First, I thank the Minister for bringing forward the plan. As always, he is very active in health matters, and he certainly has a passion for this. I also thank right hon. and hon. Members who have spoken. Their information and evidence-based contributions have added greatly to the debate. Their knowledge is certainly greater than mine, but I must say that Alex Cunningham and Sir Kevin Barron have made significant contributions.
I am my party’s health spokesperson in this House, and I want to provide a bit of background about Northern Ireland. The right hon. Gentleman referred to some of the facts from Ireland, and I will look at this from a Northern Ireland perspective. We in the Democratic Unionist party set out our health policies in “Our plan for a world class health service”. When we had a functioning Assembly, that was one of the things we were very proud of; I hope we will get back to those days very soon. One of the aims was to improve the health service, and one of the pillars and listed successful health outcomes over the past few years was a decrease in smoking.
We have clearly had a policy and a strategy to address this issue. In 2012, the Northern Ireland Public Health Agency published its public health strategy “Making Life Better” for 2012 to 2023. In 2015, it published “Tobacco Control Northern Ireland”, which stated:
“Smoking has been identified as the single greatest cause of preventable illness and premature death in Northern Ireland”.
The tobacco control paper noted that in 2014, about 16% or one in six of all deaths in Northern Ireland were attributable to smoking. Over the ten years to 2015, smoking caused between 2,300 and 2,400 premature deaths per year. That indicated how important it was to reduce tobacco smoking and its take-up.
Across Northern Ireland, the standardised death rate due to smoking-related causes in the most deprived areas was 54% higher than the overall regional rate and 129% higher than the standardised death rate in the least deprived areas, and relative health inequality was getting worse. A general theme coming through from all those who have made contributions is the take-up of smoking in areas of deprivation across the whole of the United Kingdom of Great Britain and Northern Ireland. There is also a related gender gap. The standardised death rate due to smoking-related causes was highest among males in the 20% most deprived areas, more than twice that of males in the 20% least deprived areas, and almost five times that of females in the 20% least deprived areas. According to the report, smoking cost Northern Ireland some £450 million a year.
We quite clearly had a big issue that we were trying to address, and I believe the strategy implemented through “Tobacco Control Northern Ireland” was a methodology to do just that. Reducing smoking prevalence remains central to Northern Ireland’s public health policy, and we clearly support what the Minister has said, and what other Members have said, because they also recognise that. Although health is a devolved responsibility, many other areas of public policy relevant to reducing smoking prevalence remain the responsibility of the Government in Westminster, and our contribution takes that into consideration.
If I may, I want to comment on e-cigarettes. The right hon. Member for Rother Valley very clearly outlined the advantages of e-cigarettes and vaping. Some of the figures are incredibly important. Vapour particles from e-cigarettes are 73% water, which means that they quickly evaporate into the atmosphere, and the evidence of experts shows that 99% of the nicotine is retained in the vapour. It is very important to appreciate the advantages of e-cigarettes.
According to the UK national health service, there is no evidence of direct harm from passive exposure to e-cigarette vapour, and if we look outside the United Kingdom, evidence from other countries—France is one example—suggests there is no harm from passive vaping, based on current scientific knowledge, facts and figures. In 2016, the UK Government issued advice to employers to encourage workplaces to adopt pro-vaping policies so that it would be as easy and convenient as possible for workers to switch. That was on the basis that international peer-reviewed evidence indicates that the risk to the health of bystanders from exposure to e-cigarette vapour is extremely low. Again, there is an evidential base. Not so long ago I asked the Department of Health and Social Care whether it would consider introducing vaping areas in hospitals. People who are visiting hospitals go outside to smoke, and those who want to vape do not necessarily want to go to those smoking areas. I hope that the Minister will consider that idea.
In Newtownards, the major town of my Strangford constituency, a number of shops sell e-cigarettes. I suggest that those shops function because of the take-up of e-cigarettes—that is why they can pay their bills and why they exist. Very often, someone walking down the high street in Newtownards and elsewhere can see puffs of smoke. They are almost taken aback, and then they get the smell of strawberry, raspberry or cashew nuts, and realise that someone is vaping.
I want to comment on that point because it is important. Bob Blackman mentioned the US, and a survey carried out there suggested that vaping flavours may discourage smokers from returning to cigarettes. It stated:
“The results show that non-tobacco flavours, especially fruit based flavours, are being increasingly preferred to tobacco flavours by adult vapers who have completely switched from combustible cigarettes to vapour products.”
That was a survey of 20,000 adult frequent vapers in the United States, and of those 20,000, 16,000 had completely switched from smoking to vaping, and 5,000 were dual users who smoked and used vaping products—I want to add that point to the debate, because we must consider those results and look at the best ways to tackle this issue.
Hon. Members have asked how we can advance our strategy further. The Tobacco Control Northern Ireland report stated that exposure to smoking behaviour
“continues to occur in films deemed by the British Board of Film Classification as suitable for children and young people…this tobacco imagery extends beyond the film industry into mainstream television broadcasts”.
More than 60% of incidences of tobacco use occur before the 9 pm watershed, thereby providing a possible source of young people’s exposure to tobacco. A clear causal link has been established between smoking initiation among young people and smoking on screen in the entertainment media. The impact is down to the amount of smoking that young people see, not whether it is glamorised or not. The greater the exposure to smoking—however it is depicted—the greater the risk of smoking uptake, and I am sure that the Minister will come back with his thoughts about that.
Will the Minister ask his colleagues who are responsible for the regulation of film and TV in the Department for Digital, Culture, Media and Sport to work with the Department of Health and Social Care, and press Ofcom and the British Board of Film Classification to ensure that their codes effectively tackle the portrayal of smoking in films and television programmes that are likely to be seen by children?
In Northern Ireland, since
I know this point is not the Minister’s responsibility, but I would just like to put it on record. In Northern Ireland, paramilitaries are involved with illegal tobacco smuggling and cheap cigarettes flood the market. The Police Service of Northern Ireland and the customs authorities are involved in trying to address the issue, but if I may I would suggest that Her Majesty’s Revenue and Customs could be more involved across the whole of the United Kingdom.
In conclusion, will the Minister ensure that his officials and their counterparts in HMRC talk to their opposite numbers in Northern Ireland, Scotland and Wales about their experience of the retail register scheme, and the lessons to be learned from the experience of the devolved Administrations? We can live these issues collectively, bringing our knowledge from the regions we represent. Hopefully, out of that we can construct a tobacco control policy that can help us all.