It is a pleasure to serve under your chairmanship, Ms Nokes, and I wish my hon. Friend Bob Blackman many happy returns. I declare an interest as a vice-chair of the APPG on smoking and health; I hope, therefore, that I can speak for a little more than six minutes, if that is okay.
The north-east is the most disadvantaged region in England, with high rates of smoking and all the harms that it brings. However, I am proud to say that in the last five years, the fastest declines in smoking rates have been in the north-east. Credit goes to our local authorities, which prioritised tackling smoking and banded together to fund Fresh—the longest-running and most effective regional tobacco control programme in the country. However, the north-east started with much higher smoking rates than the rest of England, so we have further to go to achieve a smokefree 2030.
More than 4,000 people died prematurely from smoking in our region last year, with 20 times as many suffering disease and disability caused by smoking, yet there is also an economic cost to our already disadvantaged communities. Smoking costs the north-east £685 million in lost productivity, £125 million to the NHS and £67 million in social care costs to local authorities. We simply cannot afford this strain on our economy.
When the smokefree 2030 goal was launched nearly three years ago, the Government acknowledged the scale of the challenge, admitting that it would be extremely challenging and promised bold action to finish the job. Since then, however, the Government have sat on their hands. Rather than stepping up their efforts to achieve the smokefree 2030 ambition, the Government have failed to announce a single new policy to that effect, while the £1 billion cut to public health funding since 2015 appears to be baked in.
The Minister knows that half the difference in life expectancy between the rich and the poor is due to differences in smoking rates. The Government’s lack of action threatens our ability to achieve not just the 2030 smokefree goal, but their levelling-up mission to narrow the gap in life expectancy between areas where it is highest and lowest by 2030 and to increase healthy life expectancy by five years by 2035.
Today’s debate was originally secured to discuss the recommendations of the independent review. The fact that the review was delayed made the debate even more necessary. The Secretary of State committed, when he announced the review in February, that it would report back in April. Javed Khan said he would report back on
We want a commitment from the Government that they will accept no further delays in bringing forward a plan to achieve a smokefree 2030. Let us start with the Green Paper that announced the Government’s goal of a smokefree 2030, which was launched with much fanfare in July 2019. Further proposals included considering the “polluter pays” levy, which my hon. Friend the Member for Harrow East mentioned, and giving the ultimatum of making smoked tobacco obsolete by 2030. Cabinet Office guidelines say that Departments should:
“Publish responses within 12 weeks of the consultation or provide an explanation why this is not possible.”
The Green Paper consultation ended in 2019. In July 2020, on the anniversary of the Green Paper, the then public health Minister, Jo Churchill, told the APPG that work was under way to publish the further proposals envisaged in the Green Paper, and that she was keen to work with us to explore whether the current regulatory framework was sufficient. Since then, we have heard nothing.
The lack of an outcome on the Green Paper was disappointing, so in November 2020, we held a debate urging the Government to commit to publishing a new and ambitious tobacco control plan. We were therefore delighted when the then Minister committed in December to publishing a new tobacco control plan in 2021. The APPG commissioned Action on Smoking and Health, working in collaboration with SPECTRUM, the academic public health research consortium, to provide us with a report setting out our recommendations and the measures that the Government needed to take to achieve their 2030 ambition. The then Minister attended the launch of our report, welcomed our recommendations and committed to publishing the plan by the end of 2021. We are understandably disappointed by the delay in its publication.
There were other opportunities that could have been seized but were not. The Government were legally required to review the impact of existing tobacco product regulations, including those on standardised packaging, health warnings, product standards and e-cigarette regulations. The regulations set out in law a deadline for the review to report by May 2021. To that end, the Government launched a consultation last January to assess whether the objectives were still appropriate and whether the regulations were fit for purpose. Those regulations predated the Government’s commitment to a smokefree 2030, and it was blindingly obvious that they needed to be strengthened to match the scale of the Government’s new goal.
Since the regulations came into force, it has been clear that there are serious loopholes. The menthol ban relies on subjective rather than objective measurements to determine whether the regulations are being adhered to. An investigation by the Express newspaper revealed that the industry has exploited that loophole in the law and that Britain’s biggest tobacco giant sold £1 billion-worth of cigarettes flavoured with menthol in the year after the ban came into force.
That was not the only loophole; although e-cigarettes can be sold to those aged 18 and above, it is completely legal to hand them out free to children. While the advertising, promotion and sponsorship of e-cigarettes are heavily regulated, packaging and labelling are not. That has allowed the use of sweet names for vaping products, with cartoon characters and garish colouring, all of which appeal to children. Those are clear gaps in the law that need to be fixed without further delay.
The consultation was well timed to feed into the Health and Care Bill. ASH and SPECTRUM provided the Government with detailed and well-evidenced proposals for a number of improvements that would strengthen regulations and fix those loopholes. When the outcome of the review was not published in May 2021, as was required, we hoped that the Health and Care Bill would contain the further proposals the Government had promised to bring forward. Imagine our disappointment when the Bill was introduced to Parliament last July. Although it included measures on prevention and public health, there was nothing on tobacco or smoking, despite the Government’s much-trumpeted smokefree 2030 ambition.
That is why, in Committee, I tabled a set of amendments for increased regulation on tobacco, based on the APPG’s recommendations. The amendments included requirements to consult on a “polluter pays” levy; introduce pack inserts containing quit information; put warnings on cigarettes; close loopholes in the existing regulations on menthol and e-cigarettes; and consult on raising the age of sale to 21—a measure that has been proven to reduce smoking rates in the population at large by 30%. That measure has also been shown to reduce inequalities, because it has the greatest impact on the poorest and most disadvantaged communities. Throughout the passage of the Bill, Ministers in both Houses have repeatedly said that the Government were sympathetic to our aims and amendments, and that they would be considered for the next tobacco control plan. However, the tobacco control plan has already been delayed by a year and still does not have a publication date.
If the Government had supported those amendments, we would now have the foundation in place for a comprehensive strategy to end smoking by 2030. Instead, the Government have chosen to reject the amendments and, yet again, to kick tobacco control into the long grass. Now we are waiting for the tobacco control plan. Before the plan can be published, we have to wait for Javed Khan’s independent review, which will be followed by a public health disparities White Paper in the spring, which will in turn be followed by the tobacco control plan. That will leave only seven years to deliver the smokefree 2030 goal.
Since evidence first emerged of the harms caused by tobacco in the 1950s, smoking has killed more than 10 million people in the UK, and it continues to kill hundreds more every day. Up to two thirds of those smokers die prematurely from their addiction. There is a crucial message around children: every day, 280 children start smoking—that is more than 280,000 since the smokefree 2030 ambition was launched. Smoking is highly addictive; two thirds will go on to become daily smokers. With that in mind, can the Minister assure us that the tobacco control plan to deliver the smokefree 2030 ambition will be published no later than three months after the independent review? Will she also assure us that the Queen’s Speech will include a commitment to bring forward legislation in the next Session to deliver regulatory measures essential to delivering the Government’s ultimatum to the industry to make smoked tobacco obsolete by 2030?
I end with a comment from the chief medical officer. He pointed out that one in five people who die from cancer will die from lung cancer, and went on,
“the reason that people like me get very concerned and upset about it is that this cancer is almost entirely caused for profit…a small number of companies make profits from the people who they have addicted in young ages and then keep addicted to something which they know will kill them.”