Tobacco and Vapes Bill

Nickie Aiken Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.

[Nickie Aiken (Cities of London and Westminster) (Con)]

I thank my right hon. Friend for giving way. She is making a very important point about young people and children smoking today. It is not just about cigarettes. Shisha smoking, in particular in Westminster, Marylebone and Edgware Road in my constituency, has become very fashionable for young people. An hour of smoking shisha equates to 100 to 200 cigarettes within an hour. Will she confirm that shisha tobacco will be included in the Bill?

[Victoria Atkins]

I thank my hon. Friend for bringing the City of Westminster right into the Chamber. There are, in fact, five times more people in England today smoking non-cigarette tobacco, which includes cigars and shisha, than there were a decade ago. Worryingly, the greatest increase is in young adults. That is why we have said that tobacco in all its forms is a harmful product, and that we therefore wish to ensure we are consistent in the policy and the messaging that this is about helping young people to stop the start.

Tobacco and Vapes Bill (Second sitting)

Nickie Aiken Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Steve Tuckwell (Uxbridge and South Ruislip) (Con)]

Q The LGA has previously called for strict enforcement measures for those selling tobacco to those under-age. Do you think the Bill goes far enough in achieving that?

Cllr Fothergill: I have already said that we believe the amount of the fine needs to be reviewed. We believe it is right to do it by a local penalty notice, which is issued locally and can be enforced. We do not believe that £100, reduced to £50 if it is paid within 14 days, is sufficient. It will not have the effect that it needs to have and it should be reviewed.

We are also keen, as part of the Bill, for a review of whether we should be brought into line with Scotland on age verification. Scotland has very clear guidelines that legally, people have to produce identification that they are of an age to buy, and we think this is an opportunity for us to bring that in as well. There are two things where we would like to see enforcement strengthened: mandatory age verification and an increase to local penalty notices.

[Nickie Aiken (Cities of London and Westminster) (Con)]

Q I have a question for Mr Fell. Obviously the Bill will cover shisha, so I would welcome your views on shisha smoking and whether there is more we can do within the Bill or in general to tighten up shisha smoking.

Greg Fell: I would say that we need a licensing scheme for shisha smoking, and probably more education about the fact that it is a potent way to consume large amounts of tobacco really quickly and is quite damaging for people’s lungs. I am not sure what more could be achieved in the Bill, but I would like to see a licensing scheme for shisha bars. We enforce the law to its limits, but there are some limits to it.

[Bob Blackman (Harrow East) (Con)]

Q I thank you for covering the issue of age verification; I think it is important to have a similar scheme across the UK. The other issue relating to licensing is that there are potentially two ways of licensing. One is to add to the existing alcohol licensing regime, and the other is to have a separate regime for vaping and tobacco. Which would you prefer to operate if we were to introduce a licensing scheme?

Cllr Fothergill: It is not a topic that we have a policy position on, but my personal view is that it would need to be a separate scheme, because it would have separate enforcement and separate legalities within it. It needs to be very clear for trading standards what they are enforcing against, whereas alcohol is quite different. We should not mix the two just because they both need licensing. I think that they need to be separate.

--- Later in debate ---

[Dame Andrea Leadsom]

Q Thank you so much for being here and for all you do in the north-east. It is fantastic.

As you will know, rates of smoking during pregnancy in the north-east are some of the highest in the country. Do you think this legislation will help to reduce those very high numbers? The rate is somewhere in the region of 14% in the north-east.

Ailsa Rutter: We have made really good progress in the north-east in reducing maternal smoking; that has come through very good collaboration between our local maternity services and our local authorities, as well as the fantastic leadership from key people in the local maternity and neonatal system, the LMNS, and the direction from directors of public health.

As with anything, there is not one magic solution; it is about taking comprehensive measures. The tobacco age of sale increase will undoubtedly have a really positive impact on reducing maternal smoking. It needs to be coupled with important things that we must continue to do as well, so we also welcome the increased investment for stop-smoking services.

We hugely welcome—thank you—the reinvestment in the evidence-based health harms campaigns. We are thrilled that nationally you are using our fantastic “smoking survivors” TV advert featuring Sue Mountain. The role of financial incentives is also really important; we know that they have a very strong evidence base. This will have a positive impact on maternal smoking.

[Nickie Aiken]

Q If there was one thing you could add to this Bill, what would it be?

Ailsa Rutter: Gosh! There are already some fantastic elements in the Bill. The key thing for me is to make sure that we can get the Bill through—particularly the focus on tobacco. It is really good to think that there is going to be subsequent consultation on the important elements around vaping. Factoring in what colleagues said previously, we need a simple mandatory age verification scheme. That is already in place in Scotland, and I would certainly welcome its introduction in England.

[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.

Tobacco and Vapes Bill (Third sitting)

Nickie Aiken Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

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

Q Thank you to all the CMOs. I would like to press that point a little further. Should the advertising of vapes be in alignment with that of tobacco products, for simplicity and understanding? Should the rules on where people can vape be in alignment with those for tobacco products, so not in indoor spaces or in cars transporting children? Are we missing an opportunity, in the light of the opening comments about the addiction to nicotine, to create a nicotine-free generation, as opposed to a tobacco-free generation?

Professor Sir Chris Whitty: I wonder whether Sir Michael might want to go first, and then Sir Frank.

Professor Sir Michael McBride: We have to start somewhere. What we actively want to do, at this point in time, is encourage those individuals who smoke to quit smoking. We recognise that there are nicotine replacement products other than vapes that are very effective and that individuals successfully use, but for some individuals, as has been stated already and as is outlined in the relevant NICE guidance, vapes can be effective and are safer than smoking. It is about finding the sweet spot—hence the powers to consult.

We need to get a balance to ensure that we are absolutely not creating circumstances in which vaping is attractive to young children, starts a lifetime of addiction to nicotine and is potentially a gateway to smoking tobacco, as I think your question is suggesting. But at this point in time, this is an important step to ensure that the next generation are protected from smoking tobacco. We need to support those individuals who currently smoke or are currently addicted to nicotine to gradually move away from that addiction. That includes supporting smokers who currently smoke to quit, but we are increasingly seeing individuals who wish to quit vaping and are finding it difficult.

We are at the start of a journey. As Sir Chris has said, we do not want to delay this Bill and this important step change, in terms of making very significant progress. Sir Frank, do you want to add to that?

Sir Francis Atherton: Very briefly. The principle of alignment is a positive one. Keeping it simple for the public is in the interest of messaging, as a general point. In Wales, we did try—in 2016, I think it was—to align smoke-free and vape-free public places. Personally, I think that there is merit in that, but we have to be careful, because some of the arguments are different. The arguments around smoke-free public places are based on passive smoking, but we do not have a lot of data on passive vaping; many people see it as a nuisance, but that is a very different argument. We need to be a little bit cautious about that, even though I would personally be in favour.

The important thing is to remember that we really need to keep vapes as the quit tool. Your point about moving towards a nicotine-free next generation is absolutely right; that is really what we want to do. If we can make it less acceptable and less prevalent that children take up vaping, we should move towards that. The reality is that over the last three years we have seen a tripling of vaping among our children and young people. That is just unacceptable. The measures in the Bill will help deal with that and lead us, we hope, towards the nicotine-free generation that you talk about.

[Nickie Aiken (Cities of London and Westminster) (Con)]

Q I want to go back to the vapes point. As we have all agreed and you have highlighted, vaping was, for all intents and purposes, a product to help people off tobacco, but it has become a product marketed in its own right. What are your personal and professional views on the Bill as it stands? It would stop people selling vapes to under-18s and stop members of the public or family members buying them on behalf of under-18s. Should we ban under-18s from using vapes full stop? Also, should we move vapes on to a prescription basis to ensure that they are aimed at people who want to give up smoking?

Professor Sir Gregor Ian Smith: My view on the Bill as it stands is that it is a starting point for how we take this work forward. It is adequate in that sense because this is a really important area. For me, the absolute priority has to be to remove young people’s ability to access vapes and so begin the journey to nicotine addiction.

I am not in favour of criminalising the possession of these products, but I am certainly in favour of banning their sale to younger people. If we can achieve that at this stage, and, as Sir Michael said in his previous answer, if we can begin to shift the culture so that people do not start to use vapes and begin to become addicted—potentially also by using other nicotine and tobacco products—for me that will be a good job done.

If we do things that way, it will allow us to protect the useful use of vapes: where people with a lifelong addiction to tobacco can use them as way to help them stop. That is the only justification that I can see now for the way we have set this up and for continuing to use vapes in society: as a useful tool for those with a pre-existing addiction to tobacco, so that they can reduce the harm and gradually stop using tobacco—through formal cessation services, as well.

Professor Sir Chris Whitty: I agree with Sir Gregor. To reiterate, the Minister wanted to get a balance and most people would agree that criminalising people for individual possession is a step further than anyone would want and is needed. I do not think there is a clamour for that from anybody, and I think it would not help the Bill.

On prescription vapes, I would like to see those available for use at the moment. So far—I will go into the reasons for this on another occasion—no products are available that we can prescribe. We would all very much like those products to be there so that people can prescribe them. That is different from saying that they should be only on prescription; at this point, we do not even have any products to prescribe at all. If we did, that would be a very firm step in the right direction, but it depends on the industry coming forward with products.

Speaking directly to the industry, I should say that I do think there is a very important niche for prescription vapes. They would be very useful for some people, particularly those on low incomes who, for other health reasons, have free prescriptions. I encourage anyone from the industry who is listening to think seriously about bringing forward a prescription vaping product appropriate for aiding people to quit.

[Bob Blackman (Harrow East) (Con)]

Q I think the whole panel have said they are 100% behind the Bill. It is great that the whole medical fraternity is going together, but are there any tweaks that you would like to see in the Bill that could make it stronger—for example, making age verification the same in England as it is in Scotland? One of our concerns is that we have a chance to get primary legislation in only once every 10 years or so, and doing it now would be far better than waiting.

Professor Sir Chris Whitty: I have had the privilege of being more heavily involved in this Bill than the other CMOs, so I am going to ask them to answer it. My short answer is that this is a fantastic Bill. What I do not want is for the Bill to be delayed and therefore to not get through in the parliamentary time available. There is always a danger with these things, particularly when we are up against the clock, of the best being the enemy of the good. This is more than good; this is an outstanding Bill, to be clear, in terms of the Prime Minister’s bravery in putting it forward and, I think, the huge support from the general public and massive support from those working in healthcare. Really, what we want to do is get this through. I fully accept the points you are making, but that is my real concern about proposing any additions. Maybe you can start with Sir Michael, then Sir Gregor and then Sir Frank.

Professor Sir Michael McBride: I think this is a situation where perfection risks snatching victory from us. The most important thing, having looked at the Bill closely, is that this is an excellent Bill. I think we have all indicated that this is a once-in-a-generation opportunity, as your question suggests. We need to seize this opportunity. I and my colleagues fully support this Bill. I think this is a point that we will look back on five or 10 years from now and we will say that we were on the right side of history in supporting the Bill. This will make a fundamental difference to the next generation and generations to follow. Again, it is entirely consistent with the commitment in the Northern Ireland Executive to gradually phase out tobacco smoking. I fully support the Bill as it stands.

Professor Sir Gregor Ian Smith: I have nothing much more to add. In my view, this is a momentous point in time when we have the ability to really safeguard the future health of generations of people who will not be exposed to the regretful, harmful addiction to tobacco that they might have encountered. I am very satisfied with the content of the Bill as it is just now. The point Sir Michael makes about perfection being the enemy of good is a really important one. This is an opportunity that, to be honest, I really did not anticipate seeing in my career, yet here we are discussing a potential piece of legislation that will allow us to improve the health of people in our country for years and generations to come. This is an opportunity that we cannot afford to miss.

Sir Francis Atherton: There are no changes to the primary legislation that I would recommend at the moment. One thing I would say is that in Wales, we were very impressed with the Khan review, which gave us a really good steer. Many of the Khan review recommendations will be dealt with through the Bill, while a couple will not. I think the Bill as it stands has enough flexibility, particularly around vaping, to allow secondary legislation to keep up with the industry as it adapts and as it tries to find ways around the barriers to getting young people addicted to nicotine.

If I had a wish from the Khan review, it would be around the industry making a contribution to those costs I was talking earlier—the cost to the NHS—so sort of a levy on the industry to correct the damage, or a polluter pays thing, as is being introduced for the gambling industry. However, I do not think that would fit at all with the current Bill.

--- Later in debate ---

[Mary Kelly Foy]

Q This question is particularly for Professor Hawthorne. From your experience, can you tell us what impact smoking tobacco has on our most deprived communities?

Professor Hawthorne: It is much more prevalent. There is a theory called future discounting. If you have few choices—if you do not have much money and much choice in what you eat, what you do and where you work—you do not think about your health in 20 years’ time; you think about today. Many people feel that smoking helps them get through the day, and that is what they do. It is a really difficult thing to talk to people about because some people will say to me, “I’ve just got to. I can’t get through my day otherwise.” I can say, “There are alternatives. There are other ways that we can help you get you through your day,” but you have to get them round the clock face that I was talking about, until the point comes when they say, “I’ve got to do it now.”

[Nickie Aiken]

Q Vapes—or e-cigarettes, whatever you want to call them—were introduced to help people to stop smoking. Professor Hawthorne, I would be particularly interested in your view on this, as a GP. We know that vaping has been turned into a massive industry now, but if the whole point of vapes, or e-cigarettes, is to get people to stop smoking tobacco, what is your view about vapes being prescribed?

Professor Hawthorne: Do you mean as part of a smoking cessation programme?

[Nickie Aiken]

Yes, rather than having them sold as they are at the moment.

Professor Hawthorne: That is an interesting question. I prescribe nicotine patches; why should I not prescribe vapes? That would be my thought.

[The Chair]

I call Dr Caroline Johnson—you have all been so kind to one another, we are now ahead of time.

Tobacco and Vapes Bill (Eighth sitting)

Nickie Aiken Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Preet Kaur Gill]

I thank the hon. Lady for that intervention, but as I said my greatest concern remains promotions in store and on social media, because that is where lots of young people consume this information. My view is that we need to get on with cracking down on the companies that deliberately sell these products to children in the first place.

[Nickie Aiken (Cities of London and Westminster) (Con)]

I fully support what the hon. Member for East Renfrewshire says about sports marketing and vape companies. I pay tribute to my hon. Friend the Member for Sleaford and North Hykeham for the work that she has been doing in this policy area, and I fully support what my hon. Friend the Member for Harrow East just suggested.

With this Bill, we have perhaps a once-in-a-lifetime opportunity to send a clear message to the tobacco companies. More importantly, we can say to young people, our children and parents generally, “Do not take up vaping.” Vaping has always been meant to be about stopping smoking, but sadly it has become a stand-alone product. I was shocked when I walked through my neighbourhood of Pimlico last week and saw that we now have a huge stand-alone vape shop that sells only vapes.

The new clause seeks to do the right thing, but it does not go far enough, so I ask the Minister whether we can step back, before Report, to understand what the Government can do to send a clear message about all advertising, marketing and sponsorship across the whole nation, whether it is TV or radio advertising or any form of sports sponsorship. We have to treat vapes as we treat tobacco.

[Dame Andrea Leadsom]

I thank all hon. Members for this discussion. I have to say that I agree with them. It is extraordinary that vapes are advertised and promoted in places that are seen by children. I pay tribute to the hon. Member for East Renfrewshire for her determination on this matter. She and I were discussing earlier the fact that we both know teenagers who tell us that in many cases it is not one in five vaping but more like four in five. I think that will resonate with a number of hon. Members, so we have to do everything we can.

I also pay tribute to my hon. Friend the Member for Sleaford and North Hykeham, who I believe is the only paediatrician in the House. She has done so much to seek to improve all health issues for children, but she is particularly passionate about this area. She is away on a trip with the Health and Social Care Committee, quite rightly, but I regret that she cannot be here to debate this issue. I know that she would have strong views; I have heard her speak powerfully about the need to clamp down on advertising and sponsorship.