Tobacco and Vapes Bill (Fourth sitting)

Debate between Mary Kelly Foy and Rachael Maskell

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[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?

--- Later in debate ---

[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.