates between the richest and poorest in our communities; and smoking places an enormous strain on the NHS, while the overall economic burden of tobacco use to society is estimated at more than £13 billion a year. We must also remember that tobacco use is harmful not only to individual smokers, but to others around them.

Reducing smoking rates is a public health priority for this Government. In early 2011, we published the Tobacco Control Plan for England, which set out a comprehensive package of evidence-based action to be implemented at national level to support local areas in driving down rates of tobacco use. We also set out in the plan the importance of our efforts to reshape social norms around tobacco use to promote health and well-being. The noble Lord, Lord Faulkner, and the noble Baroness, Lady Finlay, asked what our plans were for refreshing the tobacco control plan. As they said, the plan sets out action until the end of this year. Like both noble Lords, I, too, hope that whoever are in government after the election continue to take comprehensive and effective action on smoking. However, it will be, essentially, for the next Government to take that decision.

From the outset, we ought to reflect the enormous amount of progress that we have made over the past decade. Smoking rates in England are at their lowest since records began. Today, around 18 per cent of adults are smokers, down from around half of adults smoking in the 1970s. Almost 2 million fewer people in England are smokers compared to a decade ago, and London has some of the lowest smoking rates in the country. We know that the majority of smokers take up smoking when they are teenagers. Most smokers were regularly smoking before turning 18 years of age—before they were able to make informed, adult decisions about tobacco use.

The good news is that rates of regular smoking by children in England between the ages of 11 and 15 years have declined by some 70 per cent since 2000. However, I want to be clear that continuing to reduce the uptake of smoking by children is essential. Research published in 2013 shows that every day around 600 children aged between 11 and 15 years start smoking in the United Kingdom.

The Government have taken action to protect young people from tobacco and nicotine addiction and a range of new powers relating to smoking were introduced through the Children and Families Act 2014. We have laid regulations to end smoking in private vehicles carrying children in England, which shortly will be considered in your Lordships’ House and in the other place. New legislation will stop adults buying tobacco on behalf of children.

The Department of Health is currently consulting on proposed regulations to bring the same age-of-sale requirements into place for electronic cigarettes that exist for tobacco. I would just say, on electronic cigarettes—mentioned by the noble Baroness, Lady Finlay—that while there is emerging evidence that e-cigarettes may be helpful to some people wishing to quit smoking, the quality of products on the market remains highly variable. We continue to work towards a regulatory framework that ensures for those smokers who want to use e-cigarettes to cut down or quit that they meet quality standards and are accompanied by sufficient information to enable informed choices. However, e-cigarettes are not risk free. We do not know enough about the long-term health effects of adults, let alone children, using e-cigarettes. Furthermore, as there have been no long-term studies to examine whether e-cigarettes serve as a gateway to tobacco use, we cannot be certain at this stage about whether there is a gateway effect from the use of e-cigarettes into tobacco smoking, so further research is needed to answer that question definitively.

The display of tobacco products in shops can promote smoking by young people and undermine the resolve of adult smokers trying to quit. Legislation to end tobacco displays has already been implemented for large shops such as supermarkets. All other shops selling tobacco, including corner shops, will need to end their displays of tobacco on 6 April.

The issue of standardised packaging for tobacco has been raised by almost every Peer who has spoken. I want to be clear that the Government have not made a final decision on whether to introduce legislation for standardised packaging. We held a final, short consultation that closed in August and the results are informing decision-making. It is important that the Government have time to carefully consider all issues relevant to the policy. I assure noble Lords that a decision will be made in due course. However, in saying that, I reassure your Lordships that we in the Department of Health are, as I speak, very actively working towards a decision. The draft regulations for standardised packaging were notified to the European Commission under the technical standards directive on 29 August. We have received detailed opinions from 11 member states, which extends the “standstill” period to six months. This will expire on 2 March 2015 and until then we are unable to make regulations, although I hear what the noble Baroness, Lady Finlay, says about laying regulations.

As regards evidence from Australia—

[Lord Faulkner of Worcester]

Before the noble Earl moves on, will he confirm that Sir Cyril Chantler’s report, which he commissioned, is helpful to him in coming to a view as to whether or not standardised packaging should be introduced? Does he accept the report and its conclusions?

[Earl Howe]

Undoubtedly it is extremely helpful although I am sure that the noble Lord would be the first to acknowledge that there are considerations that Sir Cyril did not address, which we obviously have to do across government before taking a final decision.