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Public Bill CommitteesI declare an interest as a practising pharmacist. [Interruption.]
I cannot hear everything because of that noise, but I am co-chair of the all-party parliamentary group on smoking and health.
(1 week, 1 day ago)
Public Bill CommitteesQ
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.
Q
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.
Q
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.
Q
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.