Tobacco and Vapes Bill (Fourth sitting)

Mary Kelly Foy Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Dr Johnson]

Q Do you have any more details about the medical effects of vaping on non-smokers?

Professor Agrawal: Nicotine itself can raise the heart rate and raise blood pressure, although usually less so than tobacco. As I said, we do not advocate vaping for anybody who does not smoke.

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

Q Good afternoon to you both. You have explained to us the horrors and the multitude of harms that tobacco smoke can have on an adult who smokes. Can you explain a bit about the effects that second-hand tobacco smoke has on children, who have even less choice in the matter?

Professor Agrawal: We know that second-hand smoke causes a range of diseases for children, whether that is triggering asthma exacerbations or infections, such as middle-ear infections. There is a bunch of infections that are much more likely in children whose parents, carers or siblings smoke, and they are exposed to that second-hand smoke. By treating adults who smoke and helping them quit, you will also help their children.

One thing I did not talk about earlier was the impact on poverty. Helping adults to stop smoking increases household income and reduces child poverty. Action on Smoking and Health has estimated that something like 250,000 children live in households that are below the poverty line because of adults spending on smoking. Stopping smoking has myriad benefits, whether helping children, reducing poverty or reducing health inequality. That is why this Bill is so pleasing.

Tim Mitchell: From a surgical point of view, in my practice as an ear, nose and throat surgeon, one of the commonest conditions we see is glue ear in children. That is a condition where fluid behind the eardrum affects hearing, and potentially affects speech. That is the condition for which children sometimes have grommets or ventilation tubes put in their ears. It is one of the commonest operations that children undergo. The risk of that is significantly increased in children who live in households with smokers. There are other disease pressures as well, as my colleague alluded to. It has a significant impact.

[Rachael Maskell (York Central) (Lab/Co-op)]

Q Are we missing an opportunity to create a nicotine-free generation, alongside a smoke-free generation? We heard earlier that GPs were not able to prescribe vapes. Would that help your practice and help people quit, if you had those tools in your hands when seeing your patients, to encourage them to transition from smoking, which is so dangerous, to vaping?

Professor Agrawal: The first question was?

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[Dame Andrea Leadsom]

Q Okay, but obviously an excise duty then enables more enforcement and the track and trace scheme to which the hon. Member for Birmingham, Edgbaston referred to come into play for vapes, which could then mean better knowledge of which are legal and which are illicit. Would that be true?

Mr Lawson: I guess the source of funding is a separate question, but if there was enforcement of the current regulations there would be a lot of revenue generated from the enforcement and penalties under the current regulations, which may fund track and trace or other policies.

[Mary Kelly Foy]

Q To follow on from Andrea, most of the experts we have heard from to date have been from the NHS or the medical profession—people with skin in the game and promoting good health and tobacco cessation. Who funds you to do your work?

Mr Lawson: We are self-funded. We work with trading standards, so they fund part of our work. We work with the industry ensuring products are compliant. My other company develops medical products for quitting smoking and vaping. We straddle both sides—the tobacco side and the medical side.

[Mary Kelly Foy]

Q So it is self-funded.

Mr Lawson: I set the business up, yes.

[Mary Kelly Foy]

Q And you work with trading standards in the local authority?

Mr Lawson: We work with trading standards across England and Wales currently. Almost without exception all the testing that has been conducted on vaping in the UK would have come through our lab. The data that trading standards has is from the testing that we do for it, and from the enforcement that it has taken as well. The MHRA, as far as I know, does not conduct any testing.

[The Chair]

If there are no more questions, we thank you for coming. We will move on to the next panel.

Examination of Witnesses

Professor Allison Ford, Dr Rob Branston and Professor Anna Gilmore gave evidence.

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[Rachael Maskell]

Q But these people have never smoked, because, having been born from 1 January 2009, they would not have been introduced to smoking. That would be unlawful.

Professor Ford: Given the potential harm that nicotine can cause to young people, and the fact that generally everyone is in agreement that if you have never smoked, you should never vape, yes. I do not see an argument why we would need young people to use nicotine. That is my personal view.

Professor Gilmore: I would support that. These measures have been put in place in some cities in the US in Massachusetts and California, where they have implemented both smoke-free and nicotine-free generations. They have not been evaluated yet, but I know that other cities are now implementing the same policies, so I think they must have been going reasonably well. I am in touch with colleagues in the US to try to get any evidence from those measures as they emerge.

You are right: nicotine, as I mentioned, is harmful to the developing brain, so ideally we should be aiming for smoke-free and nicotine-free generations in future, in line with the smoke-free generation legislation, while making sure that current smokers are able to quit using nicotine. But that is recreational nicotine, not pharmaceutical nicotine.

[Mary Kelly Foy]

Q I think a lot of people will be quite shocked at the statistics that you have just outlined to us on the profits big tobacco is making and the shocking tactics it uses to keep users addicted, ultimately killing half the people who buy its products. I know that this is not in the Bill, but would you support a “polluter pays” levy, so that at least the tobacco industry could give something back to society for the harm it is causing at an individual level, by killing people, and at the societal level, at the expense of our NHS? Do you think that that could be added to the Bill? I do not want to put you on the spot with that question, but in principle would you support a levy on the tobacco industry?

Dr Branston: Absolutely. I would very much welcome that. It is obscene that the industry can make so much profit by killing up to two thirds of its long-term users. Addressing that profit incentive will go a long way to stopping the interest that the industry has in selling these deadly products. As you know, those products cause massive costs to society, so I think it is entirely reasonable that the companies make a bigger contribution.

In that regard, I know that the excise tax that is currently levied on tobacco products is not directly paid by the tobacco firms—it is passed on to smokers who are addicted to those products—so the “polluter pays” levy is an idea that I would strongly support. I encourage others to do so as well. Not only does it have the economic advantage of raising money that could be used to address the harms caused by smoking, but it would restrict the industry’s ability to price its products as it is currently able to. We know that it uses clever pricing tactics to make tobacco both affordable and profitable for the industry. On every level, a “polluter pays” levy would be a win-win for society, so I absolutely support it.

Professor Gilmore: I would support that 100%. If I go back to my response to the earlier question about how we have a system problem, that is the sort of measure that can help us to address that system problem. Dr Branston and I have published on the idea of “polluter pays” or using a price cap system, so there is some evidence out there, and some evaluations or modelling of the impacts it might have and the revenue it would bring in. I would really support that.

[Trudy Harrison]

Q Has anybody on the panel made any assessment of any kind of business association between the tobacco companies and the vaping companies, and also the ultra-processed food companies? The common denominator seems to be addiction. Is there any connection between those three industries, and perhaps even the pharmaceutical companies, which may be part of the solution for people who have become addicted to those three products?

Professor Gilmore: I can talk a little bit about this. We run a website called tobaccotactics.org, which you can use to look up the organisations that might be lobbying on behalf of the tobacco industry. It identifies the front groups and third parties that are lobbying for it. We know that at least some of those third parties also lobby for the ultra-processed food and alcohol industries and take money from all those industries. That certainly goes on. We also know that they use the same practices, and that sometimes all those unhealthy commodity industries have worked collectively to change whole systems of policymaking. They pushed for the better regulation agenda, for example, because they thought it would make it harder to pass public health policies and environmental policies. We have gone on to show that systems such as better regulation make it harder to pass public health policies, because they provide those powerful industries with a route to feed in their misleading evidence and data.

There is also a revolving door. You see a lot of movement of staff—executives—from one of those unhealthy commodity industries to another. The investors also link them, so there are links at all sorts of levels. To be honest, I do not know the extent to which they learn from each other about addiction and the manipulation of products to make them addictive, but it would make sense.

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[The Chair]

Mary Kelly Foy has the final question.

[Mary Kelly Foy]

Q When I was first involved in tobacco control over a decade ago, at the advent of vapes it was said, “This is shocking. It’s awful. It will keep that normalisation of smoking, because it is that habit of putting something in your mouth and it is cool. Let’s not use vapes.” But over time I have come to learn that that habit is great for people who are trying to quit smoking, so vapes are seen as a positive tool. Has that put back the denormalisation of smoking for young people? I do not think they would go around saying “Let’s get a nicotine patch”. You have not seen any aspect of that? It has not slowed down that denormalisation?

Professor McNeill: No, and that is why it is important to keep them separate, and their relative risks.

Professor West: What is really interesting about the concern that people had, which is perfectly reasonable a priori, is that people can tell the difference. There has been no sense in which the increase in vaping has led to an increase in the sense that all smoking is okay.

[The Chair]

On behalf of the Committee, thank you. That brings us to the end of this afternoon’s sitting.

Ordered, That further consideration be now adjourned. —(Aaron Bell.)