Tobacco and Vapes Bill (Second sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Bob Blackman]

Q What is your view on the limitation of the number of premises that would be allowed to sell tobacco or vaping products?

Cllr Fothergill: I could not answer that one, I am afraid, but I would be happy to come back to you with a view on that.

Greg Fell: I have the same view. It is not my area of expertise so I would rather think about that one carefully.

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

Q This is a question for Greg. It would be useful for the Committee and for people watching to hear your view on the impact of smoking and tobacco on public health.

Greg Fell: It is the single biggest cause of death. There is no real question about that. It may not be in many years’ time when smoking prevalence has come down, but right here, right now, it is. No other product is available that kills more than half its users when used according to the manufacturer’s instructions. Death is often preceded by a long illness—sometimes a short illness, but often a long one—often in folk of working age. Most people who die from smoking-related illnesses die too early.

Sheffield-wise—I know my numbers locally—it is a bit north of 700 deaths a year out of 5,000 or so, so not insignificant. To give you a reference, covid killed 1,500 people over the period of the pandemic. Smoking kills 700 people every year, year on year, and that is before we get into the illnesses. Aggregated across the country, that is 80,000-odd people—a Wembley stadium-sized group of people, a non-trivial number. It is also very inequitable and led by addiction. People spend enormous amounts of money on smoking, so stopping smoking would free up that money to be spent in other ways. Smoking remains the No. 1 cause of death and it is very inequitable—almost certainly causing the largest gap in healthy life expectancy and life expectancy inequality.

[Mary Kelly Foy]

David, do you want to add anything?

Cllr Fothergill: I think Greg summed that up perfectly.

[Preet Kaur Gill]

Q Why do you support the complete ban as opposed to raising the age from 18 to 21, as many people often say? I know the Khan review has talked about not getting to a smoke-free future if we did that, but is there anything you would like to say about that?

Greg Fell: Years and years ago, the narrative was about raising the age of sale to 21, but I think the evidence has shifted. I hear from a number of stakeholders and sources that the tobacco industry is targeting its public relations at slightly older young people—the 18 to 25 age group. If you were to stop at 21, the tobacco industry would just change its marketing and you would therefore get a new target group recruited into smoking. Nobody thinks that that is a good idea, so the evidence is shifting.

The ban sets a really important norm. We can all remember walking out of a pub smelling of cigarettes. We cannot imagine that now, so continually shifting the norm changes population behaviour just by norm shifting, which is important and often underplayed. I would support the lifting lid—I think that is the right phrase.

Cllr Fothergill: I think Greg is absolutely right. At the LGA, we support the progressive lifting of the age as opposed to raising it to 21. We think that is the right way to go. It will then move through the population over a number of years rather than just being static at a single point.

--- Later in debate ---

[Trudy Harrison (Copeland) (Con)]

Q Thank you, Ailsa, for all the work that you do up north in the north-east. I represent the north-west, Cumbria, which also has higher than national average rates of mothers saying that they are smoking at the point of birth—about 12.3%. I am told by our authority in Cumbria that about 3,500 hospital admissions, 74,000 GP appointments and 80,000 sick days are caused by smoking-related illnesses. But why not just do more of what you are doing in the north-east? Do you really need this Bill to tackle the problem?

Ailsa Rutter: I think we are doing some really good work in the north-east but I absolutely think that this Bill is required. I go back to the uniquely lethal nature of tobacco smoking; that is the one key argument that we need to think about. This is guaranteed to kill. For me, this is about a societal shift.

I am really pleased with the huge shift in the north-east on the social norms of smoking. We talk to people who smoke every single day, and you have their backing because they desperately do not want their own children to fall into the same trap. As I mentioned before, this is about aspiring into the future. We are all conscious of the pressure and strain on our NHS. Think about the impact—one in four beds in the north-east and elsewhere with somebody suffering from a smoking-related condition. I think our NHS colleagues in particular really welcome this.

There is another important aspect when it comes to the economic costs. We all get the healthcare costs and we also really understand the strain on social care, but actually it is business that bears the brunt of this. That can surprise people. It is about the lost productivity and people having to retire early and dying early. I would like to think about who these people are. I have mentioned the pivotal role of Sue Mountain and the showing of her TV advert, but so many other people have come forward who sadly were diagnosed in their late 40s—women in the north-east who are desperate to tell their stories. Cathy Hunt, diagnosed with lung cancer at 49; Claire Oldfield, diagnosed with lung cancer at 49. Their real appeal to you today is to think about taking this seismic leap forward and about the leadership the UK can show globally by recognising that smoking had a beginning and a middle, and it is down to us to say that it can have an end.

[Mary Kelly Foy]

Q Thanks to Ailsa for everything that Fresh does in the north-east and for the wonderful results we have seen in the north-east, which is a very deprived area in places. I want to follow up on the question on evidence in vaping. Although there are still a few grey areas and unknowns about vapes, we know that vaping is much less harmful than tobacco. Crucially, it is a really important tool for those people who do smoke. What evidence does Fresh use to back up this argument? Do you feel there is a worry that if we focus too much in the Bill on youth vaping, we will leave behind those dependent, addicted and, very often, deprived smokers?

Ailsa Rutter: I think we are really fortunate in the UK. The UK has shown great leadership by commissioning evidence-based reviews that are completely independent of Government; we have had eight of those now since 2014. That has been incredibly important. Fresh is not complacent. We have been monitoring the evidence around the rise in vaping and how this is positioned in terms of public health for the last 20 years—since we were set up. I would strongly recommend that many of the really useful questions we have had today could be answered by looking at those systematic reviews from the Office for Health Improvement and Disparities. In particular, when people say, “We don’t know what’s in vaping,” there is a significant chapter on the constituent chemicals and so on in vaping, and the magnitude of potential harm.

I have forgotten the second bit of your question, Mary.

[Mary Kelly Foy]

It was about the use of vapes by heavily dependent smokers.

Ailsa Rutter: Yes. In the north-east, vapes have been a “game changer” for some of our heavily addicted smokers. I have permission to share with you the fantastic role that vapes have played in our biggest mental health trust, Cumbria, Northumberland, Tyne and Wear. We are talking about people who have been smoking 40 or 50 cigarettes a day, often for decades, who have really struggled to imagine that they could ever get off lethal smoking. Being able to give them something that still gives them their nicotine, but in a much purer, safer and cleaner form, has been a game changer.

Vapes are being used successfully in our drug and alcohol treatment services—on the point about alcohol, the two often go hand in hand. If we are really intent on ending smoking, we must do more on alcohol. Wearing my Balance hat—Balance is the alcohol bit—it is really important that we do not think of risk-taking behaviour in youth as just vaping. Last week, the World Health Organisation published a report that shows that across 44 countries, the UK sadly has the highest use of alcohol among 11-year-olds. I hope nobody thinks that the amount of alcohol promotion, advertising, marketing and so on is okay. I think it is quite important that we look at risk-taking behaviours in the round.

[Bob Blackman]

Q In answer to my colleague, Nickie Aiken, you raised the primary issue of age verification. We get an opportunity to change the law on tobacco and vaping only once every 10 years or so, so it is quite important that we get as much in as we can. What other improvements would you like to make to the Bill to strengthen the argument you are putting, to get people to quit smoking or not even start in the first place?

Ailsa Rutter: That is a really good point. I think it goes back to not wanting to delay the progress of the Bill. It is not necessarily for legislation, but it is important that we have a very clear communications strategy. Reflecting on previous legislation, much of the high levels of compliance we have seen in this country have come from very proactive communications in advance. We need to be really careful that the narrative does not get overly confused. It worries me enormously that too many people are staying on smoking because they are scared of even trying to switch over to a significantly less harmful product. I worry enormously about scaring people. It is absolutely right that we have evidence-based messaging to children and young people, but they are messengers who go back to their parents, and we know that it is very important that they are sending clear messages back. So, I will defer on your question about additional amendment—sorry.

--- Later in debate ---

[Dr Johnson]

Q I proposed a ten-minute rule Bill to ban disposable vapes last February, so I am delighted to see that the Government have brought in an statutory instrument to do exactly that. I am disappointed, but not surprised, to hear you say that industry is doing its best to circumnavigate the regulations before they are even brought in.

I have two questions. First, how do we ensure that the regulations are flexible enough for us to be able to stay ahead of such measures? Secondly, could you say a bit about the effect on wildlife? My hon. Friend the Member for Penrith and The Border (Dr Hudson) has talked about puppies picking these things up in their mouths and the danger they can pose if the puppies bite into them. Could you talk a bit more about the danger that they pose to wildlife when they are thrown away?

Laura Young: Of course. On the regulations, I think that we have to think creatively and innovatively about some of the workarounds that might be being used. We are already seeing charging ports just being popped on the bottom. Of course, that might mean that the battery can be recharged a few extra times, but if it cannot be refilled with the solution, it is still, in practice, a single-use item and will have to be thrown away eventually.

The issue is about ensuring that we look at the builds and make sure that they are modular and that the circular-economy principles that we want to achieve are set in stone. I think that that means working as best as possible with the retailers and the manufacturers—although that will be really difficult—and looking to other initiatives, whether that is single-use plastics bans or treaties on plastic, one of which has just come to an end globally, to see what we can do.

I will tell you a story about the wildlife. A wildlife photographer, a birdwatcher, was taking some images of a marine bird doing a very normal activity, which was picking up a shellfish—what looked like a razorfish—and dropping it from a height to smash it open to get some delicious dinner. But after this young gull had failed multiple times, this photographer realised that, unfortunately, what it was actually picking up and dropping was a disposable vape. We are seeing not only domestic animals, such as cats and dogs and things that we love as pets, getting hold of disposable vapes and potentially breaking them open, but actual wildlife being impacted—picking them up, thinking they are shells on the beach, and trying to eat what is inside them.

That is just from the very short time that we have been paying attention and looking out for this, and from keen birdwatchers capturing it, so we know that there will be extensive wildlife impacts. We are only now scrambling around to try to find more evidence, but we know that it is already happening, and that that is just one example. The photographs are on Twitter, if anyone did want to go and find them. It is sad, but it is definitely the reality of what we are seeing.

[Mary Kelly Foy]

Q Just a very quick question: would you agree that this is symptomatic of the throwaway society that we live in? We have disposable vapes, plastic toys with happy meals and toasters—all small appliances that do not last long enough. They are all thrown away and are damaging the environment. I know that, in Durham, all sorts of electronic devices are thrown in the river, and that is interfering with wildlife.

[The Chair]

It is a fair question; it is not within scope of the Bill, but it is a fair question.

Laura Young: Yes, absolutely. Just last week, I and other leading scientists from across the UK published a piece in Science, the science magazine: a letter about disposable technology, using vapes as an example—the first in a wave of disposable, cheap tech that is having an impact—and about the need for a global effort to tackle this. That is absolutely a hot topic right now; if we do not get a grapple on it now and use vapes as an example of how to tackle it, we will just continue to see disposable electronics, which are all jam-packed full of things that we need for other devices for a green economy.