Tobacco Control Plan

Paul Williams Excerpts

Thursday 19th October 2017 Commons Chamber

[Dr Paul Williams (Stockton South) (Lab)]

I am grateful to my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing this important debate.

There used to be a time when cigarettes were perceived as cool—but people were being conned. Powerful tobacco companies were placing their products in movies and using careful branding to make us think that cigarettes would make us more attractive, more athletic, or even smarter. What they forgot to tell us was they also leave people unable to breathe, cause heart attacks, and kill half of those who use them. Some 15% of adults in the UK still smoke. In some parts of my constituency, half of all people still smoke. Not surprisingly, these are also the areas where people die youngest. I predict that in 50 years’ time nobody will smoke. We will look back on the 20th and early 21st centuries and shake our heads and laugh at the idea that people were poisoned with tobacco and paid for the privilege.

Like many Members in the Chamber, I would like to see England smoke-free. That means no young people starting to smoke because they know that it will make their breath smell and their teeth bad, no pregnant women smoking because they know that each time they smoke a cigarette their baby is also smoking a cigarette, and no young parents smoking because they know that their kids will copy them as soon as they are old enough. It means people in their 40s and 50s quitting, because lungs decline rapidly if people continue smoking beyond this age, and in time they struggle to breathe. It is never too late to stop. It is best never to start, because stopping smoking is one of the hardest things that someone will ever do—but one of the most worthwhile. As many Members have mentioned, half of all cigarette smokers will die of smoking-related conditions. There is a powerful case for continuing to take stronger action towards a smoke-free society, and I welcome much of the tobacco control plan for England.

It is important to recognise success. Smoking rates in the north-east of England have fallen to just over 17%—down by almost a half since 2005, and the largest regional fall in smoking rates in the country. Having 200,000 fewer smokers in the region could mean 100,000 fewer premature deaths. This is, in part, due to the work of successive Governments who have pushed the issue up the agenda.

I welcome all the ambitious targets that the tobacco control plan for England sets for future reductions, but I particularly welcome the focus on stopping smoking in disadvantaged social groups. The decline in smoking in our society has not been uniform and, as in many areas of society, many people have been left behind. However, it is wrong to think that just providing services to people living in poverty will be enough. My experience of working in areas of socioeconomic deprivation in England has taught me that health behaviours do not occur in isolation. It is genuinely hard for someone to stop smoking if they are worried about how they are going to pay their next bills; they are threatened with losing their benefits, perhaps even having to wait six weeks for universal credit; they have insecure work; they live in a community threatened by crime and antisocial behaviour; and they are struggling to look after their family. Smoking is often a symptom of other problems. Reducing smoking requires poverty reduction and true engagement at a community level to make life better and easier for people living in areas of deprivation.

I would now like to focus on those with mental health conditions. As has been mentioned, the smoking rate among people with mental health conditions has remained stubbornly high. In Stockton South, the rate is about 40%, even though smoking rates have fallen among the rest of the population. It is one of the single largest factors in the lower than average life expectancy among people with a mental health condition. For someone who has a mental health problem, stopping smoking is good not just for their physical health but for their mental health too. There is evidence that if someone with depression stops smoking, it can have an effect on improving their mental wellbeing similar to taking antidepressants.

Closing the gap in smoking rates is not a straightforward task. It is a challenge that requires a collaborative approach, including not just the NHS but communities, mental health charities, anti-smoking organisations and, not least, smokers themselves. I welcome the plan’s commitment to work with the Mental Health and Smoking Partnership to identify how we reduce rates of smoking in this population. However, while the ambition of the plan is welcome, it is not clear how the Government intend to assess progress within the population of those with mental health problems. I would be grateful if the Minister could tell us what he intends to do to make sure that there are reliable, national ways of measuring smoking rates among the whole population of those with mental health conditions, not just those with severe mental health problems. Government should know how they will assess whether targets are being achieved.

Like other Members, I am concerned about cuts that local authorities are making to public health funding, their hands often tied by huge Government cuts. I am particularly concerned about cuts in smoking cessation services. The evidence is quite clear: well-run services that combine behavioural therapy and prescription of nicotine replacement products offer smokers who want to quit the best chance of success. Community-based interventions to tackle inequalities are stressed in the plan, but that will be empty rhetoric unless the funds to do this work follow. The five year forward view and the sustainability and transformation partnerships place a significant emphasis on prevention. The pressure on NHS services in future can be significantly eased if we ensure that we make the necessary investments in prevention now. Government must finance the public health provision necessary to put effective tobacco control policies into action and to enforce tobacco control legislation where it is being broken. That Government commitment is threatened by austerity, and by cuts in local government funding in particular.

It would be a welcome boost if the political consensus that exists in this House—it spreads across all parties— on the need for tobacco control were supported by a commitment to fund local authorities in England to deliver the radical steps that we now need to make the next push towards a smoke-free society.