I beg to move,
That this House has considered national no smoking day.
It is a pleasure to serve under your chairmanship, Mr Efford. Many of us will be well aware that yesterday was No Smoking Day, an annual awareness day in the UK that aims to help people who wish to quit smoking. This year, No Smoking Day is raising awareness of the greatly increased risk of developing dementia that results from tobacco use. Through this debate, I hope that we can raise awareness of the considerable health risks associated with tobacco products.
It shocks me that, despite two out of three smokers dying from smoking-related illness, there are still 6.6 million people in the UK who smoke regularly. I firmly believe that if people were more aware of the self-inflicted harms that they are causing by using tobacco products regularly, that figure would drop considerably, and those people would be less inclined to continue smoking. It is therefore crucial that we reverse the withdrawal of Government funding for the no smoking public awareness campaign, which effectively highlighted the dangers associated with smoking and the support that is available to help people quit.
The wider health implications of smoking are truly frightening. Every single day in England, 150 new cases of cancer are diagnosed as a direct consequence of smoking. Additionally, a person is admitted to hospital with a smoking-related illness every single minute. Tobacco products are the biggest cause of death in the UK, killing on average 78,000 people a year through cancers, respiratory diseases, coronary heart disease, heart attacks and stroke, vascular disease, asthma and chronic obstructive pulmonary disease, or COPD. To be clear, that is 78,000 avoidable deaths caused by self-inflicted harm.
Smoking affects some socioeconomic groups more harshly than others. In areas around the city of Kingston upon Hull, 22% of residents engage in tobacco use, and in Blackpool the figure is as high as 20.6%. That encourages children and other members of the household to take up smoking, because they follow the example of others and have much easier access to such products in the home. When a parent smokes, their offspring are four times more likely to share the habit. I was horrified to learn that 90,000 children between 11 and 15 in this country regularly smoke, despite the fact that it is illegal for premises to supply tobacco to those children. The younger a person starts smoking, the harder it is for them to give up, and the more likely they are to continue the habit into their adult life. Some 80% of regular smokers started smoking before the age of 20.
Smoking in pregnancy is far too common, and it is an area that I have constantly campaigned on. If a mother is happy to smoke, being fully aware of the health implications, she is risking not only her health but the life of her unborn child. As soon as an innocent child, not even born, is subjected to heightened health risks because of smoking, it becomes a far more selfish and cruel act. Smoking during pregnancy is the leading modifiable risk factor in poor birth outcomes, including stillbirth, miscarriage and pre-term birth. Further, it considerably heightens the risk of the child contracting respiratory conditions; attention and hyperactivity difficulties; learning difficulties; problems of the ear, nose and throat; obesity; and diabetes. Unfortunately, there are over 51,000 babies subjected to such experiences each year. I am sure we all agree that that is 51,000 innocent babies too many.
As I mentioned, the theme of No Smoking Day this year was the increased risk of dementia, so it would be remiss of me not to touch on the strong links between smoking and dementia. A recent study ranked smoking third out of nine modifiable risk factors leading to dementia. The World Health Organisation estimates that 14% of cases of Alzheimer’s disease worldwide are potentially attributable to smoking, and states that smoking increases the risk of vascular dementia and Alzheimer’s. Studies also show that people who smoke heavily—more than two packs a day—in mid-life have more than double the risk of developing Alzheimer’s disease or other forms of dementia two decades later.
It is important to recognise that there is probably an even stronger connection between smoking and dementia than the figures suggest. That is because a higher proportion of smokers die prematurely, so it is possible that the association between smoking and dementia has been obscured through a selection bias. Given that dementia is now the most feared health condition for all adults over the age of 55, I am sure the Minister will help to ensure that the data is shared with smokers whenever possible.
Smoking is not only hugely damaging to the health and wellbeing of individuals; it also puts a gigantic strain on the public purse and wider society. In 2021-22, the tax revenue from sales of tobacco reached £10.3 billion. That may seem a generous return to the Treasury, but it is tiny compared with the £20.6 billion that smoking actually costs the public finances. Let me break those figures down: £2.2 billion fell on the NHS, £1.3 billion fell on the social care system, and a staggering £17 billion was lost as a result of the reduction in taxes and increased benefit payments that arose from losses to productivity, including from tobacco-related lost earnings, unemployment and premature death.
The addictive nature of smoking products pushes many households into significant financial hardship. On average, those who smoke regularly spend more than £2,400 a year on tobacco. In 2022, that figure was enough to cover the average household energy bill—granted, perhaps it does not anymore, thanks to inflationary pressures. Research looking into the income and expenditure of households containing smokers found that 31% fell below the poverty line.
The socioeconomic inequality of smoking is huge. Those from poorer backgrounds and on lower incomes are considerably more likely to smoke, and in turn experience heightened health risks. Consequently, people born today in England’s more affluent areas are expected to live up to a decade longer on average than those in the least affluent areas. In Kingston upon Hull, 22% of households contain smokers, and the average income is £31,000. Comparatively, in west Oxfordshire, where the average salary is £40,000, the smoking rate drastically decreased to only 3.2%. Some £21.4 million in earnings is lost each year to smoking-related causes, and a further £20.2 million is lost due to smoking-related unemployment.
As I said, smokers are far more likely to contract cancer. I was unfortunate enough to witness that at first hand. When I was only 23, both my parents died as a direct result of smoking-related cancers. They died within a month of each other, which was a tragedy for my family and something that I remember every single day. It was a devastating period for my family, and the prospect of suddenly having to raise three younger sisters at a very young age was frightening—an experience I do not wish on any other individual.
Cancer treatments are not cheap. The average cost of treating a patient for lung cancer is more than £9,000 a year. That is a huge burden on already strained NHS budgets, and in many cases it is self-inflicted through smoking. Further, 75,000 GP appointments a year are a result of smoking-related illness. At approximately £30 an appointment, that could save the UK Government £2,250,000 annually and—very importantly in this day and age—would shorten waiting times for patients with other ailments. As I am sure my hon. Friend the Minister will agree, it is clear that we need to take urgent action to tackle this damaging practice.
It is a pleasure to speak under your chairmanship, Mr Efford. On No Smoking Day, I am delighted to welcome the progress we have made as a country, and I am grateful to the hon. Member for securing the debate. I must declare that I am a non-smoker. In only a few years, smoking policy has worked. It has massively reduced prevalence, and people are healthier, fitter and living longer. Given how few Members are present, Mr Efford, I understand that I can talk a little longer, rather than having to intervene two or three times.
I thank the hon. Member for that brief intervention. From my perspective, I would encourage anyone who smokes and who wants to give up to try vaping. If vaping is considered by that individual to be a safer alternative, I would encourage them to try it. However, I am one of those people who say that we have to be very careful about vaping, because we do not know the long-term effects. It is certainly healthier to choose vaping as a way to give up smoking. However, I am concerned about the number of young people who are taking up vaping directly, and who may then go on to smoke, or to other ways of getting nicotine into their system. That is a really serious problem for the long term that the Government have to address.
As I was saying, the Government have set out a vision for England to be smoke-free by 2030, which I strongly welcome—I hope we can do it even more quickly than that —but Cancer Research UK, which has supplied me with information on this issue, has modelled the Government’s plan and suggests that they will not achieve the target until 2039 if recent trends continue. That is not good enough. The delay will cause around 1 million smoking-related cancer cases in the UK alone, so can my hon. Friend the Minister confirm how we will get back on track to reaching a smoke-free 2030?
Nothing would have a bigger impact on the number of preventable deaths in the UK than ending smoking. Smoking rates have thankfully come down, as indicated by the hon. Member for Ealing, Southall (Mr Sharma), and I want further action, so that the downward trend continues. Back in 2021, the Government committed to publishing a tobacco control plan, which we have yet to see. Smoking causes around 150 cases of cancer a day in the UK, meaning that since the last tobacco control plan expired in 2022, around 10,000 people’s lives have been changed forever with a smoking-attributable cancer diagnosis. Can the Minister confirm when the tobacco control plan for England will eventually be published? “Soon” is not good enough.
In June 2022, Javed Khan published his hugely anticipated independent review of tobacco control, which was commissioned by the UK Government. Like many others, I was pleased to contribute to the review, and we welcomed its pronouncements. It set out policy recommendations that would see England become smoke-free by 2030. However, despite being given clear recommendations and a road map of how to achieve the target months ago, the Government have yet to respond. I understand that Ministers have changed over the last year, particularly as a result of the changes in Government, but it is not good enough that we have not had a response to the long-awaited review.
It was stated that a response would be available in the spring. I am not sure if that is spring 2022, spring 2023 or, worse still, spring 2024, but the reality is that in ministerial terms, “spring” can be flexible—hence why we call it spring. Spring is almost upon us, so we await the response to the report. We need to know which recommendations the Government will choose to adopt, and which they will not, and why. Will my hon. Friend the Minister confirm when specifically the response to the Khan review will finally be published?
Next week’s Budget is a critical moment at which the Government must take the urgent action we are calling for. Without additional, sustainable funding, it will not be possible to deliver all the measures we need to make England smoke-free. Severe funding reductions have undermined our ability to deliver such measures. We need to encourage and help people to quit smoking. The reductions have been greatest in the most deprived areas of the country, where smoking is most likely to occur. Sadly, in 2022, only 67% of local authorities in England commissioned a specialist service open to all local people who smoke. That is largely due to financial pressure, following reductions to the public health grant. National spending in England on public education campaigns has dropped from a peak of 23,380,000 in 2008-09 to a mere 2.2 million in 2019-20. That is a 91% reduction. I am disappointed that funding for the No Smoking Day public awareness campaign has been completely scrapped, despite a mass of evidence suggesting that it was a highly effective campaign that had a direct effect on people who continue to smoke.
The four largest tobacco manufacturers make around £900 million of profits in the UK each year. Profit margins on cigarette sales are significantly higher—as much as 71%—than on other typical consumer products. Consequently, the all-party parliamentary group on smoking and health, which I have the privilege of chairing, has called on the Government to introduce a “polluter pays”-style charge on the tobacco industry. That would finally make the tobacco industry pay for the damage its products cause to our nation’s health, and for the strain on the NHS. Remember: this is the only product that people can legally buy that will kill them if they use it properly. It is an outrage that smokers are preyed on by these big tobacco companies. I accept that I may not get the answer I would like, but will the Minister confirm that the Government will introduce a “polluter pays” charge on the tobacco industry in the upcoming Budget?
I have a ten-minute rule Bill going through Parliament that would require people who sell tobacco products to be properly licensed. If the Minister cannot endorse the Bill, I would welcome a commitment from him and his Department to dealing with this issue once and for all, so that we have a proper licensing regime for the sale of tobacco products in this country.
As I come to the end of my speech, I remind colleagues that making Britain smoke-free by 2030 is a well backed public initiative. Recent polling showed that 70% of people supported the Government’s investing more money in helping England to reach the target. Of those people, 74% would prefer the money to come from the tobacco industry, so that it pays for the pollution it causes.
I thank hon. Members for attending the debate. I look forward to hearing the contributions from the Labour and SNP spokespersons, and the Minister’s response, as well as contributions from colleagues from across the House. I commend the debate to the House, and urge the Minister to take urgent action on tobacco today; that would improve the health of the nation, reduce pressure on the NHS, and put money back in the pockets of those who need it most.
I remind Members that it helps the Chair determine who wants to speak if they bob in their places. I do not intend to impose a time limit; we have plenty of time for Back-Bench speeches. If my hon. Friend the Member for Ealing, Southall (Mr Sharma) has more of his intervention that he wants to use, perhaps he will make a speech when we reach the end of the list of speakers. I call Mary Glindon.
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this debate. I hold him in high regard as a stalwart champion of the no smoking campaign. It is so sad to hear what made him into that champion. I am sure that what happened in his family has happened in many families in recent years.
I am not a smoker, but, as I have said in past debates on this subject, I was brought up in a household where both parents smoked. My mother died of breast cancer at the age of 72 and my father had a bad chest all his life. She was a Woodbine smoker, I might add. My late husband was a smoker for most of his life, from 1957—the year I was born—when he was only nine years old, and he gave up the habit on a number of occasions. Eventually, like so many smokers, he turned to vaping instead, which was a great relief to him and his pocket. How expensive smoking is for those on low incomes has already been referred to. It will come as no surprise to colleagues that I will talk about vaping as a safe alternative for those who already smoke.
One recommendation in last year’s Khan report on making smoking obsolete was about promoting vaping. Khan stated:
“The government must embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco. We know vapes are not a ‘silver bullet’ nor are they totally risk-free, but the alternative”,
as has already been said, “is far worse.”
Dr Debbie Robson, a senior lecturer in tobacco harm reduction at King’s Institute of Psychiatry, Psychology and Neuroscience has said:
“The levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke.”
And Professor Ann McNeil, a professor of tobacco addiction at the institute, has said:
“Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet around two-thirds of adult smokers, who would really benefit from switching to vaping, don’t know that vaping is less harmful”,
although evidence shows that vaping is
“unlikely to be risk-free.”
I thank my hon. Friend for that intervention. I will raise the issues he has just mentioned in my speech to reinforce what he has said.
In the past, Public Health England has stated that vaping was 95% safer than smoking tobacco, but anyone who does not already smoke should not be encouraged to take up vaping. I think we would all share that message, including those of us who champion vaping over smoking.
As a member of the all-party parliamentary group for vaping and given my interest in smoking cessation, I have worked with tobacco companies such as British American Tobacco UK and Japan Tobacco International as well as the UK Vaping Industry Association. Both the tobacco companies and the UKVIA are united in their efforts to make vaping products as safe as possible through regulation and to help prevent young people taking up vaping. I emphasise that because the companies are very conscious of the problems.
Although we acknowledge the importance of vaping in contributing to the fall in smoking since it entered the mainstream, one of the biggest concerns is products targeted to attract children and young people to start vaping. The industry is extremely concerned about rogue retailers selling e-cigarettes to minors, and are calling to increase fines for offenders to a massive amount. The UK Vaping Industry Association adheres to section 22 of the Advertising Standards Authority guide, which prevents the marketing of e-cigarettes to children. It calls for a licensing or approved retailer and distributor scheme to filter out retailers who are not applying the law, so that consumers and lawful retailers can feel confident that the vape products they purchase adhere to strict safety standards.
Given the rise of rogue traders selling vaping products to children—as well as illicit products—due to the lack of sufficient deterrents and enforcement, the industry sent an open letter to the Health Secretary with a number of recommendations, including increased penalties of at least £10,000 per instance of traders flouting the law. The Minister may be well aware of that, so I will not go into any more detail. Colleagues can look at that if they wish.
A recent press investigation into the increasing number of vaping products entering the UK market that do not comply with the tobacco and related product regulations, particularly in relation to the company ElfBar, prompted the British American Tobacco to conduct its own research. An independent, accredited laboratory carried out an analysis of ElfBar’s 600 products, which can be purchased from major UK supermarkets, including Asda, Tesco and Sainsbury’s. Shockingly, all the products tested contained significantly more than the permitted 2% of nicotine-containing e-liquid—often up to 50% or 60% more.
Following the publication of that information, a meeting was convened between the Medicines and Healthcare Products Regulatory Agency, the Office for Health Improvement and Disparities, and ElfBar last month. However, to date, no action has been taken by MHRA or Trading Standards to remove those non-compliant products from the market. The problem reinforces the industry’s call for tighter controls and fines, which I hope the Minister is considering in full.
The industry is also aware of the concerns about single-use vapes, which offer a cost-effective and easy way for those on low incomes to quit smoking, and thus help to address health inequalities. A recent report from the Office for National Statistics showed that smoking is at an all-time low, and acknowledged the important role played by vaping in reducing those figures. A proposed ban on single-use products could put doubt into the minds of smokers and vapers about the use of e-cigarettes, and that could lead them back on to the smoking trail. It is important to point out that the UKVIA is working to ensure compliance with the waste electrical and electronic equipment directive, and is working with the industry and other bodies, including the Department for Environment, Food and Rural Affairs, to proactively look at ways to maximise the recycling and reuse of vaping products.
It has been said before that vaping is not a panacea. However, it is a way out for people who have smoked for years and cannot give up the habit. It releases them from the dangers of smoking and moves them on to something we hope is less dangerous, and a lot more risk free. I hope the Minister will look at all the considerations that need to go into the tobacco control plan, and will work with those industries so that vaping can be an effective and safe tool as an alternative to smoking in the future.
It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Harrow East (Bob Blackman) for securing this important debate.
As we have heard, smoking is the biggest driver of preventable lung disease and health inequalities. According to the charity Asthma + Lung UK, it is responsible for half of the difference in life expectancy between the richest and poorest. In particular, smoking causes nearly twice as many cancer cases in England’s most deprived areas as it does in the least.
I want to acknowledge the progress that has been made, specifically in my region of the north-east. The north-east has seen the biggest decline in adult smoking rates since 2005, when our region became host to the UK’s first ever dedicated regional programme for tobacco control, Fresh; but smoking remains a key driver of health inequalities in our region, where four out of 10 households with a smoker are living in poverty.
In my local authority area of Gateshead, where 17% of adults still smoke, healthy life expectancy is just 58 years. That is five years lower than the national average, and there is an even wider gap between Gateshead and more affluent areas. That is a real problem. I see too many constituents suffering from chronic obstructive pulmonary disease, of which smoking is the leading cause. Their lives are limited and cut short by COPD—by the effects of smoking. Some of us on the all-party parliamentary group on respiratory health have raised this issue in debates on COPD.
The Government have promised to extend healthy life expectancy by five years by 2035. Last year, the Khan review argued that the smoke-free 2030 target was vital for achieving that objective, as we have heard, but the review also found that without further action England will miss the smoke-free target by at least seven years, and the poorest areas will not meet it until 2044.
It has now been nearly a year since many of us went over to Church House to hear Javed Khan present the findings of his review, which were widely welcomed. Many of them, indeed, picked up on the report of the all-party parliamentary group on smoking and health from the previous year. The Government have had a few other things on their mind since then, with the ministerial merry-go-round of the summer and a revolving door of Ministers, but they must now focus on implementing the recommendations of the Khan review.
The indoor smoking ban in 2007 demonstrated that policy can change social norms and, in doing so, save lives. That is why we should look on smoking not only as a problem to be tackled but as an opportunity. Smoking helps to sustain deprivation, just as deprivation helps to sustain smoking. By tackling that connection, we can allow people to lead more healthy and fulfilling lives. Most people who smoke began as children; for every three young smokers it is estimated that only one will quit, and one of the remaining smokers will die prematurely from smoking-related disease or disability. In the north-east, the average age of smoking onset is just 15 years old.
The Khan review also outlined steps to facilitate a smoke-free generation by implementing a gradual rise in the age at which it is legal to purchase tobacco. The ambition of the recommendation is welcome, but its success will rely on tackling the illicit tobacco trade as well. Almost three quarters of young smokers in Tyne and Wear, County Durham and Northumberland have been offered illegal tobacco, and just under half have bought it. If we prevent children from ever starting to smoke, we can close gaps in healthy life expectancy for years, and generations, to come.
Children are four times more likely to start smoking if they live with an adult who smokes, which gives us all the more reason to tackle smoking in pregnancy. Unfortunately, since 2017, the number of mothers smoking at delivery has fallen by only two percentage points. The Khan review recommended financial incentives to support all pregnant women to quit. It also advocated the appointment of a stop-smoking midwife in every maternity department to provide expert support on the frontline. That will help to tackle another key driver of health inequalities. Currently, smoking in pregnancy is five times more common among the most deprived groups than among the least deprived. Rates are also much higher among people with a mental health condition. In my local authority area of Gateshead, more than 40% of people with a diagnosed serious mental health condition are smokers. The Government must do more to support high-risk groups who are disproportionately impacted by smoking and therefore most likely to bear the brunt of those inequalities in the future.
Smoking perpetuates inequality via its impact not only on health, but on personal finances. As we have heard, the average smoker spends just under £2,000 on tobacco. In Gateshead alone, almost 10,000 households are driven into poverty when income and smoking costs are taken into account. Meanwhile, more than 1,000 households are economically inactive due to smoking-related disease and disability. Put these financial effects together with the impact at the macro level, where local economies lose out by billions of pounds each year, and the impact is even more clear.
So what can we do? As the Khan report demonstrates, it is clear that comprehensive investment is needed to tackle smoking in our communities and address the scourge of health inequalities that result—but over the past decade, drastic cuts have undermined efforts to support people to quit smoking, particularly in the most deprived areas.
The public health grant, from which local authorities allocate funds for smoking cessation services, has been cut by almost half since 2015. That has been accompanied by a 60% fall in the number of people supported to stop smoking over the same period. Meanwhile, as we have heard, the four largest tobacco manufacturers make around £900 million of profit in the UK each year.
I am pleased that in the north-east all 12 councils and the North East and North Cumbria integrated care board have pledged funding to the Fresh programme for the next two years so that it can continue that really important smoking cessation work. I am glad to see that its latest campaign, “Don’t be the one”, will be launched on our north-east media on 20 March. If they and other smoking cessation services are to be able to continue their work effectively, to get out that message about not smoking, not least in the media, what is needed is much greater national funding.
When used as recommended by the manufacturer, cigarettes are the one legal consumer product that will kill most users. Two out of three people who smoke will die from smoking. A “polluter pays” tax will force the corporations to take responsibility for the social outcomes of their products and raise the money that is so desperately needed to fund easily accessible, high-quality support. Smoking costs the NHS £2.4 billion per year. This is a matter of invest to save. In particular, we need a specific approach for the most deprived communities and at-risk groups, including distribution of free swap-to-stop packs.
We have the opportunity now to prevent inequalities for the future. The Government must act to implement the recommendations of the Khan report and must urgently produce a tobacco control plan for England. Frankly, I do not want to be in this debate again next year, as I have been for the last three or four years, asking for a tobacco control plan again. My big ask for today is quite simple: that the Government get on with the tobacco control plan, incorporate the Khan recommendations and, simply, stop more people dying and becoming ill from smoking.
I intend to move to Front-Bench speeches at 2.28 pm. We have two speakers left. That should give you some idea of how long you have to speak, in order to allow 10 minutes for each of the Front-Bench speakers and two minutes for Bob Blackman to sum up. I now call Rachael Maskell.
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing today’s debate. I was really sorry to learn about the circumstances that have brought him here; they really do account for why he is such a passionate advocate for non-smoking.
For decades, tobacco companies have used every manipulative means possible to recruit the next generation of smokers. For them, it is about big profits—£900 million at last count. With around 75,000 victims of their exploits dying every year, those companies have to market their products to new generations to replace those who die. I am angry because they are deliberately causing harm and taking advantage of marketeering, peer pressure and a pack of lies around a pack of cigarettes to make their victims feel good about succumbing to the powers of their addictive means. Once people are hooked, companies draw their prey into a lifetime of handing over precious savings to deposit in their bank accounts.
Those companies are using their resources wisely. British American Tobacco has bankrolled the Institute of Economic Affairs, a Tory think-tank that wants to privatise the NHS. One of its trustees has reported funding a former Health Secretary with £32,000 between 2010 and 2018—the less said about him, the better. With 30 Tory MPs benefiting in all, what could their motivation be? What could BAT’s motivation be? We will never forget Margaret Thatcher taking $1 million from Philip Morris as a consultant.
It is children that these despicable companies are targeting. I have been following the vaping debate, and child vaping is the latest fad. British American Tobacco and others are at it again, addicting children to their products, using different products at different times, with different flavours and colours and cheap devices. They are once again addicting a generation. Among young people, vaping is now seen as cool, as smoking once was, but the harms of these stimulants are unknown, and a lifetime of expense lies ahead, costing users physically, mentally and financially. These wolves in sheep’s clothing need calling out, and today’s debate is a good place to start.
Tobacco is still the biggest killer, luring people into horrible diseases such as cancers—including lung cancer—stroke and heart disease, as well as dementia, which, as we have heard, is the focus of national No Smoking Day. Given that that costs the NHS £2.2 billion a year and social care £1.3 billion, I have to ask why the Government are content not to set out an ambitious plan that is ruthless with the tobacco giants yet compassionate with their victims, taking every step to draw people out of their addictions and recover their health. Why are Government paralysed when the evidence is screaming at them?
This is the difference between the Tory party and the Labour party: Labour knows that health inequality is unjust. We want to take people to a safer, healthier place. That will be our priority. Thirty years ago, I did my dissertation on this very issue for my degree, and my conclusions were simple: money buys silence. Labour must never touch dirty money, and nor will it. That money kills, whether directly or indirectly. Instead, we must invest in health.
According to Action on Smoking and Health, 9.2% of the community in my city of York smoke. While that is lower than the national average of 13%, it costs our city £46.9 million. In my ICB area of Humber and North Yorkshire, 2,500 people, sadly, die each year. The healthcare costs are £8.2 million, adding to economic costs of £19.9 million due to lost earnings and £10.9 million due to smoking-related unemployment. What a lot of money. Let us reflect: 6.6 million people smoke across the UK. There are 150 new cancer cases a day, and 54,300 a year. Every minute, another victim is admitted to hospital, with 506,100 hospital admissions attributed to smoking. Last year, the cost to the public finances was £2.6 billion.
These wretched companies are fleecing their victims of their hard-earned living, with an average smoker spending £2,500 a year. Some 70% of smokers want to quit, so we need to ensure they have the means to achieve that. Let us remember that these multimillion-pound companies prey on the poorest, with 31% of households with somebody who smokes falling below the poverty line—if ever there was exploitation, this is it. Many new communities of people coming into the UK from challenging places across the world also have a high prevalence of smoking, presenting a new challenge for public health teams, and it is important to get on top of that too.
The UK Government aim to reduce the level of smoking to just 5% by 2030, but there is no tobacco control plan. In York, the local authority’s public health grant has been cut by 40% over the term of this Government, yet we do not know what is to come in 22 days’ time, when the public health grant runs out. On top of that, we have not seen the health disparities White Paper. We understand that it has been scrapped, so what on earth is going on? Tobacco companies make an annual profit of £900 million, yet only £2.2 million is spent on prevention. We need funding, we need professionals, we need education and we urgently need to move people to a space where their lungs and bodies can start to recover.
Despite Javed Khan’s independent review of tobacco control, published nearly a year ago, the Minister has been silent. Mr Khan recommends spending £125 million each year to enable the UK to hit its target, which will be missed without the investment that we absolutely need to see; increasing the age at which people can buy tobacco products; and ensuring that every public health intervention is made. I take the point made by my hon. Friend the Member for Blaydon (Liz Twist) about the illicit trade in tobacco, which we also need to crack down on. There are 15 strong recommendations in Mr Khan’s review, and I want to see the Government taking action, responding to that report and publishing their plan.
Unlike the Minister, Humber and North Yorkshire ICB is not sitting back. Its outstanding public health team are engaging in driving down smoking levels, with a new centre of excellence to co-ordinate population-level interventions, and investing in programmes of activity targeted at those who most need them. With stop smoking support and lung health check screening, work is under way to screen and divert. Like many colleagues across the House, I am asking the Government to publish the tobacco control plan; to publish a strategy to tackle the rise in vaping, particularly among our young people; to give local authorities the means and tools to safeguard a generation; and to introduce an annual public health windfall tax on these companies in the Budget next week. It is all about profit for them, and that profit should be used for public health.
I thank my hon. Friend for making that really important intervention. We must help communities that are finding it hard to quit, including new communities. We really welcome the large number of asylum seekers who have come to York, but we know that there is a higher prevalence of smoking in that community. We must ensure that proper interventions are targeted at BAME communities too.
The figures speak for themselves, and the Minister cannot afford to sit back any longer. Labour will not. We want to save lives, and we want to save the health of our NHS too.
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this really important debate to mark national No Smoking Day. For the record, I am vice-chair of the APPG on smoking and health and was Gateshead Council’s cabinet lead on public health for 10 years, so I am passionate about making smoking history. It is telling that a number of Members present are from the north-east, and we will be reiterating the same messages.
The last tobacco control plan expired at the end of last year, and we are still waiting for the response from the Government to Javed Khan’s independent review on tobacco control. While we wait, thousands of people are getting sick and dying from smoking-related illnesses that are wholly preventable. Since 2000, more than 113,000 people in the north-east have died from smoking, and one person is admitted to hospital in the UK every minute due to smoking.
Although there is rightly a lot of discussion about smoking being the No. 1 cause of cancer, it is important to recognise the host of life-threatening and life-altering illnesses caused by smoking, including COPD, heart disease, dementia, stroke and diabetes. I am therefore delighted that this year’s No Smoking Day campaign is shining a light on the link between smoking and brain health. Smoking has been identified as one of the 12 risk factors that, if eliminated, could collectively prevent or delay up to 40% of dementia cases. Alzheimer’s Research UK found that dementia is the most feared health condition for people over the age of 55. However, only one in five people who smoke in the north-east are aware that smoking raises the risk of dementia. It is therefore vital to get that message out there. It is great that Fresh’s radio ad on this issue is estimated to reach more than 670,000 people in the north-east. I am proud that the north-east has been a trailblazer on this issue, with local authorities across the region working together to fund Fresh, which is a highly effective tobacco control programme. It has nearly halved the smoking rate in the north-east since it was set up. I am pleased to hear that Fresh will once again be funded by all 12 local authorities in the region.
Although it is great to see that work happening locally, it is vital that it is supported by much more investment at a national level. It is shocking that England is on track to miss the smoke free 2030 ambition by nine years, while projections by Cancer Research UK suggest that it will take a further 20 years to get smoking down to 5% in England’s poorest communities. The north-east is the most disadvantaged region in England. With that come high rates of smoking, which means there is further for us to go to become smoke free. The fact that smoking rates are disproportionately high among deprived communities highlights the fact that smoking is one of the leading drivers of health inequalities in our society. As we have heard, smoking during pregnancy is five times more common in the most deprived communities than in the least deprived. In County Durham, 704 women a year are smokers when they give birth, while 41,233 children live in households with adults who smoke. That not only has severe health consequences for children living in deprived areas, but increases fourfold their chance of taking up smoking and remaining a smoker in adulthood.
As well as having a shorter life expectancy overall, men and women in the most deprived areas also suffer from ill health for more of their lives. The levelling-up White Paper identified addressing health inequalities as a priority, yet little has been done so far. The Government’s lack of action and their delay in responding to the Khan review threaten our ability not just to achieve the 2030 smoke free goal but to level up. They must take action now and look urgently to implement the recommendations in the report from the APPG on smoking and health and in the Khan review to tackle the prevalence of long-term illness in areas of deprivation.
We all know that smoking is our biggest preventable killer and, as we have just heard, it is devastating for the thousands of families who lose loved ones each year. It also has significant implications for our economy, our local authorities and our health service. It is estimated that smoking costs County Durham £211.9 million each year, £26 million of which is spent on healthcare. Preventing ill health is key, and it is clear that effective Government action on the issue would relieve the significant pressure that smoking places on our health and social care services. There is no time to waste when we consider that our NHS is in crisis as resources are stretched to the absolute limit.
We must also ensure that smokers have the best chance of success when they attempt to quit, whether that is through support from local stop smoking services or access to alternatives. At the same time, we must prevent children and young people from taking up smoking in the first place, reduce the demand for and supply of illegal tobacco, and support further enforcement around illicit tobacco.
Four years ago, the Government set out their ambition for England to become smoke free by 2030. In April 2022, I asked the Government to ensure that the tobacco control plan would deliver their ambition and that it would be published no later than three months after the Khan review. Here we are, nearly 12 months on, and I am still asking the same question and we are still waiting for action. The chair of the Durham health and wellbeing board even wrote to the Secretary of State about the Khan review, but she received a non-committal response. With that in mind, will the Minister tell us when he plans to publish the tobacco control plan and what the Government intend to commit to on the back of the Khan review? Every day that we wait, too many people are dying needlessly.
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.
It is a pleasure to serve under your chairmanship, Mr Efford, and to speak on behalf of the shadow Health and Social Care team. I congratulate the hon. Member for Harrow East (Bob Blackman), not just on securing the debate and on his opening speech, but for all the work that he has done over a long period of time on the issue. We know from his contribution today what drove him to champion the cause of smoke-free England 2030, and we thank him for the work that he has done. This is not a party political issue; it is something on which we all want action.
We also had good contributions from my hon. Friends the Members for North Tyneside (Mary Glindon), for York Central (Rachael Maskell), for Blaydon (Liz Twist) and for City of Durham (Mary Kelly Foy), and from the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), who leads on the issue for the SNP, and helpful interventions from my hon. Friend the Member for Ealing, Southall (Mr Sharma).
The first No Smoking Day took place in 1984. Back then, 35% of people smoked. In the almost 40 years since then, we have made great strides in tackling smoking prevalence. We now have a smoking rate of around 13%. We have seen a clampdown on tobacco advertisements, an increase in public awareness of the dangers of cigarettes, and, most notably, Labour’s ban on indoor smoking, which led to a truly transformative impact on public health.
Do not get me wrong—smoking prevalence is still too high, and incredibly so in some of the poorest communities in England—but it is undeniably heartening to see the progress that has been made in the last four decades. The progress is primarily thanks to the tireless work of public health researchers and campaigners, who sounded the alarm about the dangers of smoking, and who continue to put much-needed pressure on policy makers for further action.
I do not say that to give us all a pat on the back, but to highlight how political will can make a real difference. We need that political will now more than ever. This Government have committed to a smoke-free England by 2030—an ambition that is supported across the House. However, we are on track to miss the target by around nine years, which is frankly unacceptable. The Government should not commit to a target because it is politically expedient, but then never deliver it. We need to see smoke-free 2030. Why? Because every year, the evidence of the damage of smoking continues to pile up. Smoking causes around 75,000 deaths every year in the UK alone. It harms pretty much every organ in the body. As the research to mark this year’s debate demonstrates, it is strongly linked to dementia, too. In addition to the tragic human cost, smoking also costs the economy around £20 billion in lost productivity, ill health and NHS resources. The facts are overwhelming, and we must act.
I am sure the Minister will agree on all those points, and I would like to raise a few matters on which I hope we can get some clarity. The first has already been mentioned to my hon. Friends—the tobacco control plan, which seems to have disappeared into the ether. Can the Minister confirm that he still intends to publish the tobacco control plan, and when it will be released? The hon. Member for Harrow East was very forceful on this point. If, as I fear, it is being held back because the Prime Minister is scared of upsetting some on his Back Benches, the Minister should front up and admit it.
The last tobacco control plan was published almost six years ago, and it has now expired. We are left in the bizarre situation where the Government continue to insist they are committed to smoke-free 2030, but they have no plan for how they intend to get there. The Minister is driving us to a destination, but he forgot to bring the map.
In addition to providing a date for the next tobacco control plan, will the Minister provide a date for when he expects to respond in full to Javed Khan’s smoke-free review, which his Department commissioned and seems to have forgotten? Secondly, given the extremely concerning figures from ASH that show just 18% of smokers know that smoking can cause dementia, will the Minister advise Members on what action the Government will take to increase awareness of that risk? Concerns have rightly been raised by public health charities about the fact that media spending on stop smoking campaigns has declined by 95% since 2008-09. Will the Minister confirm how much his Department has earmarked for spending on TV ads for Stoptober this coming October, and if he has assessed how current media campaigns are performing in raising public awareness?
Finally, it would be remiss of me not to mention the public health grant, which has still not been released to local authorities in England. I asked the Minister about this at Health questions on Tuesday and was told the grant was coming in days, not weeks. I am not sure what that means, because we are two days on and there is still no sign of it. Any additional information the Minister can give would be greatly appreciated, not least because this grant is essential to smoking cessation services in communities across the country, including communities I represent in Greater Manchester.
It is time to get serious about tackling smoking prevalence. The last Labour Government took decisive steps to improve public health, and we would do so again. That is why the next Labour Government will consult on all Javed Khan’s smoke-free 2030 recommendations and put prevention at the heart of everything they do. Our NHS is at breaking point. Seven million people are on waiting lists. Solving that challenge obviously requires an expansion of the NHS workforce, which Labour is proud to have committed to, but unless we simultaneously tackle the root causes of why people get ill, we do not stand a chance of rebuilding our NHS and making it fit for the future.
Labour stands ready and waiting to build a healthier, happier and more prosperous England. Until then, the Minister has my assurances that whatever support the Government need to get back on track for their smoke-free 2030 target in England, Labour will provide. He need not rely on the votes of those in his party who do not necessarily understand the importance of public health. Tackling smoking is not partisan. It is in all of our interests to work towards a smoke-free 2030, so my message to the Minister is clear: we will support him, and let’s get on with it.
It is a pleasure to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Harrow East (Bob Blackman) for securing this important debate. He spoke brilliantly, marshalling his argument and speaking from terrible personal experience. I thank him for not just his speech, but his advice more generally. I thank other Members for their thoughtful contributions. The hon. Member for North Tyneside (Mary Glindon) made an important point about the huge potential of vaping to help people stop smoking because it is much safer, but we must balance that against the important point made by the hon. Member for York Central (Rachael Maskell) about the need to prevent non-smokers, particularly children, from starting vaping. The hon. Member for Blaydon (Liz Twist) made an important point about the regional and local impact of smoking, and its negative impact on levelling up. She is quite right. I notice that the north-east is well represented here today, as well as north London. I thank all hon. Members for their contributions.
Yesterday was No Smoking Day, which presents a timely opportunity to have this conversation. Since I spoke at the last Commons debate on a smokefree 2030 in November, adult smoking rates in England have gone down to 13%, an all-time low. That continues the downward trajectory in smoking rates over the past few decades, moving from 45% in the 1970s to 20% in 2010 to 13% now. As several hon. Members have pointed out, our efforts to reduce smoking are a public health success story and are widely recognised as some of the most comprehensive in the world.
In 2021-22, we invested £68 million in local authority stop smoking services through the public health grant, and nearly 100,000 people quit with their support last year. I am proud to say that we have recorded more than 5 million successful quits since stop smoking services were established across England in 2000. That is 5 million lives that have been saved or improved as a result of quitting smoking.
Last year alone, the NHS invested £35 million in tobacco-dependency treatment. The NHS has committed to ensuring that all smokers admitted to hospital are offered NHS-funded tobacco treatment services. Pregnant women are routinely offered a carbon monoxide test, which is used to identify smokers and to refer them to support to quit. National campaigns, such as Stoptober, have helped 2.1 million people to quit since their inception in 2012.
We have introduced a range of impactful smoke-free legislation, such as that referred to by the hon. Member for Denton and Reddish (Andrew Gwynne), including the ban on smoking in cars when children are present, plain packaging on cigarette packs and display bans, and raising the age for the sale of tobacco from 16 to 18. There are many more initiatives, and the legislation has been a cross-party effort. All those measures have contributed to reducing smoking rates overall, particularly among children. In 2021, just 1% of 11 to 15-year-olds were regular smokers, which is the lowest rate on record, although that is still, of course, much too high.
My hon. Friend the Member for Harrow East said that we have to go further and faster, and he is absolutely right. Smoking is still the leading preventable cause of health disparities, premature disability and death. There is an economic cost to smoking that puts a huge direct drain on household finances, as hon. Members have pointed out, and has a wider impact on productivity taxation and our wider economy. Tragically, two out of three smokers will die from smoking unless they quit.
Smokers are 36% more likely to be admitted to hospital, and the cost to the NHS is huge. The average smoker needs social care 10 years before a non-smoker, so the cost to social care is huge, too. That is why tackling smoking is central to our forthcoming major conditions strategy, which takes the place of the previous strategy mentioned by the hon. Member for Blaydon. Smoking and other causes of preventable ill health will be central to that strategy.
I will hopefully reassure the hon. Lady on that point shortly. I was saying that tobacco and tobacco control will be threaded through the major conditions strategy, but I will come to our specific plans to control smoking in a moment.
The major conditions strategy will look at cancers, cardiovascular disease, stroke and diabetes, chronic respiratory diseases, dementia—which has been mentioned several times today—and mental ill health. Smoking is a contributor to all those major conditions. Put simply, it makes all of them worse. It increases the risk of heart disease, heart attack and stroke, often disabling people for years. As my hon. Friend the Member for Harrow East mentioned, the theme for No Smoking Day this year is dementia and how stopping smoking protects brain health.
If smoking disappeared, the great majority of cancers would disappear for a large proportion of our population. More than 70% of lung cancer cases in the UK are linked to exposure to tobacco smoke. There is even a connection between smoking and diabetes. Cigarette smoking is one of the most important modifiable risk factors for type 2 diabetes. All these risks, across all these different conditions, can be changed by one lifestyle modification.
As many hon. Members have highlighted, last year the Government asked Dr Javed Khan to undertake an independent review to help to meet the smokefree 2030 ambition and reduce the devastation that smoking causes. My hon. Friend asked when we will set out our response. In the coming weeks, I will unveil a set of proposals to realise the smokefree 2030 ambition and to respond to the Khan review’s recommendations.
I thank hon. Members for their patience. Although I cannot divulge the specifics of the proposals at this time, I assure hon. Members that they are grounded in the best evidence on reducing tobacco use and its associated harms. They are bold, innovative and ambitious, and we have carefully considered the Khan review’s recommendations as part of the process. I look forward to the opportunity to share more details with hon. Members very soon and to set out more details of our road map to a smokefree 2030.
I thank my hon. Friend the Minister, the Opposition spokesperson, the hon. Member for Denton and Reddish (Andrew Gwynne), and the SNP spokesman, the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), as well as all Back-Bench colleagues who made this a very powerful debate. As we commemorate national No Smoking Day and seek to reduce dementia in society, it is vital that we look at the causal links between smoking, dementia and many other diseases such as cancer, as hon. Members pointed out.
I look forward to hearing the Government’s response very soon—that is very good news. Very soon is better than soon, and in a few weeks is even better, so we look forward to that. Clearly, the Chancellor has the opportunity in the Budget to introduce the levy that we have long campaigned for, which would directly contribute money to the national health service to treat victims of smoking.
Almost 11 years ago, I led a debate in this Chamber on standardised packaging of tobacco products. The Opposition spokesman at the time said, “Labour has no plans to endorse standardised packaging.” The Minister, who is no longer in the House, said, “The Government have no plans.” A few short years later, we got standardised packaging of tobacco products.
Those who have contributed to this debate should remember this: every single move that Governments of all persuasions have made to restrict smoking and, as a result, improve health have come from Back Benchers. Back-Bench Labour Members introduced the ban on smoking in cars with children present. We should always remember that these great initiatives come from Back Benchers.
I have campaigned on this issue since I was elected in 2010. I am afraid we cannot wait for a Labour Government to introduce the Khan review. Labour Members will have to wait a very long time to have that opportunity, so it is most important that the Government get on with the job. As I said, this has the support of the whole House. Let us get on and deliver it so that fewer people die from smoking.
Question put and agreed to.
That this House has considered national no smoking day.