Tobacco and Vapes Bill

Mary Kelly Foy Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

I declare an interest as the co-chair of the all-party parliamentary group on smoking and health. Just over a year ago, I welcomed the previous Government’s Tobacco and Vapes Bill. As the House may know, I have called for a smokefree generation for many years. I was not best pleased when the Conservatives voted down my amendments to the Health and Social Care Bill in 2021. Those amendments called for a ban on flavours and packaging targeted at children, which the shadow Secretary of State has just brought to the House’s attention. If they had not been voted down, we would already have regulations to protect children from smoking and vaping.

I join the Secretary of State in congratulating the former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak) on bringing the Smoking and Vapes Bill forward, but it was regrettable that the previous Government did not fast-track it in the wash-up before the general election. Nevertheless, I am grateful to the Labour Government for bringing this Bill forward. It is stronger than the previous legislation, and it responds to many of the issues that I and others raised in Committee with the previous Bill.

The comprehensive regulation of all vaping and nicotine products is important for addressing the concerns that vaping has become too widespread among young people. I strongly support regulations to reduce the appeal of such products, but we must ensure that the regulations are enforceable, robust and fit for purpose. My first of many questions to the Minister is this: will he confirm that a detailed policy paper will be forthcoming, setting out the policy objectives on vaping and how the new regulations will deliver against the objectives?

The Labour manifesto made a bold commitment on halving the gap in healthy life expectancy between the richest and poorest regions in England. Tobacco control is the best way to close the gap. We cannot say it enough: the range of diseases that smoking causes is extraordinary, from stillbirths and asthma in children to heart disease, stroke, dementia in old age, poor mental health and many cancers.

It will never cease to amaze me that there are people in this place who are happy to be lobbied by the tobacco companies—including, I am guessing, the shadow Secretary of State—some of whom we have heard from already, knowing full well the damage caused to individuals, families and communities, as well as to our health services. That includes communities such as mine in the north-east of England, where smoking is still the key driver of health inequalities and has been the cause of 26% of all deaths in the last 50 years and the cause of 125,000 deaths since 2020.

In my constituency of City of Durham, smoking costs us over £95 million a year, and more than £3 million is spent on healthcare. In County Durham, smoking costs us over £500 million a year, and over £21 million is spent on healthcare. In the north-east, the cost is over £2 billion, with healthcare costs at over £93 million. Nationally, smoking is still the greatest cause of preventable death, still the leading cause of premature death and disability, and still responsible for half the difference in healthy life expectancy between the rich and poor. That is why I have asked time and again in this Chamber for action.

It is a tragedy when we consider the further health implications. According to Cancer Research UK, the most deprived communities will not be smokefree until 2050. I urge the Government to restate their intention to publish a road map to a smokefree country and outline how support will be targeted at those who most need to quit. Smoking is also directly and indirectly linked to poor mental health. Nearly 40% of those who have a severe mental health problem smoke, and smoking accounts for two thirds of the reduction in life expectancy among that group.

I want to touch on the “polluter pays” levy. The Darzi review found that our health service is in real trouble. The Secretary of State is right that to rebalance supply and demand in our healthcare system, we need a major shift from sickness to prevention. The Khan review and the all-party parliamentary group on smoking and health have advocated for a “polluter pays” levy, which could raise £700 million a year to create a smokefree fund. That would ensure that the tobacco companies—not the public—pay for the harm that they inflict. Will the Minister consider that approach to fund the work needed to reduce smoking across society and to protect the NHS?

I should add that public health initiatives to tackle smoking are remarkably good value for money and that failing to fund efforts to tackle smoking is a false economy. Initiatives such as Fresh—the north-east’s tobacco control programme—have led the way in tackling smoking in our region. Fresh and others could provide best practice for the Department.

The Minister will know that the UK Government are party to the World Health Organisation framework convention on tobacco control. Article 5.3 seeks to protect policymaking from industry influence, but we have already seen that influence even at this stage of the Bill. Will the Minister confirm that the Government will live up to their obligations under the FCTC and commit to protecting the Bill from industry influence throughout its parliamentary process and the following regulations?

I am proud to vote for a Bill that will improve people’s lives and extinguish the injustice that smoking causes to individuals and society. Smoking is never about choice, and it is pathetic that some Members have argued that this is an issue of freedom; it is absolutely nothing of the sort. Tobacco companies target children and young people. Smoking is an addiction, and the only free choice is that first cigarette. When someone is in hospital, struggling to breathe because of smoking-induced lung cancer, where is their freedom? Today, we have the opportunity to give people the freedom to live healthy lives, free from disease and the inequalities that smoking causes.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

Tobacco and Vapes Bill (First sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Sadik Al-Hassan (North Somerset) (Lab)]

I declare an interest as a practising pharmacist. [Interruption.]

[Mary Kelly Foy (City of Durham) (Lab)]

I cannot hear everything because of that noise, but I am co-chair of the all-party parliamentary group on smoking and health.

[Jim Dickson (Dartford) (Lab)]

I declare an interest as vice chair of the APPG on smoking and health.

Examination of Witnesses

Professor Sir Chris Whitty, Sir Francis Atherton, Professor Sir Michael McBride and Professor Sir Gregor Ian Smith gave evidence.

--- Later in debate ---

[The Chair]

I have about three minutes left, so I will ask Mary Kelly Foy to ask a very brief question with a very short answer, because we will be finishing spot on 10.25 am.

[Mary Kelly Foy]

Q Do you have any view on how restricting vapes in public places, which is obviously a very welcome power, should be implemented so that it does not deter smokers from switching to vapes and they do not relapse back into smoking cigarettes?

Professor Sir Chris Whitty: I will suggest that Sir Frank takes this question, because it is his very last answer to a parliamentary question; he is about to stop as chief medical officer, so he is going out on a high.

Sir Francis Atherton: What the Bill does is to simplify matters, making it as simple as possible: a smoke-free place is a vape-free place as well. That does not take away people’s ability to go into a place where smoking and vaping are allowed, but it helps to disentangle the confusion that currently exists about where people can legitimately use those products. It is a simplification that can only help to lead, in the long term, to that reduction that we need. In Wales, 13% of people continue to smoke. Our ambition is to get to 5% by 2030; we will struggle to get there, but this Bill will help us to get there.

[The Chair]

I am afraid that that draws this particular session to a close. I thank our witnesses, Sir Chris Whitty, Sir Francis Atherton, Sir Gregor Smith and Sir Michael McBride, for their attendance and for their helpful contributions, and I thank Members for their helpful questions. Thank you very much.

Examination of Witnesses

Hazel Cheeseman, Sheila Duffy, Suzanne Cass and Naomi Thompson gave evidence.

--- Later in debate ---

[Sarah Bool]

Q I want to follow up on that point, because clause 12 of the Bill will actually include a ban on vending machines for vaping, but I know that there have been mental health trusts that have said that, actually, they would call for those to be exempted. Is that one of the exemptions that you would perhaps go for, and actually allow those vending machines in hospitals?

Suzanne Cass: Absolutely. I think we need to consider the vulnerable smoker at the heart of this and how they are managing to abstain from that addiction. It comes back to that addiction all the time. With smoking, nicotine is such an addictive substance that it is very difficult just to tell somebody that they cannot do it. You need to give them the right support, as well as the support that they want. When it comes to choice, that is where we need to be looking at what their choices are and how they choose to move away from that deadly tobacco use.

Hazel Cheeseman: On the mental health settings, we have done a lot of work in England with mental health trusts, and vending machines have been one way in which they have been facilitating access to vapes in quite a large number of mental health trusts. It is certainly something that we would be interested in looking at, because it will make it a bit more challenging for them to implement smoke-free policies in mental health settings if the vending machine rule applies across the NHS estate.

Also, going back to Dr Cooper’s question, in mental health settings and those places with vulnerable smokers, vapes have been really important in England in facilitating. We do not have legislation in relation to smoke-free grounds in England, but obviously it is the policy across the NHS estate that they are smoke free. Allowing vaping, particularly in those mental health settings, has been very facilitative of creating smoke-free grounds and supporting those people to maintain their smoke- free status as they move out of mental health settings as well.

Sheila Duffy: Scotland already has a ban on e-cigarettes in vending machines and has had for some years.

[Mary Kelly Foy]

Q I notice in your submission that you have a recommendation:

“The government should make good on their pledge to publish a ‘roadmap to a smokefree country’…with a strong focus on tackling inequalities.”

I am from the north-east region, where we have high deprivation and high smoking prevalence. It is the only region that has a clear vision—if you like—and declaration from Fresh and the directors of public health for how to achieve a smoke-free country. Could you explain a bit more why we need that vision and that strategy going forward?

Hazel Cheeseman: The legislation is fantastic; it is world-leading and brilliant, and it will really set us on that path toward being a smoke-free country. However, it will not be the last word in how that is achieved. We have 6 million smokers across this country, and we need to ensure that all of our agencies are lined up to do the job that they need to do to help those people stop smoking—the NHS, local government and integrated care boards across the system need to have the right approach. We also need to ensure that the funding is there to do that too. The Government have committed to the funding in stop-smoking services in local government, but we also need to see funding in mass media campaigns. The chief medical officer was talking earlier about people’s waning understanding of the harms of second-hand smoke. One way to address that would be to go back on TV and radio and explain to people what the harms of second-hand smoke are. That package of measures alongside this legislation would really help us to accelerate progress.

The Bill will massively raise the saliency of the harms of smoking with the public—there is no doubt about that. There has been, and there will continue to be, a strong public debate on the measures in this Bill. By really riding the wave of that public understanding through that coherent strategy and that investment, we could really see smoking rates start to drop, particularly in those disadvantaged populations where we continue to have persistently high levels of smoking.

[Euan Stainbank]

Q By restricting vaping products in this Bill in the same ways that tobacco products are currently restricted—be that packaging, display or potentially flavourings, as we discussed with the CMOs earlier—do you think that this will lead to greater misconceptions by the public and, quite crucially, current smokers about the relative harm between the two products?

Suzanne Cass: We obviously have an issue when it comes to the understanding of and the misconceptions around the harms of vaping. In particular, the most worrying stats are among smokers considering them as harmful as or more harmful than tobacco. That is that a significant issue. This legislation allows us to reset the clock and promote these products as smoking cessation products, using health professionals to promote them and getting the right language around them. Rather than their being seen as a recreational toy, they can be seen as a product that is going to help people to quit smoking. When it comes to the positioning of these products, it is essential to readdress those misconceptions and re-place this product.

On standardised packaging, what we did with tobacco was put it in the ugliest packaging you could ever imagine. We are not talking about that when it comes to vaping products; we are talking about plain packaging—something that is informative but not necessarily attractive to young people. There is a big difference between something that is repulsive and something that is not attractive. That is where we see the difference, and that is where we see this legislation coming into its own and allowing us to reset and to have that different conversation.

Hazel Cheeseman: I am sure we will tease more of it out through the consultation process that will follow this legislation, but some of the early research that has been done has indicated that you can, to some extent, have your cake and eat it on this. If we remove some of the attractive branding elements on packaging, which we know appeal to children, that does reduce the products’ appeal to children, but it does not damage their appeal to adult smokers and it does not damage harm misperceptions. We can progress with this legislation, via the consultation and looking properly at the evidence, to make sure that we get the balance right.

There are also provisions in the Bill to allow public health bodies to do marketing and public health messages around vapes as a smoking cessation tool. It will be important that the Department of Health and Social Care and the Advertising Standards Authority work with public health bodies to make sure that they have the right guidance to be able to do that and to give smokers directly the right information about how vapes can be used as a cessation tool.

Tobacco and Vapes Bill (Second sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Mary Kelly Foy (City of Durham) (Lab)]

Q Can I ask a question to all of you? We know that the Bill will go a long way towards reducing health inequalities. In more deprived areas, which have the highest prevalence of smoking, will the Bill also have an impact on the economics of local communities?

Professor Tracy Daszkiewicz: That is exactly the focus: reducing health inequalities and ensuring we get good health equity across all of our populations. When we look at preventable premature mortality, we know that smoking is a huge driver around that. We need to think about this across the life course. If we can stop the harms that second hand smoke causes to children, we can then think about deprivation across the life course and people who are dying early from preventable harms, with smoking being one of the risk factors.

We need to focus really narrowly on that, because it is not just about life expectancy, but about the number of years we live in good health. In my patch across Gwent in Wales there is huge variance, with up to 14 years’ difference in healthy life years between the richest and the poorest parts of the population. It is about not only the health outcomes around that, but the economic part of it, in terms of work productivity and work days lost. When we think about the cost of the NHS, which we often do, that is the cost of healthcare, but if we look at the economic picture of employability, productivity and those kinds of things, it increases that sum tenfold. We need to think about this so that when we look at the inequalities associated with smoking, we do so through a social, cultural, economic and environmental lens, to ensure that we get the full cost impact. It is something that we need to be mindful of.

Alison Challenger: I wanted to make a point about household income. We know that cigarette smoking is incredibly expensive. If one or both parents smoke in a household with a low income, that will have a considerable impact on the family’s spending capability for other things. It is not a matter of choice, either; smoking is an addiction. Seven out of 10 smokers really do not want to smoke, but it is incredibly difficult because of the level of addiction. If one or both parents smoke in a family household, that has huge repercussions for the funding of all the other household commitments.

[Sadik Al-Hassan]

Q We have touched on local variations. How do you think local variations should take into account the small variations in health inequalities that exist in different areas? You gave an example of a shop being the only shop in a village, but if that village was also an area of high deprivation, how should that affect the outcome?

David Fothergill: That is where local knowledge comes in. Taking that shop in the village, we would not say that it should not sell tobacco, but we would say that it should not be selling tobacco during these periods—for example, 8.30 am to 9.30 am, or 3.30 pm to 4.30 pm. Knowing the local communities and being able to put in local restrictions would help us to really have an impact. Clearly, in urban areas it would be very different.

When the Minister asked questions about England, Wales and Northern Ireland, I should have said that what we would really like to see—it is in the Scottish legislation—is verification, where people are required to verify their age. Challenge 25 seems to work really well with alcohol, and we would like to see that brought in. We understand that that is in the Scottish legislation, and we would like to see it brought in in England as well.

--- Later in debate ---

[Euan Stainbank]

Q Thank you. My second question digs into the illicit online vape market that you referred to. Is the issue more the structure of enforcement that you were discussing, or do you have any concern about online retailers’ age gating policies?

Lord Michael Bichard: No, the point I was making was about enforcement.

Wendy Martin: To add to that, as part of the programme that DHSC has been funding for the last 18 months, we tested out a number of issues, and one was online under-age sales. I think we tested 312 purchases, and there was a 10% failure rate. That was significantly lower than premises-based sales. There was a lot in the platform’s corporate website design to try to ask the right questions and kick purchasers out. It is very much about who does it and who takes responsibility, rather than a major problem in itself.

We also work quite closely with the Advertising Standards Authority, and it does a lot around broadcast and published media, and website compliance and claims. That is quite a well-established mechanism for enforcement. It is about the structure of enforcement, as you have rightly identified.

Lord Michael Bichard: It is probably worth pointing out—it does not relate to the online point—that I said earlier that last year we carried out 4,000 test purchases, and 26% of those were failures. Compared to the 10% online, it is significantly higher. This is a very practical point, but some of the other changes that are going to happen will make it easier for us to do test purchasing. At the present moment, we can only use children or young people, so we have issues of safeguarding and we can only do it at certain times of the day. It should become easier, in that sense, for us to enforce the legislation.

[Mary Kelly Foy]

Q We heard from a previous witness that young people say that most of the advertising for vapes is in the shops. The Bill will bring in powers to regulate vapes, and that includes advertising. How do you envisage that the ban on advertising will be enforced on the high street, locally and in small shops?

Lord Michael Bichard: It will be enforced in the same way we enforce it for tobacco and other things. This is not new. Trading standards officers employed by local authorities are constantly visiting premises, and they will therefore deal with any offences that are being committed. They also have their own local intelligence networks. We cannot afford, because we do not have enough staff, to just have a random system where we pop in every now and then. We depend on people giving us intelligence. Some of those people are members of the public, and some are from other agencies. We try to target what we do. When you visit a shop—there are something like 60,000 outlets—you can see whether the current legislation, or future legislation, is being implemented. We can take action against the retailer if it is not.

[Mary Kelly Foy]

Q I was basing that on what you said at the beginning—that trading standards had been cut by 50%—so I know that local authorities will struggle. I also know that although a penalty has been put in place, six months later that same shop will be doing exactly the same thing again. I guess the question is about the resourcing of trading standards—

Lord Michael Bichard: Absolutely. I was going to say that if you are making a case for trading standards to have more resources, I am absolutely with you. I think that trading standards does an amazing job with limited resources. One borough in London now has no trading standards officers, and that is a great worry. We are there to protect consumers in all sorts of ways, but we are also there to try to establish a fair marketplace, so we are working on behalf of legitimate businesses. A lot of retailers want to support us in dealing with bad practice among their competitors. Yes, we need more resources.

Wendy Martin: Clearly, the responsibility is on businesses to comply with the law, first and foremost, and the hope would be that the vast majority of those outlets do so, because they are either part of bigger businesses with corporate structures to ensure compliance, or part of trading associations where that training and information is available. Generally, most people want to do the right thing. What that means is that the additional resources are necessary and can be focused on those sectors where there is intelligence from consumers, enforcers and other businesses—businesses will complain, and rightly so, about competitors who are flouting the law. That enables targeting, rather than feeling the need to try to inspect 60,000 or 70,000 premises. That would not work, and it does not need to work like that.

Lord Michael Bichard: Local trading standards officers know the problem retailers, where the problems are. I started my career doing prosecutions for trading standards, so I know a bit about how they work on the ground. They know where to target their efforts. I should also point out that there is a committed workforce here. Recently, we did a survey of the workforce, and 80% of them supported the legislation. It always helps.

[The Chair]

One final quick question from Jim Dickson, before we have to go on to the next panel.

--- Later in debate ---

[Sadik Al-Hassan]

Q From what I remember, vapes really started in the UK around 2010. Do you think that the Bill is sufficiently future-proof for the next evolution of nicotine or oral tobacco products? Whatever is coming next, do you think the Bill has enough to protect us from it?

Professor Sanjay Agrawal: I have not yet had the chance to say this, but first, I think the Bill is really well balanced. It is bold and world leading; all nicotine products and non-nicotine containing vapes are part of it. The people who put this together should be congratulated, but we also have to be aware that industry never sleeps. It will try to adapt to regulation and legislation, and we need to be wary of that and make sure that we use the powers in the Bill in the future, depending on how industry responds.

For example, with disposable vapes, which are due to be banned later this year, I am sure that there will be a lot of companies right now changing their products to make them look as though they are not disposable vapes when, to all intents and purposes, they are. There will be lots of adaptation by industry that we must be wary about. The Bill provides those future powers for us to adapt to industry.

[Mary Kelly Foy]

Q As we know, we have very high levels of child poverty in this country. Much of that poverty is in the areas where there is high smoking prevalence, as well as many other health issues. How important do you think the Bill is for the health of children as they grow into adulthood, for the impact that it will have on the communities they live in, and for addressing inequality?

Professor Steve Turner: Touching on what I have said before, there are communities, invariably the poorer communities, in something called the tobacco map. If you look at the areas where tobacco use is greatest, it maps totally on top of deprivation. We have an opportunity to break that generational social norm of, “It’s okay to smoke.” The people who come to the greatest harm from cigarette smoking and nicotine addiction are invariably the poorest. What is proposed here will be a good step towards narrowing the divide we see in this country in health outcomes, which is totally determined by poverty.

Professor Sanjay Agrawal: We estimate that around 350 children a day start to smoke. A lot of those will be from the most deprived communities. In addition, smoking in the UK brings around a quarter of a million families into poverty, and those families have children. The Bill will go a long way to not only reducing the health harms to individuals, but reducing poverty and hopefully smoking-related deprivation.

To answer one of the questions earlier about the cost of smoking to the NHS, it is estimated that it costs secondary care about £1 billion a year. With primary care in addition, that is a total cost of £2.6 billion to the NHS, around £20 billion a year to social care, and about £50 billion a year in lost productivity. That is the overall cost of smoking to our society, whether at the level of the individual, poverty, deprivation, social care or workforce productivity, and that is why the Bill is so important.

[Jim Dickson]

Q Some other countries, notably Australia and Canada, have introduced mandatory health warnings for manufacturers to place on individual cigarettes and filters, because quite often, young people in particular are accepting cigarettes away from the packaging. Do you see that as a useful way of increasing the saliency of health warnings?

Professor Sanjay Agrawal: These additional measures warn people away from smoking—those who might be looking at the packaging or the individual cigarette. Remember, an individual cigarette—every time someone takes out a cigarette—is an advertisement for cigarettes. Lots of times, children are sold cigarettes on a per-cigarette basis, and they have never actually seen the packet; they have only seen the cigarettes. Therefore, having on-cigarette warnings is another measure that we can introduce to warn people off the harms of smoking. It would be great to see that.

--- Later in debate ---

[Mr Barros-Curtis]

Q Minister, could you say a bit more about why you are taking the four-nation approach? I am a Welsh MP, and we have talked about some of the positive and progressive examples that have been illustrated in Wales, which we can learn from. Is the four-nation approach one of the strengths of this Bill? Will it help to ensure that you get that world you talked about, which I suspect—although I do not want to speak for everyone—we all support? Can you say a bit more about that four-nation approach, and if that is one of the key strengths underpinning this Bill?

Andrew Gwynne: It is. The four nations that make up our United Kingdom have gone at different speeds and to different depths in terms of tobacco control over recent years. Zubir was absolutely right to point out that it was the Scottish Labour Government that first introduced the indoor smoking ban, and we followed suit soon after, but it is really important that the four nations stand together on this, not least because some of this does require a four-nation approach in legislative terms. It also means that we can meet this ambition together, and that we are all in this together, because, for me, a health inequality in parts of Greater Manchester is just as important as a health inequality in Glasgow, Cardiff or Belfast.

We need to tackle these inequalities, because they are a scourge on our society. That is why a four-nation approach, alongside the permissive nature of this Bill, means that the four nations can go forward together, but also diverge on the basis of extending consultations and so on. That is why we have the support of the devolved nations and the Ministers, who come from different political persuasions across Northern Ireland, Wales and Scotland; we are all in one, as far as this Bill is concerned, and we have shaped it together.

[Mary Kelly Foy]

Q We have heard overwhelmingly from the witnesses how important the Bill will be for tackling inequalities and bringing about a smoke-free future. I am confident that the Bill will pass. In terms of supporting the 6 million current smokers that we have in the UK, do the Government still have plans to make good on their pledge to produce a road map and strategy for reaching targets, especially in places such as the north-east and other deprived area? That way, we can keep an eye on those smokers who do want to quit and what the smoking prevalence ranges are in those areas. A few of the witnesses and submissions have called for that, saying how it would help them.

Andrew Gwynne: That is really important, and I want all Members to understand that a key aspect of reaching our smoke-free ambition is to drive down the prevalence of current smokers. That means a real investment in smoking cessation, a close eye on what is happening on the ground, and using the flexibilities in the Bill, should they be needed, to ensure that we reach that smoke-free ambition.

We announced £70 million of stop smoking funding this week, which has been weighted towards the areas with highest deprivation and smoking prevalence, so that we can try to drive down those inequalities. Obviously, future years funding is subject to the usual processes of the spending review, but let me make it clear that it is a priority of this Government to invest in stop-smoking services. We will ensure that local authorities and the public health functions of the country have the resources needed to reach a point where we are smoke free.

[The Chair]

Last, but certainly not least, I call Taiwo Owatemi.