Tobacco Control Plan

Mary Kelly Foy Excerpts

Tuesday 16th November 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Bone. I pay tribute to the hon. Member for Harrow East (Bob Blackman) for securing the debate and for his work as chair of the all-party parliamentary group on smoking and health, of which I am vice-chair.

Two years after the Government stated their ambition to make England smoke-free by 2030, projections show that they will miss that target by seven years, and double that for the poorest in society. Despite a promise of further action on tobacco, we are still waiting for the new tobacco control plan, which the Government pledged to publish this year. In the absence of that new plan, the Health and Care Bill is a timely opportunity to take the first step towards a smoke-free 2030.

Despite the urgency of the issue and my best efforts in Committee, the Health and Care Bill fails to make a single mention of tobacco or smoking. To correct that oversight, I tabled amendments to the Bill, based on recommendations made by the APPG on smoking and health, including proposals for a “polluter pays” levy, health warnings on cigarettes and inside packaging, and to close the loophole allowing e-cigarettes to be marketed at children. Those measures are all low-cost or revenue-generating, are popular with the public and could be implemented quickly and easily by the Government. Although the Government expressed support for the principle behind the proposals, they rejected every single one, saying that they wanted to wait and see the evidence.

The Government have cited the need to wait for the publication of the post-implementation reviews of the Standardised Packaging of Tobacco Products Regulations 2015 and the Tobacco and Related Products Regulations 2016. The Government were required by law to publish those by May 2021. That has now drifted to an aim to publish by the end of the year. Will the Minister say how much longer we will have to wait for the Government to start taking action to deliver the smoke-free 2030 ambition? She should know that if the APPG’s amendments are not adopted in the House of Commons, they will be retabled in the other place.

Today I want to briefly make the case for my proposals and address the Government’s arguments against them. The first proposal is to include health warnings on cigarettes and cigarette papers. Substantial research supports their implementation, and they are already under consideration in Canada, Australia and Scotland. Such warnings would be cheap and easy to implement through a simple amendment to the Standardised Packaging of Tobacco Products Regulations 2015. The Government said they were sympathetic to the aims of the measure, but they are not willing to adopt it, citing the need to conduct further research and for more evidence. Warnings such as “smoking kills” have been shown to be effective on billboards and tobacco packs, so why would they not be effective on cigarette sticks, too? Adding warnings to cigarette sticks is also important because young people in particular are likely to begin smoking with an individual cigarette rather than packs. There have also been at least eight peer-reviewed academic studies published since 2015 that specifically looked at warnings on sticks and found them to be effective, particularly in making cigarettes less attractive to younger adolescents and never-smokers.

Cigarette pack inserts that provide health information have been required in Canada since 2000. Substantial evidence shows that they are effective, and research supports their use in the UK, too. The Government have already acknowledged in the prevention Green Paper that there could be a positive role for inserts giving quitting advice in tobacco products. Pack inserts are easy and cheap to introduce and, as the Government have acknowledged, could be implemented by a simple revision of the Standardised Packaging of Tobacco Products Regulations 2015. Again, the Government refuse to adopt the amendment, citing the need for further research and public consultation and to wait for the recommendations of the post-implementation review of the SPOT regulations, yet there is no guarantee that the review will contain concrete recommendations. Indeed, the 2019 review failed to do that. My concern is that the measure needed will just get kicked into the long grass, putting the 2030 ambition at risk.

There are currently no controls on the use of branding to promote e-cigarette products, some of which, particularly e-liquids, are branded in a way that is clearly attractive to children through the use of bright colours, sweet names and cartoon characters. Research by YouGov for ASH found that in 2021, 3.3% of 11 to 17-year-old never-smokers have tried e-cigarettes once or twice; 0.5% use them less than weekly; and 0.2% use them more than once a week. Although those percentages seem low, it still amounts to 174,900 never-smokers trying e-cigarettes. Another 26,500 carried on using them, and 10,600 used them more than once a week. The ASH YouGov survey of adults and young people found that standardising the packaging of e-cigarettes and refills reduces the appeal of vaping to young people, particularly young children, while having little impact on adult smokers’ interest in using the products to quit smoking. Frustratingly, the amendment was voted down by the Government in Committee.

A further issue that must be addressed is that although it is illegal for e-cigarettes to be sold to children under 18, it is not illegal for them to be given out as free samples to under-18s. That loophole fails to deliver on the spirit of the legislation, which is designed to protect children from nicotine addiction. Clearly, the legislation needs amending to ban the sale and free distribution of any consumer nicotine product to under-18s. The Government inexplicably voted down that proposal in Committee. They said that they did not have a firm or robust evidence base at present to suggest that there was a widespread problem. As stated, around 174,900 never-smokers aged 11 to 17 have tried e-cigarettes and another 10,500 use them more than once a week. Does the Minister genuinely think that we should wait until their use of e-cigarettes becomes a significant problem before taking action to remove this loophole?

Finally, I want to talk about flavourings. The ban on flavourings in smoking tobacco was introduced because flavourings, particularly menthol, make it easier for young people to start smoking and increase the likelihood that they will become addicted smokers. However, the flavour ban only prohibits characterising flavours, which are subjective and difficult to measure, making the ban easy to circumvent and complex to oversee. Legislation in Canada bans all flavours, which is easier to implement and enforce. There is good reason to do that, as the tobacco industry has introduced several innovations that have exploited loopholes in the regulations to undermine the impact of the ban. For example, Japan Tobacco International launched a range of alternative products containing menthol, but which they claimed complied with the law. Figures in the Express revealed that 12 months after the ban came into force in 2020, the company had sold more than 100 million packs and made around £91.65 million in profits from menthol brands.

In addition, modified smoking accessories have been introduced, including cards, filter papers and filters, that are designed to add a menthol flavour to both hand-rolling tobacco and cigarette sticks. UCL’s smoking toolkit study found no decline in the proportion of smokers in England reporting menthol cigarette smoking following the introduction of the ban, and it suggested that smokers of menthol cigarettes were able to take advantage of the loophole. The flavour ban is clearly failing to prevent the sale of flavoured tobacco, which is why I propose extending the ban to all tobacco flavours, not just those described as characterising.

Again the Government oppose the measure, claiming that

“it is not clear how a ban on flavours would be enforced in practice”.––[Official Report, Health and Care Public Bill Committee, 28 October 2021; c. 815.]

That is not logical as it is much easier to enforce a complete ban on flavours than on only those defined as characterising, which is very subjective.

Does the Minister agree that the tobacco industry is making a mockery of the current flavour ban? Will she commit to closing the loophole by removing the limitation to only include flavours defined as characterising as soon as possible and extending the ban, which currently only applies to cigarettes, to all tobacco products and smoking accessories?