(4 months, 2 weeks ago)
Commons ChamberI rise to support the Bill and to make two declarations. First, I chair the all-party parliamentary group on smoking and health. The group’s objective is to encourage people who smoke to give up and young people not to take up smoking at all in the first place, which the Bill aims to achieve. My second declaration is personal. I do not want anybody else to go through what I went through, which was seeing my two parents dying of cancer—a smoking-related disease. I well remember my late mother, at the age of 47, gasping for her last breath. She had been smoking since she was 12. At the time, smoking was almost encouraged by doctors and the medical fraternity, as the implication was that it was a good thing to do.
I want to see a smoke-free generation. We have the opportunity to achieve that now. New Zealand was going to be at the forefront of this effort, but has decided not to go ahead, which means that we can now be in the vanguard of creating the first smoke-free generation in the world. However, the stakes could not be higher. Research from University College London says that 350 young people between the ages of 18 and 25 take up smoking every day. That means that 50,000 young people have taken up smoking since the Government first announced their proposals. They will face a lifetime of addiction and early death as a result.
Relatively few people in my constituency smoke—the numbers are way below average rates. None the less, smoking-related diseases accounted for 1,300 hospital admissions in the year before the pandemic. People suffer the same inequalities as a result. Some say that if we implement these measures we will not have the taxation coming into the Treasury, but in 2023, smoking cost the economy £21 billion. That is more than double the revenue that the Government get from tobacco levies. Some say that people who die early are doing us a favour by not being an imposition on the national health service. That is absolutely outrageous. We want people to live longer and healthier lives.
Let me make this clear for all those who believe in freedom of choice. I am a dyed-in-the-wool Conservative and I believe in free choice, but the only free choice that a person makes if they take up smoking is to take that first cigarette, because after that they are addicted for life; the craving is there. Although most adult smokers want to give up, the reality is that it takes 30 attempts to succeed. Only one in 10 smokers achieve that each year. Therefore, if a person smokes, they will die a horrible death, probably as a result of a smoking-related disease.
This Bill has the opportunity of creating a smoke-free generation and of making sure that young people do not get addicted in the first place. If they wish to take up smoking when they are an adult that is their choice—their free choice—but, importantly, this Bill does not criminalise those people who smoke at the moment for either purchasing or using tobacco. The legal obligation will be on the retailers not to sell tobacco to those who are underage.
Like many people, I am concerned about the number of young people taking up vaping. The reality is that we do not yet have the evidence of what that will do to their lungs in the future. We know that it will get them addicted to nicotine, which is the most addictive drug known to man or woman. Once they are addicted to some form of nicotine, the temptation is to go further. We do not know what damage is being done to people’s lungs by the delivery mechanism of vaping, but medical evidence on that will emerge. It is important that we take action now rather than waiting to see what happens.
There is clear public support for these measures. Sixty nine per cent. of the public, including more than half of all smokers, back the Prime Minister’s age of sale proposal. There is support for the Bill across the political parties. The majority of people who vote for each of our parties across the Chamber support this proposal, and that should not come as a great surprise, because no one wants to see their children or grandchildren become addicted.
Sadly, big tobacco is fighting back. Tobacco companies have even attempted to classify themselves as allies of public health. Philip Morris International threatened to take legal action against the Government to delay the legislation. I am not sure what it thinks it is saying with its new corporate slogan, “Delivering a smoke-free future” when its whole aim is to get people addicted in the first place. The other reality is that big tobacco has been trying to get many of its products, such as heat-not-burn and cigars, exempted from the Bill—exemptions that would undermine the Bill before it even takes effect. Those products still contain tobacco and harmful products, and still cause damage to people’s health. We cannot allow those exemptions to happen. Another thing that we should change is the current exemption for cigarillos from standardised packaging laws—maybe we could consider that as the legislating take place.
The other reality that I want to mention is the discrepancies between Scotland, Northern Ireland, Wales and England. Scotland has a clear requirement for retailers to identify people by their age. I welcome that, as it is the right thing to do. As it stands, the Bill does not appear to require that in Wales or in England. I hope that we can amend the Bill as it goes through Committee to allow the provision that exists in Scotland —we should support what they have done there—to apply in England, Wales and Northern Ireland.
I know that you require me to sit down, Madam Deputy Speaker, but this is a subject that I have been passionate about for rather a long time. The reality is that the smoking ban back in 2007 was led from the Back Benches. Indeed, many Labour Ministers voted against the tobacco ban—
Including the Deputy Prime Minister. From that ban through to the 2015 progress on tobacco control, such measures have consistently come from the Back Benches. In fact, colleagues from across the House have helped to implement many of them. I am delighted that the all-party parliamentary group’s recommendations have been included in the Khan review. I thank the Prime Minister for going even further than what we asked for, which was a rise in the age of sale to create a smoke-free generation by raising the age of sale by one year every year. The reality is that tobacco control measures have consistently passed through this Chamber and the other with overwhelming support from across parties every single time they have been proposed. I am confident that this Bill will be no different.
(5 years, 10 months ago)
Commons ChamberAs my hon. Friend, the chair of the all-party group on smoking and health, knows, those groups are key to delivering our tobacco control plan. We are not complacent at all; the delivery plan that was published in June sets out the actions that different agencies will take to deliver the five-year plan, and that absolutely includes mentor cessation services.
(6 years, 1 month ago)
Commons ChamberI probably cannot do all of that without trying Mr Speaker’s patience, but I should like to thank the right hon. Lady, who is one of my predecessors, for the work that she does through the all-party parliamentary group on children of alcoholics, and with the charity Adfam. Charities and other third sector organisations will play a key part in putting in bids to work with local authorities, as part of the £6 million. Public Health England is leading on that, and I look forward to having ongoing discussions with her and with other Members who I know have a deeply held personal interest in this matter.
Smoking rates are at their lowest ever, but we need to make more progress on tackling smoking in pregnancy, as I outlined in the general debate last Thursday. We are determined to redouble our efforts in this area, because smoking is still the biggest preventable killer in our country today.
I thank my hon. Friend for his answer. Smoking rates among pregnant women are still stubbornly high. What steps can he take to encourage the partners of pregnant women to give up smoking so that both partners play a part in preventing damage to the unborn child?
My hon. Friend makes a good point, which he made in last week’s debate. Public Health England and NHS England will continue to work with local areas in our constituencies to promote evidence-based ways of identifying and supporting pregnant smokers to quit. The overall ambitions in the tobacco control plan, which I published a year ago last week, will touch the general population, which of course includes the partners of pregnant women.
(6 years, 1 month ago)
Commons ChamberI already have and NHS England already has: we have already done so. We think that Philip Morris International’s move is totally inappropriate and totally contrary to the protocol. I do not think I could have been clearer either in the press or at the Dispatch Box today, and I thank the hon. Gentleman for giving me the chance to say so again.
All our local activity has the overall goal of helping people to quit smoking and stopping others starting in the first place, so how are we doing? Here is the score card. Publications by the Office for National Statistics and NHS Digital earlier this month show that we are making progress. Since 2011, the number of adult smokers has dropped by a fifth to the lowest level since records began, and we are fully on track to achieve our 2022 ambition for adults. Among 15-year-old smokers, there is good progress, and figures published last year showed that the prevalence of smoking has reduced by a further percentage point from 8% to 7% since the publication of the plan. The number of e-cigarette users in that group is also falling. Latest figures from the ONS annual population survey reveal that smoking rates among 18 to 25-year-olds are falling faster than in any other age group. Considering that that age is when most smokers start smoking, I am particularly pleased with that.
We are also making progress on inequality. Although routine and manual workers continue to have higher smoking rates compared with the rest of the population, the gap has narrowed slightly, from 26.5% at the publication of the plan to 25.7% as reported by the ONS earlier this month. Those are achievements to celebrate. Nevertheless, I must be honest with the House and say that progress on tackling smoking in pregnancy is disappointing, and in truth the figures have barely moved in the past year.
What shall we do in year 2 of the plan? First and foremost, I am determined to redouble our efforts to support pregnant smokers to quit. That will be best for them and for their babies, and we need people to understand that. Secondly, we will use the opportunity of the Government’s investment in the NHS, which the Prime Minister announced last month, to embed prevention and cessation more firmly into the culture of the NHS. Last month, the Royal College of Physicians, which has a proud record of groundbreaking reports on tobacco, published “Hiding in Plain Sight: Treating tobacco dependence in the NHS”. That weighty report calculated that the cost of current smokers needing in-patient care is £890 million a year. It points out that smokers are 36% more likely to be admitted to hospital at some point than non-smokers, and it makes the powerful argument that smoking cessation repays the cost from year 1. I welcome that report, and I will be making that case loud and clear as we engage with NHS England on the content of the 10-year plan that the Prime Minister has asked it to produce.
Thirdly, we will continue to engage with local authorities —they are now top-tier public health authorities up and down the land in England—on promoting smoking cessation as the best evidence-based means of quitting smoking. Encouraging the NHS to do more on cessation is emphatically not about removing responsibilities from local authorities. This is about creating a whole-system approach in which addicted smokers can access the support they need to quit. Public Health England will continue to provide local councils up and down the land with facts and advice on tackling smoking—for example, it will work with sustainability and transformation partnerships, which should be leading that whole-system approach in the constituencies of all English Members.
Fourthly, as I have mentioned, we will continue to raise tobacco duty to make tobacco less affordable, while also taking action to tackle the illicit trade in tobacco. Fifthly, we will maintain a careful watch on so-called novel tobacco products. The Government are keen to use the opportunity of newer products, such as e-cigarettes, to help smokers to quit, without undermining the key message that the best thing someone can do for their health is quit completely. As I said in the Science and Technology Committee’s inquiry into this subject, we will continue to keep the harms of products such as heated tobacco products under review and continue to hold the industry to account. We have been explicit that the promotion of tobacco products is unlawful, as my recent letter to Philip Morris International makes abundantly clear—that letter was written before the one I mentioned in response to the hon. Member for Stockton North (Alex Cunningham).
Last but not least, we will continue to make the case for tobacco control internationally, building on our reputation as a leading tobacco control nation with credibility in that space. We have such credibility because our consistent work in this area goes back to the coalition Government, the previous Labour Government and the Conservative Government before them, and such consistency means that we are highly credible around the world. More than 7 million people a year across the globe die from smoking-related disease, and the UK Government can help make a dent in that toll by sharing knowledge and skills.
I pay tribute to the Minister’s brilliant work both since he became a Health Minister and before then. Will he comment on some of the scientific issues raised about addiction to nicotine, compared with the very harmful by-products that are a part of cigarettes, cigars and other tobacco products? Will he comment on whether it is nicotine or the by-products that are harming people’s health and causing the most damage?
I think cigarettes cause the most damage, because of the tobacco and the nicotine. The carcinogenic properties of the former are lethal. That link was proven with the lung cancer study that started the ball rolling. I pay tribute to my hon. Friend as the chair of the all-party group for the work he has done in this area. There are a lot of things that we know and there are a lot of things that we still do not know. Some people say that I do not go far enough to promote e-cigarettes and novel products, and some people say that maybe we go too far—I mentioned Stoptober. That generally suggests to me that we are in the right place. What I would say—I think that I said it earlier—is that an awful lot of research is still needed on e-cigarettes. One Member once told me that we should make e-cigarettes free on prescription to all pregnant women. The reason I did not say, “Yes, I think that’s a good idea” is that I still think there are risks to that product. I still think that the best thing people can do is to stop chuffing on anything, whether traditional cigarettes or so-called novel products. I thank him for his intervention, and I look forward to hearing what he has to say during the debate.
It is a pleasure to follow the hon. Member for Washington and Sunderland West (Mrs Hodgson), who has done excellent work already in her shadowing role. I know that she was also at the forefront of this debate before shadowing these matters. Equally, I pay tribute once again to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), who set a precedent for future public health Ministers when, at his first outing at the Dispatch Box, he agreed to publish the long-awaited tobacco control plan. We should remember that it had been delayed for a year before it was published last year at the behest of my hon. Friend, probably much to the consternation of his officials.
I also want to pay tribute to the Minister’s predecessors, particularly the former Member for Battersea, Jane Ellison, who did a brilliant job of advancing many of the controls on tobacco that we now have in such a way as to ensure that they were delivered. I remember taking on the first debate on this subject in Westminster Hall, at which many of my colleagues were present. I think it was in September 2013, and it was the first debate after we came back from the summer recess. It took place at 9.30 in the morning, and I feared that I would have an hour and a half to fill by explaining why we should have standardised packaging for tobacco products. I have to say that both major parties were opposed to that idea at the time, but we were able to convince them otherwise and we changed the policy. That measure has now been enacted, which demonstrates the power that we on the Back Benches can have to change policy in a good way.
I must gently chide the Government, however, for taking over our Back-Bench debate. This means that we cannot pass the resolution that we wanted to pass today to encourage the Government not only to adopt smoking cessation policies but to resource them properly, to ensure that the plan is delivered. We understand that we are now having this general debate, however.
I declare my interest as chair of the all-party parliamentary group on smoking and health. We could go through the history of the progress that has been made, and the speeches from the Front Benches have shown us where we are today. I want to take us back to 1974, when I was sitting my A-levels. My late parents were both very heavy smokers. In those days, half the men in this country smoked, as did more than 40% of the women. It is hard to imagine, but in many ways it was considered healthy to smoke; it was somehow considered to be good for our lungs. Sadly, both my parents died five years later of cancer, so for me this is not only a health issue but a personal one. I do not want to see other people going through what my family had to go through as a result of using tobacco products in the way that they are intended to be used.
Smoking rates have dropped remarkably. As has been mentioned, the number of adult smokers has dropped from 7.7 million in 2011 to 6.1 million in 2017. The difficulty with figures, however, is that, as the population increases, we have to go harder and further to reduce the number of people smoking. Smoking-related diseases are the leading cause of preventable death, with 80,000 people a year dying as a result of tobacco products. In Harrow, part of which I have the honour of representing, we still have 14,000 smokers, which is difficult to understand given the encouragement to quit and all the health issues, and the cost to public services is estimated to be £37.9 million a year in just one London borough, out of 32, that has about 250,000 adults. It is clear that we need further action.
The good news is that the UK is one of the leading countries in the implementation of tobacco control policies. We are recognised as a leader in the implementation of the World Health Organisation’s framework convention on tobacco control, and I want to remind the House of article 5.3, which states:
“In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.”
The guidelines on implementing article 5.3 have been agreed by the UK and advise Governments not to enter into any partnerships, whether they be non-binding or non-enforceable, or agreements with the tobacco industry, not to accept voluntary contributions from the tobacco industry, not to accept tobacco-industry-drafted legislation or policy or voluntary codes for legally enforceable measures, not to participate in corporate social responsibility or related schemes funded by the tobacco industry, and not to permit tobacco industry representation on Government tobacco control bodies.
Former MP Paul Burstow, my predecessor as chair of the all-party parliamentary group on smoking and health, is now the chair of the Tavistock and Portman NHS Foundation Trust and co-chair of the Mental Health and Smoking Partnership. He wrote to the Minister about the letter sent by Philip Morris International, and I am pleased that the Minister has taken up the issue straight away. The company, which manufactures Marlboro cigarettes, wrote to say that it is
“keen to work with NHS Trusts and Foundations to see if we can support the NHS in helping its employees to stop smoking”.
I do not usually promote this publication, but an article in The Guardian today quotes me, Paul Burstow and the Minister making it clear that we do not want any interference from Philip Morris and that that company should not avoid its responsibilities under the code. I am delighted that the Minister has completely rejected the position of Philip Morris, which also states that it has
“written to the heads of all the NHS Foundations and Trusts in England, all Clinical Commissioning Groups, Simon Stevens, and the Secretary of State for Health and Social Care”
about the issue.
Most local authorities in England have signed up to the local government declaration on tobacco control, which is a public statement of the councils’ commitment to reduce the harm caused by tobacco. The declaration commits signatories to
“protect our tobacco control work from the commercial and vested interests of the tobacco industry by not accepting any partnerships”
and so on. However, local government officers have reported continuing efforts by the tobacco industry to engage with local authorities over tobacco control issues including, but not limited to, the illicit trade. We must be clear that the industry’s involvement is not required and not welcome.
I am delighted that, on 1 November 2017, the Minister made a clear statement in this House on the Government’s position, and I am delighted that will continue. I welcome his comments, both in his opening speech and in his letter. What else can he do to make sure that local authorities, the NHS and any other interested parties do not get sucked into this offer from Philip Morris?
On the risks we run, as the hon. Member for Washington and Sunderland West said, one of the problems is that the plan and the targets might not be met. We have to encourage everyone to get to that point. The reality is that smoking rates among young people have started to level out. There is a risk that we will not hit those targets. The target to get smoking rates down to 5% or less by 2022 is good, but I would like to see it at 0%—no one smoking. We could then say that we have achieved what we wished to achieve.
We clearly have to encourage young people not to start smoking. As has been said, more than 350 young people a day take up smoking, and 60% of them go on to smoke for the rest of their life. The huge risk is that those people will fuel the tobacco industry for the future.
There is therefore a case for further control measures, including increased funding for the initiatives, and new legislation. Although it is not appropriate to allow the tobacco manufacturers to make voluntary contributions, if they are offering to give money to the NHS and to local authorities as part of so-called corporate social responsibility, the industry clearly has money to pay for the measures we need to control tobacco and to mitigate the harm it causes, so let us make the tobacco manufacturers pay.
At a time when public sector budgets are under pressure both at national and local level, the tobacco manufacturers, if they have money, should pay an increasing share of the cost of control, as an application of the “polluter pays” principle. That is the clear recommendation of the all-party parliamentary group, and I trust my hon. Friend the Minister will therefore advance that recommendation to the Chancellor.
Consider it advanced. Time will be limited for the wind-ups, so I will address the point about young people. Earlier this week, I held a roundtable in the Department of Health with a number of charities working on drug policy and with reformed drug takers. One gentleman said to me, “The trouble was that I really enjoyed taking drugs. What I didn’t enjoy was the outcome of taking drugs.”
I have heard young people say that they really enjoy smoking but that they do not enjoy the outcome. We should welcome today’s statement by the Secretary of State for Education on the new work that will be done in schools on health and relationships education. Specifically, health education can help young people to understand the health consequences of smoking, even if they might enjoy the process of smoking.
I thank my hon. Friend for his intervention, and I completely agree that health education is an appropriate way to consider the issue.
There is a model in the United States that we could introduce. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the US Food and Drug Administration the power to regulate the tobacco industry, funded through what is called a user fee on manufacturers. The total amount to be raised is set out in legislation and apportioned to manufacturers on the basis of their share of the US tobacco product market. I ask the Minister to look at that US legislation as a way of introducing such a model.
The major recurring costs of tobacco control, and they are important, are mass media campaigns to discourage uptake and to encourage quitting. An approach such as the one in the US would: raise hundreds of millions of pounds a year from the tobacco industry; help to protect the business of legitimate retailers who obey the tobacco control legislation; help to protect Government tax revenues—at the moment, the excise tax raised £9.9 billion in 2016-17, but the loss on illicit tobacco was estimated to be £2.4 billion; pay for the mass media campaigns to discourage smoking, which we desperately need; and provide a source of revenue to local authorities, which could help to fund local tobacco control measures, including enforcement activity and the provision of support to smokers seeking to quit. Funding for trading standards has fallen substantially in recent years, from £213 million in 2010 to only £124 million in 2016, and the National Audit Office estimates that the number of full-time staff has reduced by 56% in seven years. So there are fewer people to enforce the rules that we want to see enforced. Such an approach could also support regional partnerships working to tackle illicit tobacco. The success of that has been shown in the north-east and north-west, which have concerted multi-agency enforcement activity and effective, evidence-based measures to reduce demand. So it is clear that we can deliver on this.
Polling conducted for ASH—Action on Smoking and Health—asked respondents how strongly they would support measures requiring tobacco manufacturers to pay a levy or licence fee to help encourage people to quit and prevent young people from starting to smoke. The net support for that was 71%, with only 9% opposing. So the Minister should impress on the Chancellor the need for this and the benefit of doing it.
One key issue that I wish to emphasise above all else is the need for mass media campaigns to shock people into realising how desperate smoking is and how damaging it is to health. There is nothing like seeing those sorts of mass campaigns for encouraging people to realise that they are responsible for their health. The analysis of these campaigns has shown that they are very effective but that they have declined in recent years. Public spending on such campaigns in the UK peaked in 2008-09 at £23.38 million, but now that has fallen dramatically, to only £1.5 million in 2016-17. Clearly, we need to encourage local authorities and the Department of Health and Social Care to use the opportunity to shock people so that they understand the damage they are doing. I therefore ask the Minister to look at mass media campaigns and ensure that they are used as part of the strategy.
Finally, let me say that my area now has a large number of people from the European Union who have chosen to come here to live in this country. If we go to many eastern European countries, we see people smoking everywhere; these places do not have the tobacco control that we have in this country. Those people need to be reached to encourage them to give up smoking and ensure they look after their own health. It is those people we have to reach out to fully. I look forward to other contributions from right hon. and hon. Members, and I am sure that the Minister will reply in suitable fashion.
(6 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
First, may I correct myself? I might have said that the expert working group met “companies”, not “families”. If I said “companies”, I wish to correct the record.
I agree with the hon. Lady that the notice the families were given was not good enough. I and my colleague in the other place have made that crystal clear. Some notice was given to Mrs Lyon on Friday last week that there was likely to be an event on Wednesday, but that was not confirmed until Monday, so that was the notice the family got, and I do not think that is good enough; I have made that very clear.
On the hon. Lady and the hon. Member for Bolton South East (Yasmin Qureshi), who chairs the all-party group, being locked out of the press conference, I cannot imagine how that happened, and again I have sympathy on that. I expect the MHRA to look into that and explain that to me, because, while we may disagree, I can see how that merely feeds the conspiracy theory that some have around this subject.
My hon. Friend is clearly struggling to defend this position. I urge him to look at the scope of this review and all the evidence that was presented to it, as all the evidence that was available should be looked at and looked at again. Without that, many people across this country will not be satisfied that justice has been done.
With respect, I do not think I am struggling at all; I am just setting out a very clear position. Ministers are confident in the report and the review process. I say again that this was a comprehensive independent scientific review of all available evidence by experts across the expert working group who have a broad range of specialisms.
(6 years, 9 months ago)
Commons ChamberAdult smoking prevalence is now 15.5%, the lowest ever. As the House will be aware, in July we published a tobacco control plan for England, which sets out stretching ambitions to reduce smoking prevalence still further and commits us to a series of actions to deliver those ambitions. Our end goal, as we have made clear, is a smoke-free generation.
I thank my hon. Friend for that answer. Does he agree that one of the most effective ways of helping people to give up smoking is the provision of smoking cessation services? In Harrow, the local unit managed to help 4,000 people attempt to give up smoking, with more than 50% doing so, but the answer from the local council has been to close the unit—that is very ineffective. Will he take action to make sure that this does not happen across the country?
My hon. Friend is right to raise the issue. Local authorities, not Ministers in Whitehall, are best placed to take local spending decisions, but they must be accountable for their decisions. That is why we publish information at local authority level on smoking prevalence and quit numbers, so that local decision makers can be held to account. We also offer them expert support from Public Health England. I have a strong feeling that he will continue to hold those in Harrow to account.
(7 years, 1 month ago)
Commons ChamberI will have to look into the exact point that the hon. Gentleman raises, but I should like to welcome him to his place. I worked closely with his predecessor, and the hon. Gentleman has a tough act to follow. When we publish the tobacco control plan, there will be clear local tobacco plans as part of it. We in the Government can give the best evidence of what works, but we need to recognise what is needed in each local area. I know that he has specific needs in his local area in relation to tackling this issue.
I welcome the Minister to his place. Does he agree that it is vital that anyone who approaches the national health service with a smoking-related disease should be pointed towards smoking cessation services? Does he also agree that it is vital that local authorities continue to run those services?
Yes, absolutely. Local authorities have an obligation to do that, but as I said to the new hon. Member for Ipswich (Sandy Martin), it is important that local plans come forward alongside the new national plan. Local solutions are needed for different areas, and that will be the case in my hon. Friend’s borough just as it is in my area of Hampshire.