Smoke-free Society by 2030

Debate between Mark Pawsey and Jo Churchill

Tuesday 23rd March 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank my right hon. Friend the Member for Clwyd West (Mr Jones) for securing the debate, and I am grateful to the hon. Member for North Antrim (Ian Paisley), my hon. Friend the Member for Dartford (Gareth Johnson) and the hon. Member for Strangford (Jim Shannon) for their comments. What joins us together is the passion shared across the House. Everyone wants to tackle the harms of smoking. Smoking kills.

I agree with my right hon. Friend the Member for Clwyd West that we have a good story to tell and should not be afraid to tell it. As he is aware, some good work has been done over the past couple of decades to drive smoking rates down. Rates are now at their lowest level, at just over 13% in England. It is one of the public health success stories. However, we have to do more. We cannot be complacent. There is wide variation, and smoking rates remain too high in certain areas of the country.

Like my right hon. Friend, I would look specifically at the levelling-up agenda in deprived areas, among the lesbian, gay, bisexual and transgender community, and among pregnant women and people with mental health conditions. Our focus on driving down rates across the country must be relentless. We must ensure that they are levelled where they are lowest and that no community gets left behind. The differential between good and poor areas is almost 10 times greater.

Fantastic work is being done to tackle health inequalities in different areas, including recently through the NHS long-term plan with regard to smoking in pregnancy. Its commitment to the maternity transformation fund has provided additional training to give midwives the knowledge, skills and confidence to offer brief advice to women during antenatal appointments, and upskilled practitioners to deliver stop- smoking interventions to those who need help.

[Mark Pawsey (Rugby) (Con)]

The Minister has spoken about having a good story to tell. Is not the take-up of vaping in this country a good story? She will know that we have a very active all-party parliamentary group on vaping. We are about to send her a report—it is currently in draft form—relating to the WHO conference of the parties in November. We took evidence and I wonder whether she agrees that the WHO’s negative view of vaping has been counterproductive. As my right hon. Friend the Member for Clwyd West (Mr Jones) said in his excellent speech, its attitude is partly responsible for the downturn in the number of people vaping. Given the level of interest in this debate, does the Minister think we ought to have a longer debate in order to consider these issues more fully?

[Jo Churchill]

I thank my hon. Friend for his intervention. Given that this is a 30-minute debate and there is a lot of interest in it, I agree that a longer debate might allow us to explore these things. I will comment on COP and the variety of products. We need to use everything in our armoury to encourage people to quit smoking.

We need to help people give up. We are working to ensure that no communities are left behind, as part of the bold ambition to be smoke-free in England by 2030. I listened carefully to my right hon. Friend the Member for Clwyd West talk about how we pack a punch in this area, but things will need to be evidence led. We will set out how we will deliver this later in the year, when we publish the new tobacco control plan for England in the summer. He asked me to reconfirm that we are on track for doing that, and I agree with him that it is a stretch to reach our target by 2030.

We know that the best thing a smoker can do is quit altogether. Covid-19 has brought into clearer focus the need for us to care for our health. PHE has issued guidance on the impact of covid-19 on vaping and smoking, and we know that if people smoke, they have an increased risk of contracting a respiratory infection. With covid-19, symptoms can be more severe if people smoke, but the evidence base is mixed.

As I have said, the best thing people can do to improve their health is to quit. However, it remains the goal of the Government to maximise the public health opportunities presented by e-cigarettes to reduce smoking. UK-regulated e-cigarettes are far less harmful than smoking, but I reiterate that they are not risk free, which I think plays to the comments made by the hon. Member for Strangford.

Research shows that e-cigarettes are effective in helping some smokers to quit, and therefore we need to support them. We will continue to discourage non-smokers from using them, monitor youth uptake and consider tougher regulatory proposals if we see an increase in youth rates.

There are about 3 million people currently using e-cigarettes in Great Britain. Half of those have quit smoking, which indicates that the other half are using them as part of a strategy. As my right hon. Friend the Member for Clwyd West said, and others have alluded to, it is not a panacea. The UK’s approach to the regulation of e-cigarettes has been, and will remain, pragmatic and evidence based. The current regulatory framework aims to reduce the risk of harm to children, protect against the re-normalisation of tobacco use, provide assurance on safety for users, and provide legal certainty for businesses. We are committed to ensuring that our regulatory framework enables this to continue but does not encourage non-smokers and young people to start taking up the habit.

We made a commitment through the 2017 tobacco control plan to monitor the safety, uptake and impact of the effectiveness of e-cigarettes and other novel nicotine delivery systems—and we have done just that. Public Health England has published a series of evidence reviews which further our understanding of their effectiveness in helping smokers to quit. The latest evidence review was published last month.

In our future tobacco control plan, we will consider further research on other emerging nicotine products that have the potential to help people quit—because there is no such thing as a safe tobacco product and all tobacco is harmful, including smokeless tobacco and other tobacco products that we have discussed today.

No assessment has yet been made of the safety of tobacco-free nicotine pouches. These products are not covered under the tobacco regulatory regulations, but rather the General Product Safety Regulations 2005, and the current numbers are from industry and therefore will need a degree of validation.

There are no plans to go further on snus at the moment because all tobacco products can cause harm. However, we are currently undertaking a post-implementation review on the Tobacco and Related Products Regulations 2016 and this is an opportunity for people to feed in and present new evidence for the Department to consider.

Non-nicotine vapes are regulated under the General Product Safety Regulations 2005, and we will review feedback from the post-implementation review if this area needs to be strengthened, including if the products are a health concern. We have paused a further evidence review due to the impact of covid on resources. However, we are looking for people to come forward, and Public Health England will publish its final evidence review, including a chapter on heated tobacco, later this year. The evidence suggests that these products still pose a risk to users, and, compared with e-cigarettes, we know far less about them. As such, we will be following the principle of ensuring that we have a full evidence base.

Under the Northern Ireland protocol, which the hon. Member for North Antrim referred to, things are in equilibrium at the moment. There is no difference. However, under the protocol, Northern Ireland is required to adhere to the EU’s tobacco products directive. We will work in collaboration with the devolved Administrations on matters that are reserved, and, along with that firm evidence, and in the interests of public health, put that forward.

As part of the regulatory review, the Government are undertaking post-implementation reviews. These will assess whether the regulations are meeting their objectives, and if there are gaps that need to be addressed. We have held a public consultation and we will review the responses.

The UK is a global leader and was very grateful to receive an award from the WHO for being instrumental in helping lower middle-income countries to tackle tobacco use. We are determined to tackle smoking and health inequalities both at home and abroad. We will take targeted action to support communities where rates may remain high. I would like to extend my thanks to hon. Members for debating this important subject.

Question put and agreed to.

Oral Answers to Questions

Debate between Mark Pawsey and Jo Churchill

Tuesday 23rd February 2021 Commons Chamber

[Jo Churchill]

As anybody will know, I have been heavily engaged with the dental profession over recent months, because I agree that a preventive approach to dentistry is certainly one that we need to be moving towards. The activity target is expected to increase availability for patients, who are the important part of the equation. It is important that we support the profession but enable patients to have access and reduce waiting times and backlogs. The target is based on careful modelling—on data—and takes into account guidance on infection prevention and control and social distancing measures. We recognise that there may be exceptional circumstances, which is why there are exceptions to the target level. NHS commissioners have the discretion to deal with exceptions and support dental practices. I have a meeting with everyone again on Thursday.

[Mark Pawsey (Rugby) (Con)]

What steps he is taking to ensure that improvement work on district hospitals is taken forward under the health infrastructure plan.