Read Bill Ministerial Extracts
Tobacco and Vapes Bill Debate
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(2 years, 3 months ago)
Commons ChamberSadly—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?
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) Debate
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(2 years, 3 months ago)
Public Bill CommitteesQ
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
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.
Q
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.
Q
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
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.
Q
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) Debate
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(2 years, 3 months ago)
Public Bill CommitteesQ
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
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.
Q
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.
Q
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
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 (Fourth sitting) Debate
Full Debate: Read Full DebateNickie Aiken
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(2 years, 3 months ago)
Public Bill CommitteesQ
Tim Mitchell: Just that the scientific evidence in relation to surgery and vaping is very limited. Clearly, as I have said, we see vaping as being much less of a risk to people than smoking, and from that perspective, it is very good. But otherwise, I would defer to Professor Agrawal and what he said.
Nickie Aiken (Cities of London and Westminster) (Con)
Q
Professor Agrawal: I thought it was such a well-balanced Bill, with all the objectives, whether that is making sure they are available to help people quit, or really focusing on preventing young people from being attracted to vaping. The Bill is not in isolation, as I have alluded to. The ban on disposables is undergoing consultation, and there is the excise tax. All of those measures form a whole. Yesterday, we heard about the potential for track and tracing, for example, to be used with vapes, which would therefore mean that things like retail licensing are probably not needed because a good track and tracing system will actually do the job. I think the Bill has been well thought through, not by accident, and I cannot think of anything that will not get picked up in the consultation. I suppose the one thing that is not in there is interference from the tobacco industry, front groups and lobbyists with any part of tobacco regulation, and making sure that that does not occur.
Q
Professor Agrawal: It is never too late—that is what I say to patients who are currently smoking. I see people in their 60s, 70s and 80s, so it is never too late to quit. There are always benefits. Even when people have been diagnosed with lung cancer, we can provide treatment in the form of surgery, radiotherapy and so on, and quitting smoking still helps. I think the Bill sends a clear message that we recognise that there are 6.4 million smokers and we need to support them to quit. Vaping is one means of doing that, and we are not trying to take it away from them if that is the only way they have been able to quit smoking. The Bill contain provisions to help all groups. It is not just about stopping young people taking up smoking; it recognises the need to do something for the people who are still currently smoking.
Tim Mitchell: I would say that there is still an imperative to encourage people who smoke to stop smoking, and vaping can be a mechanism for helping with that. Certainly, as surgeons, when we see people who smoke who require surgery, we encourage them to stop smoking. We know that their risk profile through surgery is improved if they can stop smoking, even just a few weeks before they have surgery. Even if they do not smoke on the day they have their operation, that has some benefits. Encouraging people who smoke to stop smoking remains a very good thing to do, in addition to the provisions in the Bill.
Q
Professor Ford: Packaging in the UK just now is doing two things: first, it is communicating a message to young people, and secondly it is having a huge impact in the retail setting. I will deal with those separately.
First, we recently conducted a pack analysis of a representative sample of vape packaging that was legally available for purchase in the UK. We found that 85% of those packs are really brightly coloured. A proportion of them have a childish cartoon font on the pack, and the language and terminology on a proportion of the packs utilised youth language and slang, so it is tapping into something that young people could be receptive to.
There is also an issue with how the nicotine content is displayed on the front of the pack. There is no consistency. Some of the packs say that the nicotine content is 2%. We know from our qualitative work that young people misinterpret that as a low percentage, but it is actually the maximum legally allowable amount in the UK. All of that together is communicating to young people that this product is for them; in our qualitative work, that is what they have told us that they believe. We have also spoken to adult smokers, and they also believe that a lot of this colourful packaging is targeting young people. At the moment, there is a mismatch between what we would ideally like vape packaging to do—we want it to speak to adult smokers—and what it is doing. It is not speaking to adult smokers; it is communicating to young people.
The second part is the impact of the packs in the retail setting. I am sure you have noticed that in the retail setting—within the store, but also in the shop front—the display made up of brightly coloured packs is vast. We did a youth tobacco policy survey in 2020 and followed that up with the youth e-cigarettes policy survey last year, in July 2023. We are finding an increased awareness of vape displays in shops among 11 to 16-year-olds across the UK, from 40% up to 68%. That is a substantial increase.
We asked those 11 to 16-year-olds last year what they think about these displays in the retail setting. Some 58% think they are colourful, 36% think they are attractive, 36% think they are eye-catching and nearly a quarter think they are attractive. That shows not only how the display feeds into the appeal but, perhaps even more importantly, how it feeds into the social norm around this product and this behaviour. To give you just a couple of other statistics, nearly a third of our sample reported that displays make them think it is okay to vape, and 64% reported that vape displays make them think that a lot of people vape, so they are really feeding into this social norm. Thankfully, the Bill covers those aspects of promotion.
There has also been an increase in young people reporting seeing vapes and vaping imagery on social media: 25% of 11 to 16-year-olds reported that in 2020, and 41% reported it last year. On your final point about sponsorships, we are seeing quite a lot of sports-associated imagery with nicotine pouches. I know that nicotine pouches should be included in the Bill, because that is another nicotine product. We are starting to see the terminology, awareness and imagery of nicotine pouches take off among young people. This is concerning, and it is one to watch. The imagery is of it being a hit or a boost that helps you to focus. There is a big association with professional footballers; we definitely saw a gender difference in terms of the males picking up on that. For nicotine pouches, there is also sponsorship on Formula 1.
Nickie Aiken
Q
Professor Ford: Yes, it is a little white pouch. You put it underneath your lip and leave it there for up to an hour. For some of these products on the market, their displays are becoming more elaborate. The packaging is very childlike and the number of those childish packs is increasing.
The products can be incredibly strong. We have seen some for sale that contain up to 150 mg of nicotine. In terms of future-proofing the Bill and having the powers to regulate a range of products, the market is so innovative and developing so quickly that it is important to stay on top of that kind of thing.
Q
If a person uses a standard stop smoking device, such as a nicotine patch or nicotine gum, the natural history is that they smoke, they use the said gum or patch, they wean themselves off the gum or patch, and then they are no longer a customer providing the industry with revenue. If a person uses vapes, however, they have a choice of flavours that help to maintain the addiction. One thing we have seen with the Bill, which contains powers for the Government to potentially regulate the flavours, is that people are using the argument that it will prevent smokers from stopping smoking. They are trying to argue that flavours do not attract children, but the evidence says otherwise. Do any of you have any comments on that?
Professor Ford: It is true that the flavours are part of the appeal of these products for young people. That appeal is made up of a whole marketing mix of things, and flavours are one element of that. We know that adults like flavours as well, and they might help some adult smokers to migrate away from tobacco, so that is also a factor.
The concern is the vast number of flavours that are available—there are thousands. The way they are described is also an issue. In our pack analysis, we looked at how all the flavours are described: you have a basic flavour such as strawberry, or a flavour blend, but you also have what we call flavour concepts, which do not denote a flavour at all. We had examples such as tiger blood and koala drool. I do not know what they taste like, but they are certainly not flavours that I am aware of.
We believe that those descriptors are tapping into this youth culture and youth slang—some other kind of imagery. They go beyond the factual content of a flavour. One easy way to help to restrict the appeal around flavours would be to restrict those flavour descriptors in the first instance. I think it is great that the Bill would contain the power to go on to restrict flavours if that is the right thing to do.
Dr Branston: Can I add that these are profit-seeking companies? They will do what they can to continue to make the profits that they are making. The profits are as addictive as the products that they make, so it is not in any way surprising to me that they design their products to be as appealing as possible to consumers, as well as being as addictive as possible to consumers.
Tobacco and Vapes Bill (Eighth sitting) Debate
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(2 years, 3 months ago)
Public Bill CommitteesI 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.
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.