Tobacco Control Plan

Steve Brine Excerpts

Thursday 19th October 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

I thank the hon. Member for Washington and Sunderland West (Mrs Hodgson), my ministerial shadow and my friend—she certainly is that.

I congratulate the right hon. Member for Rother Valley (Sir Kevin Barron) on securing this important debate. The Backbench Business Committee was an excellent innovation that arrived in this House at the same time as me—there is no correlation between those two things, I should point out—and debates such as this would not necessarily have happened without it. So well done to the right hon. Gentleman, and to all the Members who have participated. As the shadow Minister said, it is Stoptober, which is an excellent time to have this debate, but of course our passion to cut back on smoking rates is not confined to October.

Let me say a bit about the tobacco control plan and try to respond, as far as I can, to the points raised in the debate. My ministerial brief covers a wide area: public health, primary care, and cancer. That might appear to be a disparate agenda, but there is a plan. For me, all of my responsibilities come back to prevention and in particular how we prevent some of the major diseases; cancer is, of course, still the biggest preventable killer in our country, and the link to smoking is obvious and has been given by many Members. To give some obvious examples, our work to tackle the harmful use of alcohol, our strategy to tackle obesity and specifically childhood obesity, and our tobacco control plan are all about doing more to prevent ill health in our country, and above all cancer.

The TCP is not an end in itself; it is part of a plan. The shadow Minister kindly said that publishing it was down to me. At our very first health orals, she asked when it would be published, and I gave the answer that it would be published by the summer recess. She then shouted out, “Which summer recess?”, but the plan had been started and I wanted to get it right and to get it out. It is amazing what announcing things at oral questions will do to our officials. Anyway, we got it out, and I am very pleased with it.

The last TCP ran from 2011 to 2015 and was considered highly successful; I am grateful to the many Members from all parties for saying that. All the ambitions we set out in that plan were exceeded. We introduced a significant amount of legislation over the course of the plan, as did the Labour Government before then. There was the ban itself, then the ban on smoking in cars containing children, and then, last year, the introduction of standardised packaging, which is a first for Europe. The UK remains a world leader in tobacco control, and Governments of both parties have a proven track record in reducing harm caused by tobacco. The country has made a significant reduction in the prevalence of smoking over the past 25 years, from 27% in 1993 to just over 15% today. That is some achievement.

[Will Quince]

At the moment we have symbols on every bottle of alcohol sold in the UK. I appreciate that this is under EU rules, so other Government Departments would need to look at this, but could we consider having “no smoking while pregnant” symbols on all smoking products, rather than just one in six, as is the case at present?

[Steve Brine]

I will look at that point; as ever, my hon. Friend makes a pertinent point from the Back Benches—where I do not think he will be forever, I might add. [Interruption.] It is evidently not my decision.

I have given the relevant figures, and we are now considered by independent experts to have the best tobacco control measures in Europe. We published the new plan this year to build on that success, but there is no room for patting ourselves on the back in this game, and we still have a huge amount to do.

We still have 7.3 million smokers. That exerts a huge impact on our communities and our NHS. Tobacco use is the biggest contributor to cancer, accounting for more than one in four UK cancer deaths, and nearly a fifth of all cancer cases in this country. Research by the Independent Cancer Taskforce reported that up to two thirds of long-term smokers will die as a result of smoking if they do not quit. We have heard from a number of Members across the House about people whom they have loved and lost, and they are not statistics; they are people’s mothers and fathers, and sons and daughters, who have been lost to cancer. Cancer is not contracted through smoking alone, of course, although it accounts for a huge part of the cancer rate. We must remember that 200 people die every day due to smoking; I think every Member will join me in saying I want us to do better than that.

The plan sets our interim ambitions en route to that goal. Over the next five years we want to reduce the prevalence of adult smokers to 12%. In answer to my hon. Friend the Member for Harrow East (Bob Blackman), I would like to go lower than that, but that is the current figure in the plan. It is not necessarily an end-point, however, and it is not an end in itself. We should also remember the prevalence of 15-year-olds who regularly smoke. We want to get that down to 3%, and the prevalence of pregnant smokers—which so many Members have mentioned today—down to 6%. We want to reduce the burning injustice—a number of Members have used that term today— that sees some of the poorest in our society die on average nine years earlier than the richest, so we will focus, as the plan says, on people in routine and manual occupations.

We want to focus on other groups particularly affected by smoking, such as people with mental health conditions and those in prisons. The hon. Member for Stockton South (Dr Williams) rightly spoke about that being part of a wider poverty reduction programme. That has to be central to the plan, which is not just owned by the Department of Health and me. It is a cross-governmental plan and everything that we do should be part of that aim to reduce poverty. That is why the Prime Minister said what she did. I guess that the hon. Gentleman does not agree with everything she said, but surely he must agree with her words on the steps of Downing Street about poverty reduction.

[John Grogan (Keighley) (Lab)]

The statistics in some of our cities are much higher than in others. In my city of Bradford, the Minister will know that the figure for smoking prevalence is about 22%. Public health is so important; does he recognise the importance of giving more resources to public health and councils, which have experienced significant cuts in recent years?

[Steve Brine]

I simply say to the hon. Gentleman, who has not been present for the debate, that that point has been made. I also point out that we are giving £16 billion of ring-fenced public health spending to councils in England, which is significant. However, I shall come back to his point if he will bear with me.

To achieve the ambitions in the plan, we need to recognise that smoking is increasingly prevalent in particular groups in society and in particular areas. That is why we need to shift the emphasis from national to local action, and support smokers, particularly in disadvantaged groups, to quit. Now is not the time for more legislation—we have done that bit. I do not rule it out forever, but successive Governments have done that part. Now is the time to redouble our efforts to focus on our top priority groups such as pregnant women, young people and people with mental illnesses. We must focus on the people and areas with the greatest need.

Let me give an example. Yesterday, we published the two-years-on plan from the national cancer taskforce, which looks at the cancer strategy. It is full of good case studies. One that especially struck me was the Manchester lung cancer project, whereby we screen people arriving at supermarkets in certain parts of Manchester. That has led to improved cancer detection and outcomes for the local community that are quite staggering. Why do that in Manchester and not in Hampshire—in Winchester in my constituency? That is because there is a high prevalence of lung cancer driven by smoking in the Greater Manchester area. I visited Macmillan’s headquarters in London and sat and listened to some callers on their support line. I asked about regional disparities and they said that when they got calls from that part of England, they were about lung cancer, and that is no coincidence.

The example I gave is a policy response from the Greater Manchester authority, led by Andy Burnham, formerly of this parish, who has already put in place a plan that will mean 115,000 fewer smokers by 2021. I pay tribute to Andy, with whom I worked a lot in the House through my chairmanship of the all-party parliamentary group on breast cancer. I know that he has been greatly affected by that, and he is great partner for us on this matter. That is exactly the kind of thing we meant when we said in the tobacco control plan that we wanted local areas to develop their own local strategies.

There are many other good schemes locally—for example, the Fresh programme operates in a dozen local authorities in the north-east. I wonder whether the hon. Member for North Tyneside (Mary Glindon) is aware of it. She made an excellent personal speech, and I congratulate her on managing not to turn into a smoker, given the family background that she described. All the evidence suggests that children who grow up in families where the parents smoke go on to do so. The hon. Lady clearly knows something that we do not.

Leicester provides great examples of innovative stop smoking services, and the right hon. Member for Rother Valley mentioned Leicester and namechecked the council officer, who I suspect will keep that Hansard report. Well done to Leicester.

I recognise that hon. Members are concerned about local stop smoking services, but as I said in response to an intervention, we have a £16 billion ring-fenced public health budget. The Government believe that local authorities are best placed to make decisions on how the services should be prioritised to meet the needs of their populations. That is why I gave the example from Manchester. I am many things, but I am not best placed to decide what works in Leicester or Manchester; locally elected politicians are best placed.

The Government will continue to publish data that help local people hold those locally elected leaders to account. That is a crucial part of the plan. Public Health England, for which I am responsible, will continue to offer support to local authorities to help them develop their local approaches in the most cost-effective and evidence-based way. As Minister, I will continue to be a passionate advocate for evidence-based tobacco control plan policy making. It is an integral part of my mission to reduce the toll of preventable cancers.

I want to say something about the Government’s approach to e-cigarettes, which almost every Member who spoke mentioned. The new control plan commits to monitoring the safety, uptake, impact and effectiveness of e-cigarettes and so-called novel tobacco products. We must find a better term than that. The plan charges Public Health England with the responsibility of including messages about the relative safety of e-cigarettes in their quit smoking campaigns. I am pleased to say that that is already under way and that PHE’s current Stoptober campaign, for the first time, highlights e-cigarettes among the array of tools that smokers can use to improve their chances of quitting successfully.

As we like to say during Stoptober, there has never been a better time to quit. I will leave to my right hon. Friend the Chancellor the several Budget submissions around e-cigarettes. The suggestion of my hon. Friend the Member for Colchester (Will Quince) of providing free e-cigarettes to pregnant women who are smokers is certainly worthy of consideration. I noted that the hon. Member for North Tyneside is not necessarily a fan of changes to e-cigarette levies, so it is fair to say that we so not have unanimity across the House on that. PHE is already preparing its new year quitting campaign, which is rolled out in January each year, and it will reprise the hard-hitting messages that we have seen on our televisions. It is through consistent messaging that we can hope to reverse the harmful, mistaken and increasingly widespread belief that vaping is no safer than smoking. It clearly is.

The right hon. Member for Rother Valley made an excellent speech, touching on health inequalities and how smoking disproportionately hits the poorest in society. There is huge variation in the figures for pregnant women, with smoking rates of between 2.3% in London and—to correct the record—28.1% in Blackpool. He also made an excellent point about dentists and oral health. PHE-commissioned training will continue to ensure that local authorities have access to the training they need to provide effective help to quit and the information they need to work with patients. He chairs the all-party parliamentary group on pharmacy—I think we will be meeting soon—so he would say this, but he spoke about pharmacists and healthy living pharmacies, which have been particularly good. He referred to Government research, and PHE is committed to reviewing the evidence on e-cigarettes on an annual basis, and is working closely with Cancer Research UK and the UK Centre for Tobacco and Alcohol Studies to deliver a forum to ensure that we continue to have that strong evidence base.

I think I need to wind up by 3 o’clock, Madam Deputy Speaker. Is that right? [Interruption.] “Well by,” she says. Okay, let me conclude by thanking everyone who has spoken today. I particularly enjoyed the speech of my hon. Friend the Member for Chippenham (Michelle Donelan). It was hypnotic in many ways but very good, and I noted her Budget submission. As usual, I thank my hon. Friend the Member for Harrow, although I suspect that his berating me on this subject will not have started and ended today. The hon. Member for Ipswich (Sandy Martin) made a consistent point about local authority pension schemes, and it must be for local authorities to make such decisions and then answer to members of the scheme, their elected members and, of course, the residents who elect them and get to make such decisions every day.

In closing, I appreciate the many challenges and I appreciate the support that the House has given to tobacco control legislation over many years. It is now up to us to provide a national lead and to support our local authorities and ensure that they carry through what is in the plan. I thank my friend the right hon. Member for Rother Valley for introducing today’s debate and ensuring that tobacco control is no longer a partisan issue; this is now about the tobacco control plan.