Tobacco and Vapes Bill (Fourth sitting) Debate
Full Debate: Read Full DebateMary Glindon
Main Page: Mary Glindon (Labour - Newcastle upon Tyne East and Wallsend)Department Debates - View all Mary Glindon's debates with the Department of Health and Social Care
(2 years, 3 months ago)
Public Bill CommitteesI declare an interest as a member of the responsible vaping all-party parliamentary group.
The Chair
Thank you.
Examination of Witnesses
Professor Sanjay Agrawal and Tim Mitchell gave evidence.
Q
Professor Agrawal: It is never too late—that is what I say to patients who are currently smoking. I see people in their 60s, 70s and 80s, so it is never too late to quit. There are always benefits. Even when people have been diagnosed with lung cancer, we can provide treatment in the form of surgery, radiotherapy and so on, and quitting smoking still helps. I think the Bill sends a clear message that we recognise that there are 6.4 million smokers and we need to support them to quit. Vaping is one means of doing that, and we are not trying to take it away from them if that is the only way they have been able to quit smoking. The Bill contain provisions to help all groups. It is not just about stopping young people taking up smoking; it recognises the need to do something for the people who are still currently smoking.
Tim Mitchell: I would say that there is still an imperative to encourage people who smoke to stop smoking, and vaping can be a mechanism for helping with that. Certainly, as surgeons, when we see people who smoke who require surgery, we encourage them to stop smoking. We know that their risk profile through surgery is improved if they can stop smoking, even just a few weeks before they have surgery. Even if they do not smoke on the day they have their operation, that has some benefits. Encouraging people who smoke to stop smoking remains a very good thing to do, in addition to the provisions in the Bill.
Q
Professor Agrawal: In the report we have just published, we looked at a range of studies related to safety. Ann McNeill, who will be talking this afternoon, is in a much better position to talk about that work. We measured the range of toxins and the degree of exposure. E-cigarettes expose people who use them for a short time to quit smoking—which is the only thing we advocate them for—to a much narrower band of toxin, and the degree of exposure is lower. In comparison with tobacco, it is much lower, but in comparison with not using either, unsurprisingly the levels of toxins are higher. The RCP is very clear about that: if you do not smoke, do not vape.
Q
Mr Lawson: You would find it very difficult to enforce it if you were trying to take action against a manufacturer in China, where you do not have jurisdiction. I think the only way of addressing this is in the UK, where the stores are purchasing products and then selling them on illegally.
Q
Mr Lawson: The evidence I have seen is mainly from Spain, where tobacconists must be registered and licensed before they can sell products. In Spain traditionally, vape products have been sold only through licensed tobacconists. More recently, you can see them in convenience stores. I think we are seeing issues in Europe beyond the UK where products are now being sold illegally. Where they are sold in licensed outlets, you generally see much better compliance with the regulations. Obviously the licence can be removed, so it is a deterrent to the retailer to selling any of the products. That would be a good step in the right direction.
Q
Mr Lawson: The main driver behind testing has been to support trading standards in taking enforcement action against illegal products in the market. The testing has therefore focused on two main areas. One is the tank volume, the 2 ml, and the other is the nicotine strength, the 20 mg/ml, so the testing looks entirely at whether products are simply complying with the regulations. I did hear some of the last answers, but there is a very simple step: when it is applied, the MHRA notification scheme works fairly well. Most of the products that we test are not on the notification system—they are not on the MHRA’s portal. There is no check from a retailer or an importer that the products must be on that portal, so there is a bit of an issue there; you can effectively bypass the entire notification process by importing products and selling. Additionally, if the products do not contain nicotine, they are not subject to MHRA regulations.
Q
Professor West: That is a really good question. The wedge issue comes up a lot. Essentially, what is unique about tobacco is the significant degree of harm at low levels of use. With alcohol, it has been and could be argued, there is at least some degree of harm from so-called moderate use, the level of harm is of an order such that, I think, most people in society would say, “Well, you know, this is okay.” Even non-daily smoking, however—even smoking one, two or three cigarettes a week—can present significant harm, particularly of cardiovascular disease, for example, which has a very nonlinear function relating the exposure to the risk. So there is that, the unique harm.
The other unique thing about tobacco is the proportion of users who become addicted. With alcohol, alcohol dependence as it would normally be measured is present —depending on your definition—in between 5% and 10% of users. With tobacco and cigarettes in particular—not all tobacco or nicotine products are identical, but with cigarettes in particular—it is much higher than that. A majority of people who use any amount, and any form, of smoked tobacco probably have a significant level of addiction. That would be my response.
Q
Professor McNeill: Very. Keeping vapes accessible, both in terms of price and where they can be purchased, is really important for smokers to stop.
Professor West: I was going to reinforce the point about young people, smoking and disposables. It is about the unit cost, or having a low start-up cost. With disposables, if you look at it over the long run they are more expensive than having a tank device and refilling it with the liquid, but the upfront cost is greater. We do not know for sure, but certain bits of evidence point in particular directions. If you put the unit cost, or the start-up cost, together with the potential ease of use, the appeal and all the rest of the things in the package, you reach a point at which arguably you cross a threshold and then it begins to take off. Then it becomes a self-fulfilling thing, because it becomes fashionable and faddy. It is possible, if the plateau we are seeing now carries on or if it starts to go down in the absence of what we might do, that will also be testament to the social norm side of it. Running against that is the fact that nicotine is addictive, so that will drive it up. However, I think you make a good point.
Q
Professor McNeill: I certainly think the cartoon packaging and names are inappropriate and clearly targeted, at young people, as I think the previous speaker said, and they are unnecessary. As she said, they are probably not having the effect we want with adult smokers in making them feel that these products are for them, so I do think about reducing that branding. The promotions on social media seem to be important and influential, so if something can be done about that, that would be good. I also think the easy accessibility in shops is a factor.