Tobacco and Vapes Bill (Fourth sitting)

Trudy Harrison Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Bambos Charalambous]

Q So there is no obligation on the vape manufacturers to come to you to check the vape?

Dr Squire: Not if they are putting a product on the market that is not making any medical claims. If they are putting it on the market and not making medical claims, it is a consumer product and they do not have to come to us. If they start to make medical claims, including that it will help you to give up smoking, they need to come and talk to us. They should not be making medical claims without having it as a licensed product.

[Trudy Harrison (Copeland) (Con)]

Q We have heard various accounts of the impacts of vapes on children and young people—that there are limited direct consequences of vaping on children and young people’s bodies, but plentiful and multiple different indirect impacts of that behaviour in schools and such like. I am starting to hear that it almost feels like an unbearable choice between whether we protect children and young people from vaping, or prevent older people from being able to stop smoking through the use of vapes. I am struggling with making that choice; I can see both sides of the argument. Do you have a view? Could you help the parliamentarians here to understand the choice we are faced with?

Dr Squire: The Bill helps in all ways. The Bill is very clear on tobacco and, as I say, we do not have a role on that, but the proposal is to put more requirements on vapes, and in our experience more requirements add to the barrier to something getting on to the market, which is helpful. One of the problems we have with e-cigarettes is their availability.

I am not sure I see the choice between the two. We are seeing here a Bill that, as people have said before, is balanced. It recognises that vapes are useful for people who already smoke, and it puts in some very big restrictions on people who already smoke, but it also tightens the rules around vapes. I think that is what gives it the balance, which is helpful. The problem, which others are more qualified than I am to talk about, is: if we did not have vapes at all, where would people who smoke go? It is not a good answer, but if you do not smoke, don’t vape. That has been said a number of times, and we definitely agree with it.

[Preet Kaur Gill]

Q How many products that have gone through the notification process have been deemed illicit and have therefore been removed by trading standards?

Dr Squire: I think I have some figures about that— can I write to you? I do not have them in front of me, but I think they are quite high numbers. We have about 67,000 on the list at the moment, and quite a high proportion have come off as a result of the activities of trading standards.

--- Later in debate ---

[Preet Kaur Gill]

Q In your opinion, does the Bill do enough to address the sale of vapes with illegal capacities and nicotine strengths? Will it give Government the powers they need to address future trends in this area?

Mr Lawson: From the products we have tested, 78% of those are already deemed illegal based on the tobacco and related products regulations, which are the current regulations in the UK, so enforcing those regulations more stringently would have removed most of the products that people are now using. Implementing new regulations on top of regulations that are not currently enforced may not be effective in reducing the number of those products being sold on the market.

[Trudy Harrison]

Q I am the very proud mum of four daughters, aged between 21 and 25. When I think back to them as teenagers, I do not think they would have found a unicorn, a cartoon character or a bubble gum flavour particularly trendy—when they were four or five, yes—so I do not buy the idea that teenagers are attracted to such things. I worry that whatever we manage to do to avoid cartoon characters or bubble gum flavours being prevalent just will not work. For example, cigarettes are still attracting many young people, which is why the Bill is needed. I think they taste absolutely revolting, but that is not putting children off. What are your thoughts on what needs to be done to prevent teenagers from finding vapes attractive?

Mr Lawson: I am not sure we can ever prevent any youth getting access to vapes—that is an impossibility. Youth are known to engage in risky behaviours, so they will drink alcohol under age and engage in risk-taking behaviour. What we can do is limit the drivers that bring youth to using vape products, such as flavours that are appealing or cartoons they are familiar with. These are small factors that play into the overall picture as to why somebody may pick up a vape when they did not previously smoke. That needs to be balanced with the question of adults quitting smoking. If you restrict flavours to only tobacco flavour, as we see in the US pretty much at the moment, adults are then limited to flavours that remind them of smoking, and that is probably less likely to reduce the smoking prevalence in the population.

[Kirsten Oswald]

Q To extend that conversation a bit, the issue of youth vaping is particularly concerning to me and obviously to many others around the table. You spoke to the Committee about how easy it is to buy products that are illegal but that may look to the unexpert eye as if they are legal products—even to the shopkeepers, one presumes. That must be much more difficult for children and young people—even people who are at the lower age of legally buying vapes—so I wonder what your thoughts are on how that might be acted upon. I also wonder whether you think that vape manufacturing is likely to be impacted by the measures in the Bill.

Mr Lawson: I can answer that anecdotally for you. Of my friends and peer groups who vape, despite what I do for a living, they do not listen to me that the products they are using are illegal, so I think the only way to prevent those products being used is to enforce action against them being on the market to begin with. I think there is a complete lack of awareness and knowledge of the current regulations among shopkeepers, and among the population. Many people may choose to buy an illegal product despite it being illegal, but many people might not have made that decision had they known otherwise.

What we are seeing more recently in that category of illegal products is that the safety of those products is less well known than for products that have gone through the MHRA’s notification process. We have done research into their metals content, for example, and we see elevated levels that you would not normally see in a product that has been notified to the MHRA. There are a few layers of this, but I think that if consumers are not aware of the safety of the products they are using—which they are not—that is a bigger concern. Whether youth use them or not is a separate thing to that.

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[Mary Kelly Foy]

Q I think a lot of people will be quite shocked at the statistics that you have just outlined to us on the profits big tobacco is making and the shocking tactics it uses to keep users addicted, ultimately killing half the people who buy its products. I know that this is not in the Bill, but would you support a “polluter pays” levy, so that at least the tobacco industry could give something back to society for the harm it is causing at an individual level, by killing people, and at the societal level, at the expense of our NHS? Do you think that that could be added to the Bill? I do not want to put you on the spot with that question, but in principle would you support a levy on the tobacco industry?

Dr Branston: Absolutely. I would very much welcome that. It is obscene that the industry can make so much profit by killing up to two thirds of its long-term users. Addressing that profit incentive will go a long way to stopping the interest that the industry has in selling these deadly products. As you know, those products cause massive costs to society, so I think it is entirely reasonable that the companies make a bigger contribution.

In that regard, I know that the excise tax that is currently levied on tobacco products is not directly paid by the tobacco firms—it is passed on to smokers who are addicted to those products—so the “polluter pays” levy is an idea that I would strongly support. I encourage others to do so as well. Not only does it have the economic advantage of raising money that could be used to address the harms caused by smoking, but it would restrict the industry’s ability to price its products as it is currently able to. We know that it uses clever pricing tactics to make tobacco both affordable and profitable for the industry. On every level, a “polluter pays” levy would be a win-win for society, so I absolutely support it.

Professor Gilmore: I would support that 100%. If I go back to my response to the earlier question about how we have a system problem, that is the sort of measure that can help us to address that system problem. Dr Branston and I have published on the idea of “polluter pays” or using a price cap system, so there is some evidence out there, and some evaluations or modelling of the impacts it might have and the revenue it would bring in. I would really support that.

[Trudy Harrison]

Q Has anybody on the panel made any assessment of any kind of business association between the tobacco companies and the vaping companies, and also the ultra-processed food companies? The common denominator seems to be addiction. Is there any connection between those three industries, and perhaps even the pharmaceutical companies, which may be part of the solution for people who have become addicted to those three products?

Professor Gilmore: I can talk a little bit about this. We run a website called tobaccotactics.org, which you can use to look up the organisations that might be lobbying on behalf of the tobacco industry. It identifies the front groups and third parties that are lobbying for it. We know that at least some of those third parties also lobby for the ultra-processed food and alcohol industries and take money from all those industries. That certainly goes on. We also know that they use the same practices, and that sometimes all those unhealthy commodity industries have worked collectively to change whole systems of policymaking. They pushed for the better regulation agenda, for example, because they thought it would make it harder to pass public health policies and environmental policies. We have gone on to show that systems such as better regulation make it harder to pass public health policies, because they provide those powerful industries with a route to feed in their misleading evidence and data.

There is also a revolving door. You see a lot of movement of staff—executives—from one of those unhealthy commodity industries to another. The investors also link them, so there are links at all sorts of levels. To be honest, I do not know the extent to which they learn from each other about addiction and the manipulation of products to make them addictive, but it would make sense.

--- Later in debate ---

[Dr Johnson]

Q I find what you say about the disposables interesting. A year ago last February I proposed a ten-minute rule Bill to ban disposable vapes to protect the environment and children, and the Government now have a statutory instrument to do just that. I heard today from representatives who have been to those meetings that the industry is already working around those many pages of regulations to find a way to create something that just sneaks in under the balance.

Professor West: That is the tricky thing. We can ban disposables as currently construed, but once the genie is out of the bottle, as it were, and with humans being innovative, as they tend to be, especially when they can make money out of it, it will be terribly hard to nail it so that, basically, we can put the genie back in the bottle. That is why the sort of approach that is being adopted makes good sense to me so that we can respond quickly, or so Governments can do what is necessary.

[Trudy Harrison]

Q Professor West, I found your introduction on addiction absolutely fascinating. One of the things that people have said to me—I am sure it has been said to all of us here—is that could be a slippery slope, the thin end of the wedge, because there are other addictive things in society, such as alcohol, ultra-processed foods or gambling. Where do we start? What is it about tobacco products, uniquely, that gives such a compelling reason for the Bill being so necessary?

Professor West: That is a really good question. The wedge issue comes up a lot. Essentially, what is unique about tobacco is the significant degree of harm at low levels of use. With alcohol, it has been and could be argued, there is at least some degree of harm from so-called moderate use, the level of harm is of an order such that, I think, most people in society would say, “Well, you know, this is okay.” Even non-daily smoking, however—even smoking one, two or three cigarettes a week—can present significant harm, particularly of cardiovascular disease, for example, which has a very nonlinear function relating the exposure to the risk. So there is that, the unique harm.

The other unique thing about tobacco is the proportion of users who become addicted. With alcohol, alcohol dependence as it would normally be measured is present —depending on your definition—in between 5% and 10% of users. With tobacco and cigarettes in particular—not all tobacco or nicotine products are identical, but with cigarettes in particular—it is much higher than that. A majority of people who use any amount, and any form, of smoked tobacco probably have a significant level of addiction. That would be my response.

[Mary Glindon]

Q We know that in deprived areas there is high incidence of smoking. Professor West, you have been talking about the fact that disposable vapes becoming more readily available has perhaps made more people vape. Is that in any way linked to people in deprived areas being able to afford vaping more than they could if they have to buy a unit, vials, batteries and everything else? Although the Bill does not ban disposable vapes, how valuable and important is the economic value to people in deprived areas of being able to vape cheaply as opposed to smoking?

Professor McNeill: Very. Keeping vapes accessible, both in terms of price and where they can be purchased, is really important for smokers to stop.

Professor West: I was going to reinforce the point about young people, smoking and disposables. It is about the unit cost, or having a low start-up cost. With disposables, if you look at it over the long run they are more expensive than having a tank device and refilling it with the liquid, but the upfront cost is greater. We do not know for sure, but certain bits of evidence point in particular directions. If you put the unit cost, or the start-up cost, together with the potential ease of use, the appeal and all the rest of the things in the package, you reach a point at which arguably you cross a threshold and then it begins to take off. Then it becomes a self-fulfilling thing, because it becomes fashionable and faddy. It is possible, if the plateau we are seeing now carries on or if it starts to go down in the absence of what we might do, that will also be testament to the social norm side of it. Running against that is the fact that nicotine is addictive, so that will drive it up. However, I think you make a good point.