Tobacco Control Plan

Robert Courts Excerpts

Thursday 19th October 2017 Commons Chamber

[Robert Courts (Witney) (Con)]

May I say what a pleasure it is to follow the hon. Member for North Tyneside (Mary Glindon)? I am glad that vaping has been of assistance to her family, and that things are on the up from that point of view. May I also thank the right hon. Member for Rother Valley (Sir Kevin Barron) for securing the debate? We have had a really important debate this afternoon. He raised some critical points, and I thank him for doing so.

May I also take this opportunity—I have not yet had such a chance—to welcome the Minister to his place? I know he is absolutely passionate about healthcare, and that he will bring to his role all the dedication and enthusiasm of someone who is in the lucky position of having a job that is also his passion. It is good that he will be responding to the debate.

I gave a lot of thought to how I would approach the debate. For a Conservative who generally takes the approach of pursuing individual liberty, there is perhaps some tension in favouring a control mechanism that takes away people’s individual choice. Some excellent points have been made, and two speeches in particular really nailed it. The first was by my hon. Friend the Member for Chippenham (Michelle Donelan), who made the point that were tobacco discovered today, it is inconceivable that it would be freely available on the high street in the way that it is. It seems to me that that is an historical anomaly. The second was by my hon. Friend the Member for Harrow East (Bob Blackman), who spoke movingly about his parents’ deaths from cancer. I am very sorry to hear of that, but it really emphasises everything we are saying in the debate. Of course, we always have to balance the libertarian desire for freedom with the public health interest, and I hope that those two important points have really hit home with hon. Members.

I have spoken at length this week about healthcare in Oxfordshire, its future and my concerns about the way it has been managed. While we must always look at treatment—ensuring that we will one day find a cure for cancer, and in the meantime that we care for those who have cancer with every means at our disposal—we really must continue to fight. What I mean is that we must continue to decrease as much as possible the number of people who suffer cancer in the first place.

We are in the presence of some particularly cold and hard facts. The cost of having 7.3 million smokers is that smoking is the biggest killer. It is clearly identified and open to view as the biggest cause of cancer. It leads to more than 200 smoking-related deaths a day, or 16% of those who die. There are 79,000 deaths per annum —79,000 preventable deaths, 79,000 personal tragedies—to say nothing of the 20 times the number of people who, for every death, are suffering from preventable smoking-related conditions. It seems to me that there is an enormous emotional imperative: we must tackle smoking and the damage it causes.

If I have not persuaded hon. Members on an emotional level, let us just look at the hard economic facts. Smoking costs the economy £11 billion. There is a £2.5 billion cost to the NHS, with 474,000 hospital admissions. Let us just think what we could do for the NHS if we could divert that funding towards the care of conditions that are not avoidable or preventable. There is a £4.3 billion cost to employers, and a £4.1 billion cost to wider society, including the £760 million going to social care. Let us just think about how we could treat dementia or Alzheimer’s if we could divert the money from conditions that are preventable towards those that are not.

Moreover, not only is smoking a cost to the economy and a personal tragedy for those affected, but it is overwhelmingly targeted on the poorest. This health condition is actively feeding inequality. Children of smokers are two to three times more likely to be smokers themselves. The Prime Minister has spoken—very powerfully, in my view—of how the poorest are dying up to nine years earlier than the richest, and half those deaths are smoking related. This condition affects the poorest in society the most.

Surely the economic, moral and health arguments are overwhelming when it comes to the Government’s ambition of creating a smoke-free Britain. It is into that arena that the Government step with this plan.

The good news is, of course, that stopping smoking produces health benefits in months and it is easier, relatively speaking—I appreciate that it is not easy—to give up now than it ever has been. There is the technology. We have heard about the help given by vaping or e-cigarettes; last Stoptober, 53% of those who gave up did so with the assistance of e-cigarettes.

Happily, yes, the prevalence of smoking is declining more sharply than for many years, and this is where the tobacco control plan stands. The last one hugely exceeded expectations: the percentage of people smoking declined from more than 20% to 15%. I applaud the Government for taking forward bold, imaginative and forward-thinking measures as we tackle this public health crisis. The Government wish to reduce the inequality gap that I mentioned, get adult smoking rates down from 15.5% to about 12% and reduce the percentage of 15-year-olds who regularly smoke from 8% to 3%. That is so important, given that the early years govern people’s health choices for the rest of their lives.

My hon. Friend the Member for Colchester (Will Quince) and I spoke in the baby loss debate earlier this week; I mentioned that smoking was one cause of problems during pregnancy. I am glad that my hon. Friend brought that issue up again today. He is right to say that it is difficult to give up smoking. We are not being censorious in talking about pregnant women who smoke, but it would be much better for everybody if we reduced the proportion who do from 10% to 6%.

The Government are providing £16 billion for public health funding to local councils, which are best placed to marshal resources and help people in their areas. Perhaps most effective has been the mass media campaign. Many years ago now—it is a distant memory—the campaign against drink-driving started, and it has had an incredible effect in shaping public expectations. I am not suggesting that smoking is on the same level—there is a recklessness in drink-driving that is not so stark in smoking—but as my hon. Friend the Member for Chippenham said, the issue is education and making it clear that someone is much more likely to hurt themselves and others if they continue to smoke.

I will not speak for much longer, but I want to make one or two brief further points. The first is that the Government propose a joined-up approach between local authorities and NHS England, which I encourage as it produces results. I am also encouraged by the “smokefree NHS” section of the plan—the NHS leading by example. I have discussed the impact on employers; the NHS is a large employer, so it is important that it should lead the way.

Lastly, I want to comment briefly on mental health. The NHS is leading the way as far as those using, working in or visiting the NHS are concerned, and the practice of escorting people from mental health hospitals on and off premises is due to end now that the health problems have been identified. Let us be clear: although 40.5% of people with serious mental health difficulties do smoke, they want to stop smoking just as everybody else does. I hugely encourage that. This is an example of the Government’s taking an approach to mental health in the round. Yesterday, I asked the Prime Minister about help given to military personnel, but this is another example of how to ensure that the issue is not just addressed in only one silo of society.

Thank you for letting me speak for a little while, Madam Deputy Speaker. Like the British Heart Foundation and Action on Smoking and Health, I welcome the plan enormously. It builds on recent Government work on tackling smoking. The proposals are ambitious and bold, and I ask everyone to support the Government’s plan to create a smoke-free generation.