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Smoke-free Society by 2030

Volume 691: debated on Tuesday 23 March 2021

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. I remind hon. Members participating virtually that they are visible at all times to each other and to us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks. Members attending physically should clean their spaces before they use them and as they leave the room.

I beg to move,

That this House has considered reduced-risk smoking products and proposals for a smoke-free society by 2030.

It is a pleasure to serve under your chairmanship, Mr Rosindell, albeit from such a long distance. I am pleased to see the Minister there too. At the outset, I declare my interest as an honorary life fellow of Cancer Research UK.

This is not the first occasion on which I have raised the need to pursue the goal of a smoke-free society. I raised it previously in a Westminster Hall debate in 2019. I continue to pursue this issue because the ills of smoking continue to persist and they will continue to trouble our society for many years to come unless we take action now.

Today, I speak with hope. This year, we have an opportunity that we must embrace. Our exit from the European Union has provided us with the opportunity to take control of our own policy to improve public health, to contribute to the Government’s levelling-up agenda and to enhance the United Kingdom’s reputation as a world leader on tobacco harm reduction. The Minister’s Department is currently reviewing the regulations that have in recent years transposed the EU’s tobacco products directive into UK law and the Minister has committed to producing a new tobacco control plan this summer. I hope that in her remarks today she will set out what progress the Department has made in the process and confirm the plan’s anticipated publication date.

Since the last Westminster Hall debate that I secured on this issue in June 2019, the Government have committed to delivering a smoke-free society by 2030. There is no time to waste, and nor should we waste the opportunities that we have this year. The needs of the 7 million people in the UK who, sadly, still smoke must remain at the forefront of our minds. If my right hon. Friend the Chancellor is listening, I am sure he will be pleased to hear, especially in these difficult times, that nothing I propose this morning will require any expenditure by Her Majesty’s Treasury.

It should, of course, go without saying that smoking kills. While the number of people who smoke has fallen in recent years, the problem is still real, and it is a problem that reflects inequalities. We might not all see it in our constituencies, but there are large parts of the country where smoking rates remain troublingly high. The health costs of tobacco consumption fall disproportionately on the poor, ethnic minorities and those suffering from mental health conditions. Disadvantaged communities across the country are being left behind and the inequalities gap is getting worse.

In addition, statistics from the Office for National Statistics show that intention to quit has gone down almost year on year since 2015. Analysis by Cancer Research UK indicates that the Government are not on track to meet the new smoke-free 2030 target. In fact, its modelling predicts that adult smoking prevalence in England will not reach 5% until 2037. The pace of change needs to be around 40% faster than projected to deliver the ambitious target, so now is the time to act. It is time to make use of our newly restored policy making freedoms to make a difference with the forthcoming tobacco control plan.

The Minister’s predecessor closed the last Westminster Hall debate on this issue by saying:

“We will continue to be driven by the evidence.”—[Official Report, 26 June 2019; Vol. 662, c. 335WH.]

I am sure that approach is something that the Minister will be happy to endorse now, and it is something that I believe will set us on the right course to make the difference. Making a difference starts, first, with understanding that the fundamental problem with smoking is the smoke—the combustion. Acknowledging that should be the core principle under which we regulate. While it will always remain the case that smokers should aim to quit completely, if they are unable to do so, there are now many non-combustible alternatives that they can try, which will be less harmful to them.

Secondly, making a difference means that we cannot take our foot off the pedal in introducing further barriers to cigarettes and other combustible tobacco products. I am not generally an advocate for high taxes, but I can see the benefit of using taxation to increase the price gap between combustible and non-combustible products. We must do more to secure our borders to ensure that smugglers from abroad do not profit from health inequalities here.

Thirdly, and most importantly, making a difference means helping smokers who cannot quit smoking to change to something that is less harmful for them than cigarettes—products that are not combustible. The forthcoming tobacco control plan gives us the opportunity to take a fresh look at the new products and innovations in the UK, as well as those that we could have now that we have left the European Union. To make the most of that range of products in a sensible and controlled way calls for the creation of a new, reduced-risk smoking products category, to provide a robust regulatory framework.

It is important that products be regulated and controlled to ensure that they are used in the right way, but they will not be sufficiently effective if we do not get the information about them out to smokers. We have made great progress on tobacco harm reduction over recent years, but both those elements—regulation and information—should be addressed if we are to give ourselves the best chance of reaching the smoke-free 2030 goal.

We have seen great results from e-cigarettes, and Public Health England recently found that in every region of England quit rates involving a vaping product were higher than those for any other method. However, while they have worked for many smokers, e-cigarettes are not a panacea. In fact, nearly half the smokers in Britain have tried vaping, but did not continue. Now the number of vapers is falling, which should be a cause for concern for us all.

There are two measures that the Government can take to address the issue. The first concerns communications. Existing communications are not cutting through. When it published its annual vaping report last month, PHE said:

“Thousands more could have quit except for unfounded safety fears about e-cigarettes.”

Does the Minister agree that we could do better at communicating directly and clearly to smokers the harm reduction benefits of e-cigarettes and, indeed, all reduced-risk alternatives? The Government could, for example, allow the use of cigarette pack inserts or even online communications as ways to reach smokers directly.

The second measure concerns the nicotine level in e-cigarettes. The EU imposed a seemingly arbitrary 20 mg per ml limit on e-cigarettes, under its directive. The fact is that many smokers do not find that sufficiently satisfying to lead them to make a permanent switch away from combustible cigarettes. Now that we have the freedom to do so, we should look at setting our own limit at a level that would make the products more effective.

E-cigarettes will, however, never be the answer for all smokers. Nicotine pouches, which have been on sale in the UK for only a year or so, have rapidly grown in popularity. Around 100,000 people already use them. I understand that a reason for that is the success of point-of-sale advertising and the ability to advertise online. At present the products are not regulated beyond our general consumer protection laws, so they could benefit from being part of a sensible framework.

The use of heated tobacco in the UK continues to grow. Sales increased by 270% in the past year alone. The benefit is that there is still tobacco in the product, but it is not combustible. As I mentioned in the previous debate, 70% of heated tobacco users give up smoking altogether, but at the moment smokers cannot hear about those products, as they can hear about others. That is where smokers could benefit even more from receiving the targeted information that I mentioned earlier, online or from shopkeepers.

Finally, snus is another tobacco product and is currently not legal in the UK owing to a ban imposed by the EU. In Scandinavian countries such as Sweden, which are exempt from the EU ban, the availability of snus has had an enormous positive impact on smoking levels. Lifting the ban would show that our policy is driven by evidence, making the UK the true global leader in tobacco harm reduction. If all these smoke-free products were part of the controlled framework, with the same regulations, we would give smokers the best possible chance of moving away from cigarettes and we would give the country as a whole the best possible chance of achieving a smoke-free 2030.

Before concluding, I must touch on the opportunities that Brexit offers us in tobacco harm reduction. Every two years, we send officials from the Minister’s Department to the conference of parties to the World Health Organisation’s framework convention on tobacco control, a body that has taken positions that run completely counter to our own. Worryingly, just last month the WHO proposed a ban on vaping. The Minister will undoubtedly have noted the remarks of Clive Bates, an expert and the former director of the anti-smoking group Action on Smoking and Health, who said that that proposal was “irresponsible and bizarre”.

When we have attended the COP before, we have had to conform to the views of the EU grouping. This year, we will be attending, albeit perhaps only virtually, in our own right. This is the opportunity that I urge the Minister to consider. We have a strong story to tell on tobacco harm reduction at home, and we now have the freedom and ability to embrace bold, innovative new policies, such as those I have suggested this morning; so will we simply go along to get along at the COP, or will we do what is right by taking a bold and progressive stance in favour of tobacco harm reduction and proudly defend our own domestic position? I believe there is much that the world can learn from our approach, and I therefore urge the Minister to make the tobacco control plan one that will help us to deliver a smoke-free 2030, and one that we can showcase to the world later this year.

It is an honour to serve under your chairmanship, Mr Rosindell. I congratulate the right hon. Member for Clwyd West (Mr Jones) on the way in which he brought this motion to the House; it is very timely and was very well introduced. I refer hon. Members to my entry in the Register of Members’ Financial Interests: I am the chairman of the Gallaher Trust, a job creation and skills development charity in my constituency, set up after the last tobacco manufacturing plant sadly closed there some years ago.

The right hon. Gentleman raised the point that tobacco harm reduction is a strong story for the United Kingdom to tell. That is a very solid line on which the Minister should listen and respond. I am sure other Members will talk about the opportunities of vaping for small companies, whether they be retail outlets or manufacturing companies in the United Kingdom, and for helping to reduce the harm associated with tobacco. That is a strong piece, and it needs to be looked at. It is challenging, because people just want tobacco usage to end. Of course, anyone who has been a smoker knows that it is just not that simple, and that there have to be harm reduction programmes in place.

I also refer briefly to security and criminality. I have encouraged the Government and Her Majesty’s Revenue and Customs to continue to work closely with the companies at the heart of producing these products. Whether it is the tobacco manufacturers or spin-off companies that develop these products, it is important that we work with credible, accountable companies that can be held to account.

Last year, The House magazine and Dods very kindly helped to sponsor a programme to put out a report called “The Gathering Storm”, published by Japan Tobacco International. It looked at the issues to do with criminality around this entire sector and how the criminals are alive to every opportunity to bite into this, to seize these opportunities and pollute this area. It is absolutely important that the Government are alert to the opportunities that criminals see and face them down bit by bit. The only way they can do that is in conjunction with the large companies that know exactly what they are talking about, that work in and understand this sector and have an interest in protecting legitimate trade, not in promoting illegitimate activity. I hope the Government will put resources in place to assist with that.

Finally, my comments would not be complete if I did not mention the Northern Ireland protocol. You may ask, Mr Rosindell, “How can you bring that into this debate?” Put simply, it is about consumer choice. Companies have already indicated that they cannot bring to Northern Ireland the same products as they can bring to, and make in, the United Kingdom. Consumer choice is not available to the consumer in Northern Ireland, whether it be for actual tobacco products or for spin-off vaping products. They are not going to be available in Northern Ireland because of EU regulations pertaining to, and chaining down, one part of this United Kingdom. It is a disgrace. My message to the Government after every meeting I have with them is to please fix the protocol—fix it and fix it fast, because it is permeating every aspect of life in Northern Ireland.

I will be very brief, Mr Rosindell. I congratulate my right hon. Friend the Member for Clwyd West (Mr Jones) on securing this debate and on his excellent speech. I fear that it is going to be incredibly difficult to achieve a smoke-free society by 2030. It could be achievable, however, if we embraced vaping far more than we do at present and if we promoted those products as being 95% risk free, as stated by Public Health England, and as being substantially safer than smoking. It is not risk free and people who do not smoke should not vape, but it is absolutely right that we encourage smokers to take up vaping. There are a variety of different, innovative ways to do that, including my right hon. Friend’s suggestion of inserting in cigarette packets a card encouraging the smoker to use a particular vaping product.

Brexit gives us the opportunity to ensure that vaping regulations pertain to vaping. That is not the case at present: they are lumped together with tobacco products, which creates and radiates the fear that vaping is as dangerous as smoking. Too many people in this country feel that there are greater dangers with vaping than actually is the case. Through Government changes to regulations, we can change that and ensure that people who smoke are made aware of the comparative benefits of vaping. Post Brexit, there is a great opportunity to ensure that that happens.

I just want to add a few comments. It is all very well to say that smokers should transfer from cigarettes to vaping, but I have a concern. Although I am encouraged that the number of people quitting cigarettes and turning to vaping products shows that they are more successful than nicotine-replacement therapy, does the Minister agree that we need to ensure that people are not, to use an Ulsterism, jumping from the frying pan into the fire? Does she believe that this has been looked at robustly enough to reach a determination? If cigarettes are harmful, we have to be absolutely sure that vaping is safe as an alternative.

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank my right hon. Friend the Member for Clwyd West (Mr Jones) for securing the debate, and I am grateful to the hon. Member for North Antrim (Ian Paisley), my hon. Friend the Member for Dartford (Gareth Johnson) and the hon. Member for Strangford (Jim Shannon) for their comments. What joins us together is the passion shared across the House. Everyone wants to tackle the harms of smoking. Smoking kills.

I agree with my right hon. Friend the Member for Clwyd West that we have a good story to tell and should not be afraid to tell it. As he is aware, some good work has been done over the past couple of decades to drive smoking rates down. Rates are now at their lowest level, at just over 13% in England. It is one of the public health success stories. However, we have to do more. We cannot be complacent. There is wide variation, and smoking rates remain too high in certain areas of the country.

Like my right hon. Friend, I would look specifically at the levelling-up agenda in deprived areas, among the lesbian, gay, bisexual and transgender community, and among pregnant women and people with mental health conditions. Our focus on driving down rates across the country must be relentless. We must ensure that they are levelled where they are lowest and that no community gets left behind. The differential between good and poor areas is almost 10 times greater.

Fantastic work is being done to tackle health inequalities in different areas, including recently through the NHS long-term plan with regard to smoking in pregnancy. Its commitment to the maternity transformation fund has provided additional training to give midwives the knowledge, skills and confidence to offer brief advice to women during antenatal appointments, and upskilled practitioners to deliver stop- smoking interventions to those who need help.

The Minister has spoken about having a good story to tell. Is not the take-up of vaping in this country a good story? She will know that we have a very active all-party parliamentary group on vaping. We are about to send her a report—it is currently in draft form—relating to the WHO conference of the parties in November. We took evidence and I wonder whether she agrees that the WHO’s negative view of vaping has been counterproductive. As my right hon. Friend the Member for Clwyd West (Mr Jones) said in his excellent speech, its attitude is partly responsible for the downturn in the number of people vaping. Given the level of interest in this debate, does the Minister think we ought to have a longer debate in order to consider these issues more fully?

I thank my hon. Friend for his intervention. Given that this is a 30-minute debate and there is a lot of interest in it, I agree that a longer debate might allow us to explore these things. I will comment on COP and the variety of products. We need to use everything in our armoury to encourage people to quit smoking.

We need to help people give up. We are working to ensure that no communities are left behind, as part of the bold ambition to be smoke-free in England by 2030. I listened carefully to my right hon. Friend the Member for Clwyd West talk about how we pack a punch in this area, but things will need to be evidence led. We will set out how we will deliver this later in the year, when we publish the new tobacco control plan for England in the summer. He asked me to reconfirm that we are on track for doing that, and I agree with him that it is a stretch to reach our target by 2030.

We know that the best thing a smoker can do is quit altogether. Covid-19 has brought into clearer focus the need for us to care for our health. PHE has issued guidance on the impact of covid-19 on vaping and smoking, and we know that if people smoke, they have an increased risk of contracting a respiratory infection. With covid-19, symptoms can be more severe if people smoke, but the evidence base is mixed.

As I have said, the best thing people can do to improve their health is to quit. However, it remains the goal of the Government to maximise the public health opportunities presented by e-cigarettes to reduce smoking. UK-regulated e-cigarettes are far less harmful than smoking, but I reiterate that they are not risk free, which I think plays to the comments made by the hon. Member for Strangford.

Research shows that e-cigarettes are effective in helping some smokers to quit, and therefore we need to support them. We will continue to discourage non-smokers from using them, monitor youth uptake and consider tougher regulatory proposals if we see an increase in youth rates.

There are about 3 million people currently using e-cigarettes in Great Britain. Half of those have quit smoking, which indicates that the other half are using them as part of a strategy. As my right hon. Friend the Member for Clwyd West said, and others have alluded to, it is not a panacea. The UK’s approach to the regulation of e-cigarettes has been, and will remain, pragmatic and evidence based. The current regulatory framework aims to reduce the risk of harm to children, protect against the re-normalisation of tobacco use, provide assurance on safety for users, and provide legal certainty for businesses. We are committed to ensuring that our regulatory framework enables this to continue but does not encourage non-smokers and young people to start taking up the habit.

We made a commitment through the 2017 tobacco control plan to monitor the safety, uptake and impact of the effectiveness of e-cigarettes and other novel nicotine delivery systems—and we have done just that. Public Health England has published a series of evidence reviews which further our understanding of their effectiveness in helping smokers to quit. The latest evidence review was published last month.

In our future tobacco control plan, we will consider further research on other emerging nicotine products that have the potential to help people quit—because there is no such thing as a safe tobacco product and all tobacco is harmful, including smokeless tobacco and other tobacco products that we have discussed today.

No assessment has yet been made of the safety of tobacco-free nicotine pouches. These products are not covered under the tobacco regulatory regulations, but rather the General Product Safety Regulations 2005, and the current numbers are from industry and therefore will need a degree of validation.

There are no plans to go further on snus at the moment because all tobacco products can cause harm. However, we are currently undertaking a post-implementation review on the Tobacco and Related Products Regulations 2016 and this is an opportunity for people to feed in and present new evidence for the Department to consider.

Non-nicotine vapes are regulated under the General Product Safety Regulations 2005, and we will review feedback from the post-implementation review if this area needs to be strengthened, including if the products are a health concern. We have paused a further evidence review due to the impact of covid on resources. However, we are looking for people to come forward, and Public Health England will publish its final evidence review, including a chapter on heated tobacco, later this year. The evidence suggests that these products still pose a risk to users, and, compared with e-cigarettes, we know far less about them. As such, we will be following the principle of ensuring that we have a full evidence base.

Under the Northern Ireland protocol, which the hon. Member for North Antrim referred to, things are in equilibrium at the moment. There is no difference. However, under the protocol, Northern Ireland is required to adhere to the EU’s tobacco products directive. We will work in collaboration with the devolved Administrations on matters that are reserved, and, along with that firm evidence, and in the interests of public health, put that forward.

As part of the regulatory review, the Government are undertaking post-implementation reviews. These will assess whether the regulations are meeting their objectives, and if there are gaps that need to be addressed. We have held a public consultation and we will review the responses.

The UK is a global leader and was very grateful to receive an award from the WHO for being instrumental in helping lower middle-income countries to tackle tobacco use. We are determined to tackle smoking and health inequalities both at home and abroad. We will take targeted action to support communities where rates may remain high. I would like to extend my thanks to hon. Members for debating this important subject.

Question put and agreed to.

Sitting suspended.