My Lords, despite reductions in smoking rates, smoking remains the leading cause of preventable death in England. E-cigarettes are not risk free but are less harmful to health than smoking tobacco. Each year, more than 50,000 additional people who would not have quit through other means quit smoking through e-cigarette use. We continue to monitor the evidence base on e-cigarettes. The next Public Health England annual review is due in February 2020.
The Government have consistently highlighted that quitting smoking and nicotine use completely is the best way to improve health. Although they are not risk free, research shows that e-cigarettes are effective in helping smokers to quit. That is why we committed in the long-term plan to roll out “stop smoking” services in the NHS, to support improvements even on our smoking cessation rates—smoking is now at its lowest level on record, down from 18.4% in 2013 to 14.4%.
My Lords, does the noble Baroness agree that, looking back over the past 10 or 20 years, apart from the ban on smoking in public places, vaping has been the most successful intervention to reduce smoking? Does she therefore agree that we need to be cautious before we rush into trying to ban or overregulate its use, as some campaigners want?
As I said, more than 50,000 additional people quit smoking through e-cigarette use each year. We see e-cigarettes as an effective and safer route to quitting smoking than other routes. However, we understand that, at the moment, there is no evidence on the impact of long-term vaping, which is why Public Health England continues to update and publish the evidence base on e-cigarettes annually. We will continue to monitor the impacts of that use.
My Lords, modest process changes could be made to enable patients who need medical cannabis to gain access to it. This is the most effective way of reducing public use of cancer-inducing cigarettes and vaping, which I understand is not risk free, although we do not know all the results. Will the Minister agree to meet me to discuss these process changes, which really could make a big difference and save people?
The noble Baroness is an avid campaigner on this, and I commend her on the work she does on it. I would be delighted to meet her to discuss this, of course, but I am also pleased with the progress we have made in bringing forward clinical trials to improve the evidence base around medicinal cannabis.
My Lords, my noble friend will be aware that this week sees the centenary of the prohibition amendment in the United States, a policy that resulted in disastrous health outcomes and a huge increase in criminality and was repealed within 10 years. Does she feel that history is being repeated with America’s policy of prohibiting vaping but not regulating it for product safety, resulting in a number of deaths caused by the illegal use of substances in vaping—contrasted with this country, where product safety regulation has enabled us to do safe vaping?
My noble friend has asked a comprehensive and pointed question. It is notable that e-cigarette use among young people in the United States has increased dramatically— 78% in high-school students and 48% in middle-school students. We have not seen that in the UK because of the very effective and tightly regulated methods we have brought in around advertising and access for under-18s, which have borne fruit. I am proud of the way in which we have managed that in the United Kingdom.
My Lords, is the Minister aware that smoking has again become much more normal, and indeed quite fashionable—particularly in the form of e-cigarettes, among not just smokers but young people and people who have never smoked? Does she consider that this risks growing nicotine use and dependence? If so, what is being done to monitor and evaluate in health terms the increased use of e-cigarettes?
I am not quite sure I agree with the fundamental hypothesis of the noble Baroness’s question. If the normalisation hypothesis were true, we would not have expected to see smoking rates continue to decline as they have. Since 2013 smoking rates have fallen from 18.4% to 14.4%, and among young people regular use is very small. It is at 2% for those who have never smoked and is very rare or less, at 0.5%, for 11 to 15 year-olds.
Will the noble Baroness be good enough to check the facts and assertions made by the noble Viscount, Lord Ridley? The facts are that during prohibition in the States, health improved and did not decline. Will she check that and give him the correct facts on it? Also, will she make sure that before we make any great changes on cannabis, we look very carefully indeed at what is happening in those states in America where cannabis is freely and openly sold for recreation purposes, and check on the number of people now dying from accidents and a whole range of associated problems? True, it is raising tax, but it is also raising many social problems.
I assure the noble Lord that when it comes to questions around medicinal cannabis and smoking, one of the reasons the UK is successful is that we approach our policy based on the most excellent evidence base. We are world-renowned for the approach we take to using evidence and putting it into policy most effectively. We are considered the European leader in smoking policy, in particular when it comes to our most recent tobacco control plan, and we will continue to be so.
My Lords, the noble Baroness has mentioned that smoking among children is relatively low, but it is growing fast: it has more than doubled in the last four years. I strongly urge her to speak to schools. My own conversations suggest that in the last year and a half to two years it has increased more than fivefold. Does she agree that flavours such as gummy bear, twister lollipop, jelly babies, pixie tarts and unicorn milk are quite clearly aimed at children? It really is time that we looked at the rules around this.
The noble Lord is absolutely right: there must be no complacency when it comes to any kinds of illicit drugs or substances aimed at children. We have very active policies, led by the Home Office in partnership with the department of health, to ensure that we keep up with all these substances. On smoking and the use of e-cigarettes, my figures are slightly different from his, and I am very happy to discuss this with him after Questions.