National No Smoking Day

Stuart C McDonald Excerpts

Thursday 9th March 2023 Westminster Hall

[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing the debate and, more than that, I thank him for his tireless and enduring campaigning. He has spoken about this issue on many occasions, and we acknowledge and thank him for that.

We have come a long way, but the impact of smoking is still immense, as we have heard. It is also very personal, and we heard from the hon. Member himself, and from other hon. Members, about that personal impact. On that note, I pay tribute to my researcher Gillian, who helped me to prepare for the debate with her usual expertise, but also with even more passion than usual. That is because she lost her father, Tom Barr, suddenly in February 2021 to COPD caused by smoking. In a way, this is a tribute to him and to Gillian, of whom he was rightly proud.

As has been highlighted, this year’s national No Smoking Day theme is “Stopping smoking improves your brain health”, because research shows that quitting smoking reduces the risk of dementia. ASH Scotland’s theme this year is “Quit and win”, which focuses on the benefits for people’s health, wellbeing and personal finances of giving up the habit. The Scottish Government also have two campaigns that run throughout the year: “Take it right outside”, which focuses on communicating the harms of second-hand smoke and the importance of a smoke-free home and car, and “Quit your way”, which addresses the individual needs of people who wish to quit.

Let me turn first to the impact on people and communities. The hon. Member for Harrow East rightly spoke about the frightening consequences of smoking and, in particular, set out the significant link between smoking and dementia, as did the hon. Member for City of Durham (Mary Kelly Foy). According to ASH Scotland, smoking causes 100,000 hospitalisations and 9,000 deaths in the country each year. The Scottish health survey 2021 sets out that smoking is the cause of about one in five deaths and is the primary preventable cause of premature death and ill health.

As we have heard, particularly from the group of north-east MPs, who are well represented here today, a further major challenge is the way in which smoking exacerbates and widens health inequalities. In the most deprived communities in Scotland, one in three people smoke, compared with one in 10 in the least deprived communities. ASH Scotland also highlights that the average smoking household in the country’s lowest income group will spend up to 30% of its income on tobacco in 2023—around nine times more than the 3.35% estimated to be spent by similar households in the highest income groups. It is clear that the huge cost of cigarettes, coupled with the cost of living crisis, is pushing more people into worsening poverty. In that sense, addiction is not just a public health issue but a social justice issue.

There has been some interesting recent research by the British Medical Journal, which found that in Scotland, residents of areas with high outlet density are more likely to smoke and less likely to be ex-smokers, with related evidence that the most deprived neighbourhoods in Scotland have the highest density of retailers. Addressing the density of retailers could be one way to seek to address these inequalities.

I turn to the impact on public services and the economy. As we have heard, smoking remains the biggest cause of cancer and death, and it uses a considerable amount of NHS resources across each of the four nations. The annual cost to NHS Scotland of treating smoking-related diseases is estimated to exceed £300 million, and it could be higher than £500 million each year. Ill health and disability caused by tobacco, alcohol, weight and obesity are estimated to cost the Scottish economy between £5.6 billion and £9.3 billion each and every year.

It is clear that smoking continues to wreak havoc on people’s lives and create a significant drain on our health and social care services. The hon. Member for Blaydon (Liz Twist) was quite right to say it is important we acknowledge that progress is being made. We have seen a reduction in the number of people smoking, from 31% down to 17% in 2019. That is still falling, and the pattern is similar across the UK.

We should acknowledge the measures introduced by Governments of different political persuasions in the different parts of the United Kingdom, often at similar points in time—for example, the ban on tobacco advertising in 2002 in Scotland; banning smoking in enclosed public spaces from 2006; raising the age at which tobacco can be purchased from 16 to 18; making prisons smoke-free from November 2018; and banning smoking around hospital buildings in 2020. There are various other measures on top of those as well.

As we have heard, there is a lot more work to do. We need to go further. The target set currently by the Scottish Government is to reduce smoking rates to less than 5% of the adult population by 2034. We are really seeking to create a new generation who have never smoked and do not want to smoke, and to put tobacco use out of sight and out of mind for future generations.

Five years on from the original tobacco action plan, the Scottish Government are due to publish a new one in autumn this year. They are considering a range of additional measures about prohibiting smoking in areas that have so far been untargeted—for example, public playgrounds, outdoor care areas and so on. We should be considering even more, and this debate has highlighted many policy areas that should be considered by Governments at all levels, including those in the Khan review.

We have heard about the possibility of further regulation and increasing funding for tobacco control, as well as suggestions for some sort of windfall tax on tobacco manufacturers. Given the costs borne by public services for a product that is wreaking considerable harm and sold at huge profits by just a handful of tobacco companies, I thought the hon. Member for York Central (Rachael Maskell) made some powerful points in that regard. The hon. Member for Blaydon highlighted various recommendations in the Khan review that are designed to address smoking during pregnancy; again, that requires serious consideration. All Governments should continue to learn from each other about what works best.

The final thing I will touch on is simply getting the message out there that help is available. We all acknowledge that quitting is not easy. Giving up smoking and dealing with the related cravings, triggers and withdrawal symptoms can be incredibly hard, as anyone who has tried can attest. Smoking is extremely physically addictive. The physical feelings that people get from it include improvements in mood, increased concentration, reduced anger and stress and relaxed muscles, but they are all very short term. That means that many people who stop smoking can feel anxious and suffer many withdrawal symptoms—disruption to their routine, triggers, cravings and side effects.

The message to get out there is that support is available. If someone feels able to take the first step, it is not something they have to do themselves. Localised support is available from NHS stop smoking services, GPs and local pharmacists. They are all there to help people and point them in the direction that is right for each individual person. For example, support from NHS Lanarkshire, one of the two health boards in my constituency, includes one-to-one telephone or video calls, local pharmacy support in the form of free stop smoking help, nicotine replacement therapy delivered to people’s homes, personalised quit plans and a helpline. People can search online for further information.

Smoking creates unimaginable pain and suffering for both the smoker and, as we have heard, the families who have to watch their loved ones suffer. Giving up is absolutely worth it, though—people can get their lungs back, that heavy feeling in their chest goes away and they can breathe in the fresh air and feel their energy levels and a clear head returning. Stopping smoking improves physical health and immediately reduces the risk of heart disease, cancer, stroke, diabetes, rheumatoid arthritis and dementia, as well as improving mental health and wellbeing in as little as six weeks of being smoke-free. That is transformational, and it can be done. If people can be supported to do that, they will benefit, their families will benefit and all of us will benefit, and we will be grateful for that.