Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how learning from serious incidents involving accidental Clozapine withdrawal is being recorded and shared nationally across NHS mental health services.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Clozapine is used to treat people with schizophrenia in whom other medicines have not worked. It is also used to treat severe disturbances in the thoughts, emotions, and behaviour of people with Parkinson’s disease in whom other medicines have not worked.
The known side effects of clozapine are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine. The SPC states that clozapine should be stopped in a number of clinical situations including after developing a low white blood cell count, fever above 38oC, high blood glucose, also known as hyperglycaemia, as well as jaundice or clinically relevant increases in liver enzymes. If clozapine is restarted it must be carefully titrated and monitoring requirements followed.
Inadvertent withdrawal of clozapine is an issue that is included in the National Health Service’s Time Critical Medicines Safety Improvement Programme, with further information avaiable at the following link:
https://www.sps.nhs.uk/articles/safer-use-of-time-critical-medicines-programme/
The programme is supporting over 50 NHS hospitals to improve the reliability of administration of Time Critical Medicines such as clozapine.
In July 2024 a thematic review of clozapine safety conducted in the North West of England was shared with the NHS England National Medication Safety Officer Network. This included a range of clozapine safety resources published online, such as:
- Managing the risks associated with patients prescribed clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-the-risks-associated-with-patients-prescribed-clozapine/;
- Clinical considerations for patients prescribed clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/clinical-considerations-for-patients-prescribed-clozapine/;
- Managing constipation in people taking clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-constipation-in-people-taking-clozapine/;
- Clozapine use in adults with swallowing difficulties, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/clozapine-use-in-adults-with-swallowing-difficulties/;
- Managing specific interactions with smoking, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-specific-interactions-with-smoking/; and
- Managing complexities of medication use across care boundaries, which includes a podcast on clozapine safety and which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/.
As with all medicines, the safety of clozapine is kept under continual review by the Medicines and Healthcare products Regulatory Agency (MHRA) using a number of data sources. The MHRA is currently reviewing the blood monitoring requirements associated with clozapine.
Asked by: Tim Farron (Liberal Democrat - Westmorland and Lonsdale)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people died from smoking in England in each year since 2021.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The latest estimates for smoking-attributable mortality in England are for the period 2017 to 2019. The Smoking Profile, produced by the Department, reports 191,903 smoking-attributable deaths of people aged 35 years old and over in the period 2017 to 2019 in England, which is just under 64,000 deaths each year. Further information on the Smoking Profile is available at the following link:
Asked by: Tim Farron (Liberal Democrat - Westmorland and Lonsdale)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, which public health factors created the 10 largest direct cost impacts on the NHS in 2024; and how much the NHS spent in 2024 on tackling the health impacts of the following public health factors: (a) air pollution, (b) alcoholism, (c) obesity, (d) excessive salt consumption and (e) smoking.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Global Burden of Disease data considers the top ten public health factors in the United Kingdom in 2023 in order of importance to be: tobacco, high body mass index, dietary risks, high fasting plasma glucose, high blood pressure, high alcohol use, high cholesterol, occupational risks, kidney dysfunction, and drug use. Further information on the Global Burden of Disease data is available at the following link:
https://vizhub.healthdata.org/gbd-compare/
The following table shows the various estimates of the cost to the National Health Service of the five factors specified:
Risk factor | Estimated NHS cost | Source of Estimate |
Air Pollution | £1.6 billion for fine particulate matter and nitrogen dioxide combined between 2017 and 2025. | Public Health England Agency, 2018 |
Alcohol | £4.9 billion annually | Institute of Alcohol Studies, 2021/22 |
Obesity | £9.3 billion annually | Frontier Economics & NESTA, 2025 |
Hypertension (excessive salt consumption is linked to an increased risk of hypertension) | £2.1 billion annually | Optimity Matrix (commissioned by Public Health England), 2014 |
Smoking | £1.8 billion annually | Action on Smoking and Health, 2025 |
Comparisons of costs should not be made between these estimates because of the different methodologies used in their construction.
Asked by: Tim Farron (Liberal Democrat - Westmorland and Lonsdale)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 10 May 2023 to Question 183643 on Public Health, what methodologies were used to estimate the costs to the NHS for each of the five risk factors specified.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The applicable methodologies for the National Health Service cost attributed to each of the risk factors outlined are explained in the following reports.
The estimated air pollution related costs to the NHS can be found in the Public Health England report ‘Estimation of costs to the NHS and social care due to the health impacts of air pollution: summary report’ , from 2018, which is available at the following link:
https://www.gov.uk/government/publications/air-pollution-a-tool-to-estimate-healthcare-costs
An estimate of the NHS and healthcare costs of alcohol from 2021/22, produced by the Institute of Alcohol Studies, can be found at the following link:
https://www.ias.org.uk/factsheet/economy/
Estimated obesity related costs to the NHS can be found in the Frontier Economics report for NESTA, published in July 2025, ‘The Economic and Productivity Costs of Obesity and Overweight in the UK’, which is available at the following link:
Estimated Hypertension related costs to the NHS can be found in the Optimity Matrix Cost-effectiveness review of blood pressure interventions, ‘A Report to the Blood Pressure System Leadership Board’, published November 2014, available at the following link:
The most recent estimated smoking related costs to the NHS can be found in the press release, ‘New figures show cost of smoking to society in England dwarfs tobacco tax revenue’. This is available at the following link:
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of trends in the level of health inequalities associated with a) asthma and b) chronic obstructive pulmonary disorder.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care (DHSC) is aware of the disproportionate impact that asthma and chronic obstructive pulmonary disorder (COPD) have on deprived communities. The Government is acting on smoking, air pollution, and poor housing that will particularly benefit such communities.
Smoking is the number one preventable cause of COPD. The Tobacco and Vapes Bill will be the biggest public health intervention since the 2007 indoor smoking ban and will help deliver our ambition for a smoke-free United Kingdom.
Poor air quality can exacerbate COPD and asthma. To address this, DHSC is working across Government with the Department for Environment, Food and Rural Affairs to tackle air pollution, and the Department for Energy Security and Net Zero to fix housing and reduce damp and mould. Infections can also exacerbate COPD and asthma, so the National Health Service is running winter vaccine campaigns against respiratory infections including COVID-19, flu, and pneumococcal disease.
To enable faster diagnosis of asthma and COPD and earlier access to treatment, access to spirometry tests in community diagnostic centres (CDCs) is growing and will continue to do so as more sites come online. The first five months of 2025/26 saw an increase in CDC spirometry testing of approximately 2000 tests per month more than in the previous year.
Asked by: Lee Anderson (Reform UK - Ashfield)
Question to the Home Office:
To ask the Secretary of State for the Home Department, if she will give police further powers to combat antisocial drug smoking within houses.
Answered by Sarah Jones - Minister of State (Home Office)
The police, local authorities and other relevant agencies already have a range of flexible tools and powers that they can use to respond to anti-social behaviour, including drug misuse. This includes the powers provided by the Anti-social Behaviour, Crime and Policing Act 2014, such as the Closure Power, which the police and councils can use to close premises which are being used, or are likely to be used, to commit nuisance or disorder, and the power provided under Section 17 (1) (b) of the Police and Criminal Evidence Act (1984) for police officers to enter a property without a warrant to arrest a person for an indictable offence, where there are reasonable grounds for believing the person is on the premises.
It is unlawful to possess or supply controlled drugs without a Home Office licence and we expect the police to enforce the law, but the use of such powers is an operational decision and, as with all intrusive police powers, must be exercised in a lawful, necessary, proportionate and accountable way, in accordance with the PACE Codes of Practice.
Drug Testing on Arrest (DToA) is another key tool that helps the police to identify individuals who have been using illicit drugs and support them to change their behaviour and reduce future offending. Through the Crime and Policing Bill we are expanding the offences which can trigger a test and enhancing powers to widen the range of drugs that can be tested for.
Tacking anti-social behaviour, including dug misuse, is a top priority for this Government and a key part of our Safer Streets Mission. We have committed to adding 13,000 neighbourhood police and community support officers into local communities and ensuring residents have a named officer they can turn to when things go wrong, and we remain committed to working across public health, education, policing and wider public services on prevention to drive down drug use and ensure more people receive timely intervention and support.
Asked by: Tim Farron (Liberal Democrat - Westmorland and Lonsdale)
Question to the Cabinet Office:
To ask the Minister for the Cabinet Office, what estimate his Department has made of the number of premature deaths in (i) England and (ii) the UK attributable to (a) smoking, (b) air pollution, (c) alcoholism and (d) obesity in the last 12 months.
Answered by Josh Simons - Parliamentary Under Secretary of State (Department for Science, Innovation and Technology)
The information requested falls under the remit of the UK Statistics Authority.
A response to the Hon gentleman’s Parliamentary Question of 5th of January is attached.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department has taken to reduce rates of cardiovascular disease in (a) South Holland and the Deepings constituency and (b) Lincolnshire.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The South Holland and the Deepings constituency and Lincolnshire have implemented a number of programmes to reduce the rates of cardiovascular disease (CVD), including:
- One You Lincolnshire, which provides holistic support for adults to act on modifiable risk factors for CVD such as smoking cessation and weight management;
- targeted collaboration between pharmacies and general practices to provide home blood pressure monitors to key at-risk groups of the population; and
- continued support and promotion of the NHS Health Check in a range of community settings, including initiatives to provide translation support and one-to-one guidance, to help increase both the uptake and awareness of the programme.
The Government is committed to reducing premature mortality from heart disease and stroke by 25% in the next 10 years. To accelerate progress on this ambition and tackle unwarranted variation across the country, we will publish a CVD modern service framework in 2026. The framework will support consistent, high quality, and equitable care whilst fostering innovation across the CVD pathway.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what data they collect on the annual consumption of handmade cigars.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Currently there is no agreed definition of what constitutes a handmade cigar, therefore there is no Government data collected on their annual consumption.
However, there is data on cigar usage from the International Tobacco Control Policy Evaluation Project which is produced every two years. In 2024 in England, of adults aged 18 years old or older who currently smoke or quit in the past two years or who currently use vapes, heated tobacco produces, and/or oral nicotine products, 5.1% reported past 30-day use of cigars.
Additionally, HM Revenue and Customs publishes data on clearances of tobacco products which relates to the amount of tobacco products cleared onto the United Kingdom’s market for sale. This data is published every month.
Asked by: Andrew Rosindell (Reform UK - Romford)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, what assessment she has made of the implications for her Department’s policies of levels of tobacco excise taxes in Australia; and what assessment she has made of the potential relationship between trends in the level of tobacco excise taxes and (a) the size of the illicit tobacco market and (b) associated organised criminal activity.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
Australia imposes some of the highest tobacco duty rates globally with excise accounting for a significant share of retail price. In the UK, tobacco duty aims to both raise revenue and reduce harm to public health by discouraging smoking. High duty rates make tobacco less affordable and are a proven way to reduce smoking prevalence and have helped reduce the percentage of adult smokers in the UK from 26% in 2000 to 10.6% in 2024.
The illicit tobacco market is dominated by organised crime groups that make money by smuggling and selling illicit tobacco products in the UK. Strong enforcement is essential in tackling the illicit tobacco market. HM Revenue and Customs and Border Force have had illicit tobacco strategies in place since 2000. Our latest strategy, “Stubbing out the problem”, was published in January 2024. The Department continues to investigate how the illicit tobacco market is evolving, including through its compliance activity, and the extent to which that may affect overall tax receipts seen.
Whilst tobacco duty has been progressively increased over time, successive illicit tobacco strategies have proven effective in tackling the size of the illicit tobacco market, reducing the tobacco duty tax gap from 21.7% in 2005/6 to 13.8% in 2023/24.