Smokefree 2030 Target

I beg to move,

That this House has considered the Smokefree 2030 target.

It is a pleasure to serve under your chairmanship once again, Mr Evans, and thank you for stepping in to ensure that the debate can take place. We will be considering the 17 April statement to the House on achieving a smokefree England by 2030, cutting smoking and stopping kids vaping.

The debate is co-sponsored by me, in my capacity as chairman of the all-party parliamentary group on smoking and health, and by my friend, the hon. Member for City of Durham (Mary Kelly Foy), who is a vice-chair of the group. The APPG wants to ensure that Parliament has the chance to debate the announcement made by the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), and to consider whether those measures are sufficient to end smoking by 2030 and level up the health and wellbeing of some of the most deprived communities in the country.

At the outset, I commend my hon. Friend the Under-Secretary for announcing the first tobacco control measures since the Government set out their Smokefree 2030 ambition way back in 2019. Since 2021, the APPG has been calling for greater funding to help smokers to swap and to stop, and to provide incentives to help pregnant smokers to quit. We are extremely pleased to see that those measures have been taken forward.

However, while the measures recently introduced by the Government to achieve a Smokefree 2030 are welcome, they are insufficiently ambitious, as they provide only a quarter of the funding called for by the Government’s own independent review last year. Meanwhile, big tobacco continues to make extreme profits selling highly addictive, lethal products that kill if they are used correctly.

The idea of a levy on the industry is popular and feasible, and is supported by voters of all political persuasions, as well as the majority of tobacco retailers. The manufacturers clearly have the money and high profits, so they should be made to pay to end the epidemic. This is more than just a health crisis because delivering a Smokefree 2030 is integral to delivering economic growth, which is a mantra for the Government and for Opposition parties.

Analysis conducted by Landman Economics on behalf of ASH—Action on Smoking and Health—found that, in addition to causing around 75,000 premature deaths a year in the UK, in 2022 smoking cost the economy a staggering £173 billion, including lost productivity and premature death.

Let me break those figures down. The cost to the public finances was £21 billion, which is nearly double the tobacco tax revenues of £11 billion. The cost to the NHS was £2.2 billion, and to social care £1.3 billion. Those figures are substantial, but they pale into insignificance beside the £5 billion of social security payments and the £11.8 billion of lost income tax and national insurance—people who are sick from smoking are unable to work. That is public money, and it will continue literally to go up in smoke for years to come unless we take urgent and bold action.

I welcome the measures announced by the Minister in April, but I recognise that they still fall well short of the recommendations in Dr Javed Khan’s independent review. Of the four “must do” measures recommended by Dr Khan, only one—promoting vaping for adult smokers—has been fully adopted by the Government. The recommendation to improve prevention in the NHS has been partially implemented via the new NHS long-term plan with respect to tobacco treatment services, but those have been constrained by a lack of funding.

Dr Khan’s top two recommendations, which are increased investment in tobacco control and increasing the age of sale, have not been adopted, which has left tobacco control efforts desperately underfunded and put the Smokefree 2030 ambition in critical jeopardy. While I commend the Government’s ambition and commitment to make smoking obsolete by 2030, to date that ambition has not been matched by funding. Dr Khan’s independent review made it clear that a Smokefree 2030 cannot be delivered on the cheap. Speaking recently on improved public sector productivity, the Chancellor stated that

“we count the number of hospital treatments but not the value of preventative care, even though that saves lives and reduces cost.”

I could not agree more.

Public health interventions, such as smoking cessation, cost three to four times less than NHS treatment for each additional year of good health achieved in the population, yet this is where the largest budget cuts have fallen to date, with the public health grant falling by a quarter in real terms since 2015 and funding for tobacco control falling by almost half. Local authorities have done their best to continue delivering vital tobacco control activity despite these funding cuts, but there is much more that we can do. If the Government are serious about the Smokefree 2030 ambition, they cannot keep asking local government to do more with less. More funding must be made available to deliver it.

Last year, Dr Javed Khan called on the Government to urgently invest an additional £125 million per year in a comprehensive Smokefree 2030 programme. One of his options for raising that money was a “polluter pays” levy on tobacco manufacturers, based on the principle that those responsible for the problem should be required to fix it. The principle has been accepted on numerous occasions: the landfill levy; the tax on sugar in soft drinks; requiring developers to pay for the costs of remediating building safety defects; and, most recently, a statutory gambling levy. The “polluter pays” model would enable the Government to limit the ability of manufacturers to profit from smokers while protecting Government excise tax revenues. That will prevent big tobacco gaming the system as it currently does with corporation tax.

Despite paying little corporation tax, the big four tobacco companies make around 50% net operating profits in the UK—far higher than the average of 10% for UK manufacturers overall. Imperial Brands is the most profitable, with 40% market share in the UK and over 70% net operating profits in 2021. Why should an industry whose products diminish the health of users be allowed to make such excessive profits? A levy could raise £700 million a year while capping the profits on sales to ensure that the costs are not passed on to smokers. Some £700 million from tobacco manufacturers would more than cover the £125-million additional funding that Dr Khan estimated was needed for tobacco control, with money left over for other prevention and public health measures.

[Mr Virendra Sharma in the Chair]

Amendments to the Health and Care Act 2022 calling for a consultation on such a levy were tabled by the hon. Member for City of Durham, who is co-sponsor of this debate, and were accepted in the House of Lords last year. Health Ministers were sympathetic, but the Treasury opposed the measure, so it was voted down by the Government, despite overwhelming public support for a levy. Some 75% of the British public think that tobacco manufacturers should be made to pay. My first question to the Minister is: can he tell me, if the Government will not commit to a levy on tobacco manufacturers, how, when and where will they find the additional funding needed to deliver the Smokefree 2030 ambition? Since 2020, public health Ministers have committed to publishing a new tobacco control plan, initially by July 2021 and then by the end of 2022—we are still waiting. The previous tobacco control plan expired last year, leaving us without a strategy or any targets for reducing smoking rates among the most disadvantaged groups.

In the absence of national leadership, local authorities are stepping up to the plate. For example, the London Tobacco Alliance, which I am proud to support, launched last year. It is leading the charge to make the capital smoke-free by 2030. I am sure the Minister will join me in commending the alliance and other regional partnerships across the country that are committed to tackling smoking in their communities. In place of a tobacco control plan, the Minister has said that tackling smoking will be “central” to the major conditions strategy. However, the recent call for evidence for that strategy was not reassuring, and certainly did not place smoking front and centre. My second question is: if the Minister will not commit to a new tobacco control plan—I wish he would—can he at least reaffirm that smoking will be central to the major conditions strategy and that further tobacco control measures will be included in the major conditions strategy when it is finally published? I assure the Minister that he has the full support of the APPG in his efforts to tackle youth vaping, and recent announcements by both the Minister and the Prime Minister are warmly welcomed.

My views on youth vaping were summed up expertly by the chief medical officer:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape; marketing vapes to children is utterly unacceptable.”

The APPG is deeply concerned about recent figures published by ASH showing that there has been a significant rise in youth experimentation with nicotine e-cigarettes, driven by cheap, colourful disposable vapes and child-friendly marketing.

I congratulate my hon. Friend and the hon. Member for City of Durham (Mary Kelly Foy) on securing this debate. Although I acknowledge that vaping has a role in helping adults to quit tobacco smoking, youth vaping has unintended consequences, as my hon. Friend is starting to elaborate. We have seen a surge in such vaping, and there are huge health and environmental concerns. As he said, the products are targeted at young people, with colourful packaging and flavouring. The Government have taken some strong steps. Does my hon. Friend agree that we need to go faster to stop this unintended public-health ticking time bomb?

I thank my hon. Friend for that intervention. It reminds me that 11 years ago I led a debate in this place on introducing standardised packaging for tobacco products. At the time, both the Government and the Opposition said they had no plans to support such a measure. Of course, we now have standardised packaging of tobacco products. I hope we can get standardised packaging of vaping products as well.

The Government recently issued a call for evidence on the best approaches for tackling youth vaping. I look forward to seeing the response. First and foremost, the Government should make disposable vapes, which are the worst things for the economy, much less affordable, by adding a £5 excise tax. That would also make the distribution of those products subject to much more stringent controls, making it easier to prevent illicit and underage sales. It would in particular ban the issuing of free samples to young people.

Will the Minister tell us when the Government’s response to the call for evidence on youth vaping will be published, and whether it will include specific enhanced regulation to address loopholes in the law? I welcome the Minister’s commitment to adapting the tobacco trace and trace system, to strengthen enforcement and to target the illicit market. I particularly welcome the Minister’s commitment to exploring how to share information with local partners about who is registered on the track and trace system, which is critical.

Does my hon. Friend agree that there is a critical role for trading standards in enforcing measures against illegal vapes, counterfeit tobacco and underage sales? We could greatly secure the environment for the consumer by trading standards enforcing the laws.

My hon. Friend must have read the next part of my speech. At present, trading standards officers have one arm tied behind their back in the fight against illicit tobacco, due to a lack of options for identifying and cracking down on retailers who repeatedly flout tobacco regulation. We know that retailers who sell illicit tobacco products are much more likely to sell tobacco to children, undermining tobacco-control regulations. They also seek to hook children on the addictive product that kills more than half of long-term users, by giving or selling them vapes in the first place.

Retailers are required to have an economic operator ID before they can trade in tobacco, under the current tobacco tracking and tracing regulations. Through adaptation of that system, local enforcement will easily be able to identify retailers who are breaking the law, and hold them accountable. That is the approach that I recommend in my ten-minute rule Bill, which would introduce a retail licensing system, similar to the one that exists for alcohol. Retail licensing for tobacco was recommended in Dr Khan’s independent review.

The Minister will be pleased to know that that approach has the support of the public and retailers. Survey evidence from ASH, published last autumn, found that more than eight in 10 small tobacco retailers support the introduction of a tobacco licence, backed by mandatory age verification. Will the Minister commit to publishing further detail on his plans to strengthen the track and trace system, before Second Reading of my ten-minute rule Bill on retail licensing in November?

It is undeniable that big tobacco and those representing its interests never cease in their attempts to undermine public policy, not just on tobacco but on vaping. Only last weekend, The Observer revealed that lobbyists connected to big tobacco were funding Facebook campaigns opposing new vaping regulations. Regulations, I think we can all agree, are desperately needed to protect children. It was exceptionally well timed, therefore, that yesterday the Department of Health and Social Care published guidance for all parts of Government on our legal obligations to protect public policy from the commercial and vested interests of the industry—guidance that I very warmly welcome. The Department of Health and Social Care, as custodian of the World Health Organisation framework convention on tobacco control, has been staunch in its support for that treaty and has upheld our legal obligation to strictly limit any engagement with the industry solely to that required for effective regulation of the industry. Will the Minister put it on the record that Government—the Executive, legislature and judiciary—are required to limit interactions not just with tobacco manufacturers but with any organisations or individuals with affiliations to the tobacco industry, including lobbyists or industry trade bodies, such as the UK Vaping Industry Association, which lists big tobacco among its members?

Order. I have two announcements to make before I call the next speaker. This debate will still finish at 11 am. I intend to start calling Opposition Front Benchers at 10.30 am. Rather than setting a time limit now, I make this request of all Members: try to be brief, so that everybody can contribute. I hope that, in that way, we can deal with the situation. I call Mary Kelly Foy.

It is a pleasure to serve under your chairmanship, Mr Sharma, and to follow my co-sponsor of this debate, the hon. Member for Harrow East (Bob Blackman). He is also the chairman of the all-party parliamentary group on smoking and health, of which I am a vice-chair. I declare that interest.

As we have heard, the measures announced by the Minister in April were a step in the right direction. However, they fell very short of the comprehensive strategy outlined by the APPG and the Khan review, and it has taken far too long—almost four years—for the Government to get going on this. In the meantime, tobacco continues to kill an estimated one person every five minutes in Britain. The deaths are disproportionately concentrated in regions such as the north-east—regions that have some of the highest rates of poverty and, in turn, the highest rates of smoking in England. In the north-east, nearly 13,000 people died prematurely from smoking between 2017 and 2019. This has an economic cost for our communities of over £100 million in healthcare costs and £64 million in social care costs. All the while, tobacco companies make record profits, leaving the taxpayer and families to pick up the pieces.

We are fortunate in the north-east to have a highly effective regional tobacco control programme—Fresh—funded by all the local authorities in the region and the local integrated care board, and it has proven successful over the years. Just yesterday, it launched a new behavioural change campaign called “Smoking Survivors”, which features two women from the north-east who have quit smoking and survived cancer. However, national funding for behavioural change campaigns such as that fell by around 90% between 2008 and 2018. Although regional activity is vital, we need strong leadership from the Government if we are to see every region be smoke free by 2030.

Like the hon. Member for Harrow East, I welcome the Minister’s recent announcement on tackling youth vaping, but why did it take so long for the Government to act? When the Health and Care Act 2022 was going through Parliament in 2021, I tabled amendments that would have given the Government powers to prohibit child-friendly branding on e-cigarette packaging and to ban the free distribution of vapes to under-18s, which, as we know, has strong cross-party support. To my amazement, not only did the Government fail to adopt my amendments, but they voted them down.

I urge Members to stick to about five minutes.

It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate the hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Harrow East (Bob Blackman) on securing this important debate. The Department of Health and Social Care’s announcement in response to the Khan smoking review of last year was a positive step to ensure the UK remains a world leader on harm reduction and has a strong chance of reaching the Government’s ambitious Smokefree 2030 target. That said, I worry there is a serious risk that the target will be missed, with an estimated 13.3% of adults in the UK still smoking. The Department’s announcement that a reduction in smoking would also reduce the number of hospital admissions is clearly correct. It would help the Government’s priority of reducing NHS waiting lists.

The Government are taking a harm reduction approach to tackling smoking. As the Minister said, the person who quits today is the person who is not in a hospital bed tomorrow. I therefore welcome the Government’s highly pragmatic approach to vapes, but only by embracing all smoking alternatives—not just vaping, but gum, patches and NHS stop smoking services—can the UK give itself the best chance of hitting its Smokefree 2030 target, with the health benefits that would result from that.

There are 3.3 million vapers in the UK, but vaping does not meet the needs of all smokers looking to stop. Furthermore, because it does not closely mimic smoking, 35% of current vapers use vapes and cigarettes alongside one another, as confirmed by Action on Smoking and Health. Other products, such as “heat not burn”, heat tobacco rather than burning it, and therefore produce substantially fewer harmful and potentially harmful chemicals than cigarettes. They also mimic cigarettes much more closely than vapes, which means that smokers who switch to them are less likely to continue smoking. Importantly, studies have shown that they are less attractive than vapes to younger people who have never smoked.

I thank the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing this important debate. For seven years, I was the cabinet member on Birmingham City Council overseeing public health. Because of that, I have seen the long-term health impacts of smoking on communities across both Birmingham and the UK.

It is shocking that one of the biggest causes of death in the UK—causing around 150 cases of cancer per day—is entirely preventable. Around 6.6 million adults currently smoke in the UK. In Birmingham and Solihull, more than 10,000 people are admitted to hospital per year as a result of smoking. As a district nurse, I saw the effects that smoking can have on people both with and without existing health conditions and how difficult it can be to quit. I met patients with COPD—chronic obstructive pulmonary disease—who were using oxygen to help them to breath and who would still ask to be wheeled outside to smoke because they were so addicted to smoking.

We have a very strong pro-smoking lobby in the UK. Action on Smoking and Health reported that the tobacco industry works to undermine public health measures and is increasing its marketing plans, including to market to young people and to oppose regulation. In the face of that, young people in my constituency do not stand a chance. That is why we truly need strategies to prevent our young people from starting smoking in the first place.

I recognise that encouraging the use of e-cigarettes is a vital part of the Government’s strategy. However, it is important that we do not forget about the risk associated with them. Not enough research has been done on vaping for us to know the long-term effects, especially during pregnancy, and the impact on the lives of children who vape, which are just starting to show through. Last year, 40 children in England were admitted to hospital due to vaping-related disorders, with 15 children under 10 admitted due to the effects of vaping. We are relying on best estimates to understand the impacts of vaping. It is vital that the Government commit to proper research and enforcement, including clamping down on the sale of e-cigarettes containing harmful levels of nicotine.

I thank the hon. Members for Harrow East (Bob Blackman) and for City of Durham (Mary Kelly Foy) for securing this important debate. I am always pleased to come along and make a contribution.

Although Northern Ireland does not yet have a smoke-free target, I strongly support the Smokefree 2030 ambition. I welcomed the Minister’s announcement in April, which set out a number of bold and innovative measures. Putting in place the measures needed to make England smoke free by 2030 will enhance efforts to tackle smoking across the whole United Kingdom. Although Northern Ireland and the other devolved nations hold responsibility for their own health policies, the Government in Westminster maintain responsibility for UK-wide policies, which will impact progress in the devolved nations. I know that the Minister is always keen to respond in a positive way; perhaps he could confirm that discussions have taken place and tell us their outcome.

I particularly welcome the commitment to hold a consultation on pack inserts. All of us have probably called for that—I know I have—and I am pleased to see that it has been adopted by the Government. Cigarette pack inserts providing health information have been required in Canada since 2000, and there is substantial evidence that they are effective. Research carried out in the UK supports their use here too. I hope that the Minister will confirm when the consultation will open—that is my first question.

As the Minister knows, healthcare services are under severe pressure across the United Kingdom. Tackling smoking, which is a leading preventable cause of death and disease, killing 2,300 people in Northern Ireland each year, is vital if we are to ease that pressure. In Northern Ireland, cases of lung cancer among men are projected to increase by 74% by 2035. That is massive, but the figures are even more massive for women, for whom cases are projected to increase by 91%. Smoking is responsible for over seven in 10 cases of lung cancer. Therefore, real, targeted action needs to be taken. I am keen to get the Minister’s thoughts on that.

It is a pleasure to serve under you as Chair, Mr Sharma. I commend the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing today’s debate.

Smoking is not a lifestyle choice; it is a lethal addiction that the vast majority of smokers enter into before they reach adulthood. It is also an addiction that is increasingly concentrated among the most disadvantaged in society. The Office for National Statistics recently reported that over a third of smokers are now among the poorest 20% of the population. Lest we forget, that concentration of disadvantage is fuelled by the tobacco industry, the ability of which to maximise its profits by selling lethal and addictive products must be strictly regulated if we are to achieve our Smokefree 2030 ambition and protect the nation’s health.

My constituency, like that of my hon. Friend the Member for City of Durham, is in the north-east, which is the most disadvantaged region in the country, as well as having the lowest regional life expectancy and among the highest smoking rates. It gives me absolutely no pleasure to say that. In 2021, 22,000 adults in Gateshead smoked, which cost the NHS £7 million and local authority social care £5.4 million, as well as costing £66 million in lost productivity. Those costs are due entirely to smoking and are entirely preventable.

Tobacco addiction has been levelling down communities across the country for decades and will go on doing so until the Government start to take action to deliver on their Smokefree 2030 ambition for all in society. On average, smokers spend around £2,500 per year on smoking. That is money they can ill afford. The total spend in Gateshead is £55 million—an eye-watering amount that goes up in smoke, with no benefit to the local community. Ending smoking will significantly increase disposable income in poorer communities such as mine, help grow the local economy, and improve the health and wellbeing of our communities.