Electronic Cigarettes — [Mrs Pauline Latham in the Chair]

Backbench Business – in Westminster Hall at 1:30 pm on 29 June 2023.

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Photo of Dr Caroline Johnson Dr Caroline Johnson Conservative, Sleaford and North Hykeham 1:30, 29 June 2023

I beg to move,

That this House
has considered electronic cigarette use.

E-cigarettes were introduced as a stop-smoking device, but in my opinion they have moved from being a stop- smoking device to an alternative addiction. Indeed, they are attracting many non-smokers. In 2007, there were around 10.6 million smokers, according to official figures. The number fell to 6.6 million in 2022, so 4 million smokers had stopped. Sadly, it is estimated that around 1 million of those people died, which means that around 3 million quit smoking. That is undoubtedly a huge success, although it cannot be attributed entirely to vapes.

In the Health and Social Care Committee yesterday, we heard from the industry that it estimates that around 5 million people currently vape in the UK, which means that, even by the most generous estimates, 2 million of them were not smokers beforehand—a significant proportion of the vaping market. With the market estimated to be worth £4 billion a year, these products clearly have huge profit margins. Vapes have been available for a long time, but if they are genuinely safe, healthy devices that save lives by stopping people smoking, why does the NHS not provide any on prescription? I wonder whether it is because they are not safe and the NHS has been unable to develop the safety profile as well as it might wish.

The idea that e-cigarettes are 95% safer than smoking was quantified by Public Health England. Members will no doubt have heard the figure before, because the vaping lobby never tires of repeating it, but if we look into its origins, its veracity seems to suddenly disappear. The figure originated in a 2014 paper in a journal called European Addiction Research, but it comes with some important caveats. The study was partly funded by the Italian Anti-Smoking League, and one of its authors was a member of that organisation and served as a consultant to an e-cigarette distributor at the time. That blatant potential conflict of interest did not escape the journal’s editors, who added a warning note at the end of the paper, but it certainly escaped subsequent reporting of the figure.

The scientific journal The Lancet was even more excoriating of the original article, accusing it of having

“an almost total absence of evidence” and of being based on

“the opinions of a small groups of individuals with no prespecified expertise in tobacco control”.

Furthermore, it is worth noting that the paper is seriously outdated. Since 2014, a plethora of evidence has emerged about the negative effects of these novel and fast-evolving devices, in studies that were never considered when the figure of 95% was reached. I am concerned that the statistic will age about as well as the claims made to past generations about the health benefits of smoking.

As we delve deeper into the topic, it becomes evident that a growing body of evidence links vaping to severe complications. Chronic bronchitis, emphysema, increased blood pressure and significantly worse physical performance are just some of the adverse effects associated with vaping that scientists have found. Furthermore, the high nicotine content, which some say is roughly equivalent to between 40 and 50 cigarettes in a disposable vape, poses a grave risk to the health and wellbeing of young people. We heard yesterday in the Health and Social Care Committee from Dr Helen Stewart of the Royal College of Paediatrics and Child Health—I should declare my interest as a member of that college and a consultant paediatrician—who told us about the difficulties that children are facing. Some of them are not going to the toilet during school time because the clouds of vapour they experience there trigger their asthma and make them unwell. We heard about children collapsing, too.

The number of children vaping is increasing. The evidence submitted to the Health and Social Care Committee by the vaping industry suggests that over 83% of children have never vaped or are unaware of vaping, but that flies in the face of the experience of most of the children, teachers and doctors I have spoken to. Indeed, a report on Blackpool published by Healthwatch in May found that a staggering 31% of children and young people claim to vape or sometimes vape. More disturbingly still, when I asked Healthwatch if it could break down its figures by age, it said that one in ten 10 and 11-year-olds vapes. These are children in year 6. That rises to nearly one in five 12 to 13-year-olds, while for 16 to 17-year-olds the figure was almost one in two. We have also noticed that the number of children vaping is rising extremely quickly.

I would like share a distressing incident from my constituency. In just one school, St George’s Academy in Sleaford, there have been eight reported cases of children collapsing after vaping. Those incidents occurred at different times with different children. I was deeply troubled to hear about this, so I went to visit them and met with one of the intelligence officers from Lincolnshire police, who had collected five vapes from another school.

In just those five vapes they found Velvana Fridex Eko, a modern non-toxic coolant intended for cooling cast iron and aluminium engines, as well as Avanti coolant antifreeze, Steol-M, which is designed for filling hydraulic devices, and Rauvolfia serpentina, or Indian snakeroot. Also found was Agip antifreeze, trichloro- ethylene, and poster and watercolour varnish—1-methoxy-2-propanol—along with diethylene glycol diacetate and 2-methoxyethyl acetate, a substance that may damage fertility and unborn children and is harmful to the skin if inhaled or swallowed. They also found aviptadil, a synthetic vasoactive intestinal peptide that is used to treat certain medical conditions.

These vapes do not contain what the children think they do, and they can be very dangerous. The police found that some children had significant health issues. The eight children who collapsed in Sleaford were taken to hospital. Thankfully, they have all recovered, but in one description given to me, a child taken to hospital in the back of a car had one side of his face drooped down as if he had had a stroke. His mother was clearly terrified by this. Another young boy said that he thought he was walking along through the marketplace in Sleaford when he realised that people were gathered around someone who had collapsed. Then he realised, as if looking from above, that that person was him. We have heard some really scary stories about what has been going on.

We hear that vaping is a good route to quitting, but we should balance the fact that it may help adults to quit with the need to keep these devices away from children. One of the things that makes vapes attractive to children is how inexpensive they are. We have seen them at £4 each, three for a tenner and those sorts of prices, which is clearly within pocket money range. When children can get disposables so cheaply, they are easy to discard. If a child finds that mum or dad is coming down the corridor or up to the bedroom, they can dispose of them quite quickly. When teachers come into the toilet, they can be disposed of, including in sanitary waste bins, which poses other hazards, too.

How much nicotine is in vapes? The average disposable contains 2 ml of e-liquid at 20 mg/ml nicotine strength, which I am told is the equivalent of 40 to 50 cigarettes. The reason for that is that people only take about 10% of the nicotine from cigarettes into their lungs—the rest of the time it just goes into the air—so vapes are stronger in many cases than cigarettes.

The other issue I want to raise with the Minister today is marketing tactics. We heard yesterday from the chief executive of Totally Wicked, who I challenged on his marketing techniques. Totally Wicked sponsors Blackburn Rovers and a rugby team as well, so the stadium is called Totally Wicked. The young men on the pitch—the heroes, as he called them, who those young men and women admire so much—are running around with T-shirts emblazoned with “Totally Wicked”. He said that the young people’s ones do not have that logo on. I checked this morning and found no evidence of them selling any junior shirts, which begs the question of what happened to them all. The suspicion might be that they have disappeared off sale—we do not know.

The Online Safety Bill offers an opportunity to ensure that vapes are not advertised on platforms such as TikTok. Vapes have bright, attractive packaging, with colours and flavours such as bubble gum. Why does an adult smoker need a unicorn milkshake-flavoured vape to quit? My 12-year-old daughter is too old for unicorns, she would tell me now, so why an adult would need a unicorn, I do not know. These vapes have become fashion accessories, and are being matched to outfits. Walk into any corner shop and we can see a whole rainbow from which to choose. There are understandable concerns that some manufacturers are deliberately doing that. They would all deny it, of course, and I hope that it is not the case, but with flavours such as unicorn milkshake, bubble gum, candy floss and green Gummy Bear, it is clear that these things are far too attractive to children. I ask the Minister to consider whether, if these are truly stop-smoking devices and not lifestyle products that are attractive to children, they really need to be coloured and flavoured. I do not think they do.

The environmental impact of disposable vapes has been highlighted by a number of my colleagues in the House on a number of occasions. Some 1.3 million disposable vapes are discarded in the UK every week. The vast majority are not recycled. Their complex construction and high nicotine concentration make proper disposal challenging. They also contain lithium batteries, a precious and vital resource in our transition away from fossil fuels that is being discarded willy-nilly, sometimes into rivers and water courses. That further exacerbates the environmental consequences.

Vapes have also been known to cause fires in bins, bin lorries and recycling centres. They pose a danger. I am also advised that the plastic, because the nicotine salts leak into it, becomes hazardous waste and is non-recyclable in any case. I urge the Government to back my ten-minute rule Bill and to ban these devices. A ban has been backed by the Royal College of Paediatrics and Child Health, and by the Royal Society for the Prevention of Cruelty to Animals. It is a widely supported measure.

As well as the issue with colours and flavours, we need tougher regulations on the advertising and marketing of vaping products. Health warnings should cover 65% of the front and back of the pack, in the same way as for tobacco. Sports club sponsorships should be banned. I cannot see why these products need to be advertised on sporting shirts; there is also the worry that that will make them more attractive to children.

When the former Government brought in bans on where people could smoke and where cigarettes could be displayed, the number of smokers dropped dramatically. I appreciate that that is a nanny state measure and, as Conservatives, we are reluctant to bring in nanny state measures. Nevertheless, it did work. If we were to ask people now whether we should reverse that measure, I do not think that many, if any, would agree. I suggest that as a sensible step forward.

At the moment, we are banning sweeties at the till because we think that will help to stop people becoming obese, but I have been into shops where those sweeties have been replaced with vapes. I am sure most people would much prefer that their child had a packet of Rolos than a vape.

My third point is about regulation. The industry is actually quite positive on this issue, and is keen for regulation—at least, that is what they say. At the moment, anyone can sell a vape. When I take my son for a haircut, we could get three lemon-flavoured vapes for £1 while we are there. He is only eight, so he will not be getting any, but we could. If we go to the sweetie shops on Oxford Street, we can buy them along with the candy.

Having the same sort of regulations as for tobacco or alcohol would mean that people would have to be licensed and would be challenged to make sure that vapes did not get into the hands of children, and there would be bigger fines. I saw an example of someone being fined £200 for selling these things to children. That is clearly no disincentive. A proper regulatory framework, where people lose their ability to sell these fairly lucrative products in the event that they break the regulations, will reduce the supply to children.

I also wanted to raise taxation. I appreciate that it is not the Minister’s responsibility, but he can raise it with the Chancellor and other colleagues. This measure was supported by Action on Smoking and Health in the Health Committee yesterday. If vapes are around £4 and a packet of cigarettes is £12, we could add considerable amounts—ASH is asking for a £5 tax on every disposable vape—as a way of taking them out of the range of children’s pocket money, while making sure that they are still cheaper than a packet of cigarettes for those adults who genuinely are smokers who wish to quit. Children are very price-sensitive and we need to deter them from this harmful habit.

My final point is about education. We heard from the headteacher of St George’s Academy yesterday in the Health Committee. Children need to know about vapes, and understand that they are not lifestyle products for them to use but aids for adults to stop smoking. The relationships, sex and health education curriculum review that is being done at the moment offers Ministers an opportunity to ensure that that happens. I am interested to hear what the Minister has to say.

Photo of Craig Whittaker Craig Whittaker Assistant Whip 1:45, 29 June 2023

It is always a pleasure to speak in a debate that you chair, Mrs Latham, and today is no exception. While I do not disagree with the speech of my hon. Friend Dr Johnson, I do come at the issue from a very different angle.

Every smoker is different. The reason they smoke and the reason they struggle to quit is different, and their ultimate method of quitting is different too. In my case, after smoking for the vast majority of the last 40 years, I can honestly say that I totally enjoyed virtually every cigarette I had over those decades. Quitting was never on my agenda, despite persistent nudging from friends and family members. Imagine my horror, then, when I was presented with a device called an IQOS, just to try out. It was even presented as a bet that I would find the experience similar to smoking a cigarette, but it would be about 90% less harmful for me. Just for the record, I do not have any shares in the company, nor do I stand to make any financial gain from the device.

The IQOS uses heated tobacco. On 12 March, I smoked my last traditional cigarette, and now, after losing the bet, use heated tobacco on a daily basis. My long-standing smoker’s cough has completely disappeared, and my breathing is now far stronger—I am sure that with the loss of a few more pounds it will become even stronger still.

I support the Government in their embrace of tobacco harm reduction strategies. I urge the Minister to continue to ensure access to a full range of less harmful alternatives to smoking. As we have seen, people who want to stop smoking use a variety of methods and aids to do so, whether that is patches, pouches, hypnosis, tablets or even going cold turkey. While for me the IQOS and the heated tobacco system is perfect, many people also use vapes.

While anything is better than smoking for one’s health, there are approximately 3.3 million vapers—although I think my hon. Friend the Member for Sleaford and North Hykeham said the figure was about 5 million in the UK. The only problem with vaping—apart from all the things she brought up—is that, according to Action on Smoking and Health, 35% of vapers also smoke cigarettes. The vape is dual use: people use it in places where they cannot smoke, and they smoke in places where they can. I strongly believe from my own experience that this is because vapes do not mimic the feeling of a cigarette as heated tobacco does.

On electronic cigarettes especially, I share my hon. Friend’s concerns about youth accessing vaping products. I am pleased that there are studies that have shown that heated tobacco products are less attractive than vapes to younger people who have never smoked. Additionally, the same research into heated tobacco products shows that they pose significantly less risk to users than traditional cigarettes. By heating tobacco rather than burning it, those products produce substantially less harmful and potentially harmful chemicals than cigarettes. That makes them less harmful for users—and, of course, they have stopped my long-standing cough.

We see the impact of reduced-risk tobacco products evidenced in some of the most progressive countries in the world. For example, in Japan, the first country to launch heated tobacco products, the sale of cigarettes has fallen by an average of 9.5% annually, compared with 1.8% before the introduction of heated tobacco. As a result, the burden on its healthcare system has also eased considerably, with a statistically significant reduction in rates of chronic obstructive pulmonary disease and ischemic heart disease.

Another reduced-risk tobacco product is Snus, which is not available in the UK, but is largely responsible for Sweden’s national smoking rate of 6%. That figure puts Sweden in place to be the first country in the world to reach smoke-free status. That is a target that the UK is due to miss by 2030—although I hope the Minster will tell me different. As we work to reduce the NHS backlog, it is essential that we take a pragmatic and evidence-led approach, and note research in countries such as Japan and Sweden where harm reduction policies are having a significant impact on reducing smoking rates and, as such, there is reduced demand on their health services.

While there are further lessons we can learn from other nations, we in the UK should be proud of our role as a world leader in harm reduction. For example, the Government’s “swap to stop” scheme is the first of its kind in the world. It is essential that the UK stands up for its positive harm reduction polices at international forums, such as at the upcoming COP10 to the World Health Organisation framework convention on tobacco control in Panama in November. Now the UK has left the EU, we have the freedom to speak up and ensure that our sovereignty and our health and taxation policy formation are protected. If we do not use that opportunity in November, the WHO may seek to impede our taxation sovereignty in this area. Indeed, more widely, it threatens to stop access to heated tobacco products—that is where the self-interest comes in, of course—as it looks to get signatories to apply the same rules to heated tobacco products and other nicotine products, such as vapes, as we currently do to cigarettes, despite their less harmful nature. As such, I would be grateful if the Minister outlined what plans he has to stand up for vaping and heated tobacco at COP10 in November, and committed to opposing any recommendations that are counter to our own sovereign-established position here in the UK.

As I have said, I am grateful for the opportunity to raise my personal experience of quitting smoking through the use of reduced-risk products, and we have a positive story to tell here in the UK about our approach to harm reduction. I look forward to hearing from the Minister about his plans to protect health in the UK. It has made a huge impact on my life, even after just four short months.

Photo of Gavin Newlands Gavin Newlands Shadow SNP Spokesperson (Transport) 1:52, 29 June 2023

It is a pleasure to see the MP for the second-best Rolls-Royce site in the UK in the Chair, Mrs Latham. I congratulate Dr Johnson—if I can read my own writing, which is a first—on securing the debate. She set out the issues rather well and debunked many of the various questions—sorry, various assertions; I said I could not read my own writing—that the vaping industry likes to promulgate in the media.

The hon. Member spoke about the incidents at St George’s Academy, with eight reported cases of children collapsing after vaping. I will not try to repeat the rather horrific menu of ingredients that our children are being exposed to, but that was clearly deeply concerning. The hon. Member cited, among other things, marketing techniques. I could not agree with her more, and I will elaborate on that later. She said her 12-year-old would probably say she is too old for unicorns, but I would say you are never too old for Scotland’s national animal.

Craig Whittaker took a different tack, and I am genuinely pleased for him about his tobacco harm reduction journey. As somebody who grew up with a parent who smoked—I will not say, “in a smoke-filled house”; that would be doing my mother a disservice—I have always hated tobacco, to be perfectly honest, and the thought of heated tobacco is not something that sounds particularly nice. While largely based on the right hon. Member’s experience, his speech was a bit of an advert for heated tobacco. It may well have a place in reducing tobacco harm, but I am not sure whether it reduces the harm enough. I also disagree with his final point about the World Health Organisation recommendations to make vapes and other tobacco products as difficult to acquire as cigarettes, but I am more than happy to learn more about that.

As the hon. Member for Sleaford and North Hykeham said, the number of people using e-cigarettes in the UK has risen astronomically. It has now reached around 5 million people, which is over 8% of the population. That unprecedented increase in such a short time raises serious questions about the safety of e-cigarettes from both a public health and environmental point of view. Current evidence shows that the use of e-cigarettes is less harmful and risky than smoking tobacco, but that does not mean that e-cigarettes are not harmful; they are only the lesser of two evils.

According to a 2022 YouGov survey, the occasional and regular use of e-cigarettes among 11 to 17-year-olds has doubled since the previous year. As a father of a 13-year-old and a 16-year-old, I find that deeply concerning. The adolescent brain is particularly vulnerable to the effects of nicotine. Vaping can impact young people’s brain development, impacting their cognitive functions such as attention, memory and learning.

The same study found that 40% of those using e-cigarettes have never smoked tobacco. The WHO has also stated there is evidence to suggest that “never-smoker”—a new phrase to me—minors who use e-cigarettes are twice as likely to take up smoking later in life. That raises serious concerns, as the consumption of nicotine in children and adolescents can lead to long-term developmental consequences and potential learning and anxiety disorders.

We have said many times in this place that the scale of mental health problems, particularly among young people, was increasing significantly before the pandemic, but that increase became exponential during it. Frontline staff working with children and young people at Catch22 are concerned that vaping is a habit used to cope with those negative feelings. Running away from negative feelings and problems by using substances is a dangerous path which has led many adults to addiction and mental issues later in life. In short, vaping is a gateway to risker behaviour, problematic or dependent substance use, and mental health issues.

As we have touched on already, serious concerns have rightly been raised about the marketing of e-cigarettes. Specifically, the colourful branding and variety of flavours has been likened to that of sweets and other confectionary. Combined with content that glamorises e-cigarettes on popular social media platforms such as TikTok, those tactics can lead to misinformation about the dangers of vaping among the younger generations.

In July, an investigation by The Observer found that ElfBar, a company with no moral or social compass, was flouting rules to promote its products to young people in Britain. Items were advertised in TikTok videos by influencers, who in some cases claimed to be paid for the promotions and to benefit from free products. The videos, many of which showed influencers vaping on camera, were not age-restricted and were not always clearly marked as ads. Some attracted hundreds of thousands of views on TikTok, which is used by half of eight to 11-year-olds and three quarters of 16 to 17-year-olds. ElfBar is no longer able to sell its products domestically, with China having banned them, but it is free to export them to our young people.

E-cigarette emissions contain nicotine and other toxic substances that are harmful to users and to non-users, who are exposed to aerosols at second hand. Some products claiming to be nicotine-free have been found to contain nicotine. In addition, while cigarette smokers tend to be more discreet about blowing their smoke away from other people, in my experience many vapers have no qualms about blowing large plumes of emissions, which at times resemble small clouds, anywhere and everywhere. The result is that many of us cannot avoid walking through or breathing in their vapours.

Cheap and easy-to-use disposable vapes are booming in popularity, creating a mass waste issue. Shockingly, an estimated 13.5 million disposable vapes are bought in Scotland annually—two and a half disposable vapes per man, woman and child. Discarded vapes result in 10 tonnes of lithium being sent to landfill each year, which is equivalent to the lithium content of 1,200 electric vehicle batteries. The Scottish Environment Protection Agency has stated that when single-use batteries are disposed of incorrectly, which in most cases they are, heavy metals may leak into the ground when the battery casing corrodes. That can cause soil and water pollution, and endanger wildlife and human health. Scotland is trying to move towards a circular economy and a waste-free society, and working to support the recycling of electronic cigarettes, but any regulation to ban them must come from Westminster.

Of course the waste is a huge factor, but it pales into insignificance compared with the risk to our children and young adults that vaping poses. Despite what anyone from the industry says, the flavours, styling and advertising are quite clearly aimed at the young. My view is not only that advertising should be banned, but that disposable vapes should be banned as soon as possible. What are the Government doing to address the wide availability of disposable vapes to young people—vapes that, as we have heard, are often illegal and substantially more dangerous? More widely, what are the Government doing to tackle vaping among young people and children?

Although e-cigarettes are intended to be a healthier alternative to tobacco, recent research shows a completely different and, to be frank, fairly frightening picture. Too little is known about the long-term impact of e-cigs, and the demographic using vapes is far from what I am sure many envisaged. With statistics showing the escalation in younger generations using e-cigarettes, it is crystal clear that, beyond the point I just made about banning disposables, stricter regulations on marketing and sales are essential if we are to protect future generations. A study by Action on Smoking and Health found that corner shops were the “main source of purchase” for children and young people, so we must do more to crack down on shopkeepers who sell disposable vapes to those who are under-age.

Finally, it is critical that more research is carried out to ensure that we understand the long-term impact that vaping and exposure to high levels of nicotine has on health. We must never forget that nicotine is a highly addictive drug and can have a catastrophic impact on people’s health.

Photo of Wes Streeting Wes Streeting Shadow Secretary of State for Health and Social Care 2:02, 29 June 2023

It is a pleasure to serve under your chairmanship, Mrs Latham, and to respond to the points made in the course of this afternoon’s debate on behalf of the official Opposition. I thank Dr Johnson not just for securing the debate, but for the enormous amount of campaigning work that she is doing on this issue and for the wide-ranging and detailed scene-setting speech she gave at the beginning, which highlighted the extent of the challenge and the severity of the risk to children’s health.

Sadly, I think the hon. Lady has more work to do on her colleagues in the Government when it comes to her proposal to ban disposable vapes. The Secretary of State for Health and Social Care gave a speech this week on

“recasting prevention from a Conservative perspective”— whatever that means—in which he argued that bans are left wing and an affront to personal freedom. I look forward to finding out what that means for the Government’s drugs policy, but let me be the first to welcome the hon. Lady—our new comrade—to the left. The lyrics to “The Red Flag” are in the post.

I will address the point raised by Craig Whittaker. The central argument put forward by the vaping industry is that, at their most effective, e-cigarettes are a useful tool for driving down smoking rates. As Dr Javed Khan highlighted in his 2030 smokefree review, if we want to create a smokefree Britain, using vapes and other smoking cessation aids will be essential in reaching that ambition, but we should be under no illusion: although vapes are unquestionably less harmful than cigarettes, they are none the less harmful products.

I share the deep concerns that Members have expressed about the impact that the vaping industry is having on children, because it is not targeting children to get them off cigarettes, but to get them on nicotine. I do not care what the industry leaders told the Health and Social Care Committee yesterday; frankly, they are insulting the public’s intelligence. If someone walks down pretty much any high street in our country today, they will be able to buy brightly coloured vapes and e-liquids with names such as Vimto Breeze, Mango Ice, or indeed Unicorns. There is no doubt that these products are being designed, packaged, marketed and sold deliberately to children.

It is no wonder that there has been an explosion of under-age vaping in recent years. Action on Smoking and Health estimates that in just the last three years, under-age vaping has increased by 50%, which shows that the vast majority of kids are being exposed to e-cigarette promotions. In this debate today, we have heard about the impact of illicit goods and the harmful substances that many of these products, which are often sold to children, contain. I personally have heard horrifying stories about the extent of their promotion on popular social media platforms, where children are able to buy them with ease, although, frankly, they can also chance their arm quite successfully on our high streets.

The effects of these products should seriously trouble us all. Teachers have to monitor toilets in schools where children congregate to vape; children make up excuses to leave their classroom in order to satisfy their nicotine cravings; and children in primary school, aged nine or younger, end up in hospital because of the impact of vaping. Paediatric chest physicians report that children are being put in intensive care units for conditions such as lung bleeding, lung collapse and lungs filling up with fat. One girl who started vaping while she was at school told the BBC last week that she has:

“no control over it. I start to get shaky and it’s almost all I can think of.”

I have seen some people warning of a “moral panic” about under-age vaping, but children who are addicted to a drug are unable to focus in the classroom, and it affects their behaviour in other ways, too. We cannot sit back and allow a new generation of kids to get hooked on nicotine.

I recognise that this concern is shared by Members across the House, but I have to say that it is hard to swallow the comments of Ministers, including the Prime Minister, who try to grab headlines today by promising a crackdown on under-age vaping at some time in the future, because they had a chance to vote for such a crackdown two years ago. Labour tabled an amendment to the Health and Care Act 2022 to ban the marketing of vapes to under-18s, and it was Conservative Members who voted it down. I hope that Ministers have had a genuine change of heart, but either way there will be action on this issue after the general election. The next Labour Government will come down like a ton of bricks on companies pushing nicotine to children and we will ban the branding and advertising of vapes to children.

I want to press the Minister on the Government’s progress towards their Smokefree 2030 target, which Cancer Research UK estimates they are set to miss by nine years. That will result in thousands of additional deaths due to the health impacts of tobacco and pile more and more pressure on an already overburdened national health service. Cancer Research UK also estimates that, on current trends, smoking will cause one million cancer cases by 2040. What are the Government planning to do to get us back on track?

What has happened to the Government’s tobacco control plan, which was promised in December 2021? Prevention is better than cure, so the next Labour Government will shift the NHS from being a service focused only on treating sickness to one that prevents ill health in the first place, because that approach is better for patients and less expensive for the taxpayer. We would make all hospital trusts integrate smoking cessation interventions into routine care and we would expect every trust to have a named lead on smoking cessation. This would come alongside work with councils to improve access to e-cigarettes as a stop-smoking aid, and a clamp- down on the pervasive myths peddled by the tobacco industry that smoking reduces stress and anxiety.

That is Labour’s plan to build a healthier society; that is Labour putting the vaping industry on notice that we will not sit idly by and allow a generation of young people to become addicted to nicotine. Where is the Government’s plan?

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care 2:09, 29 June 2023

It is a pleasure to serve under your chairmanship, Mrs Latham.

I start by thanking my hon. Friend Dr Johnson, who is a former colleague in the Department for Health and Social Care. I thank her not only for this debate and her brilliant speech, which was full of interesting observations and ideas, striking and concerning anecdotes, and great wit, but for her work in really driving the debate on vaping in recent months and years. She has been a leading voice in this area. Likewise, I thank my right hon. Friend Craig Whittaker for his interesting insights.

Before I get into the main body of my speech, I will address some of the specific issues raised. My hon. Friend the Member for Sleaford and North Hykeham asked about the availability of prescription products. The reason they are not available is that the producers have not come forward with them at this stage. We remain hopeful that that will happen, but we are reliant on commercial companies wanting to do it. That is not about concerns that it is less safe than smoking; it is just about commercial partners bringing that forward for approval.

The SNP spokesperson, Gavin Newlands, pointed out that, interestingly, vaping products are not available in China, even though it exports them to the rest of the world. I do not think that that has as much to do with the Chinese Communist party’s position on public health as it does with the fact that it gets huge revenues from its ownership of the tobacco industry, which is still extremely big in China. I think it has more to do with that than with an enlightened view on the relative safety of vaping and smoking.

The Opposition spokesman, Wes Streeting, asked specifically what we are doing on smoking. Smoking rates came down from some 40% in the 1970s to 21% in 2010, and they are now at a record low of 13%. That is partly because we have doubled excise duties and brought in a minimum excise tax on the cheapest cigarettes, but it is also because we continue to take further measures, including the measures I announced recently, such as the help for a million smokers to “swap to stop”, which is an innovative, world-first policy, and our provision of health incentives to help those smoking during pregnancy to stop. We know from partners in local areas that evidence-based policy works. Much has been done and there is yet more to do in the future.

I absolutely understand the concerns, and I am just as motivated as my hon. Friend the Member for Sleaford and North Hykeham by the challenge of youth vaping. Until recently, our regulations, such as the minimum age of sale, advertising restrictions and the cap on nicotine levels, had been holding down vaping rates. However, over the last two years we have started to see a surge in the use and promotion of cheap, colourful products that do not always comply with our regulations. As hon. Members have mentioned, there has been a sharp increase in children vaping and the awareness of vaping. That is of great concern to me, for exactly the same reason that it concerns my hon. Friend.

Despite its high effectiveness as a tool to help adults quit smoking, we are absolutely aware of the risks that vapes pose to children. Vapes are not risk-free. Nicotine is highly addictive, it can be harmful and there are unanswered questions on long-term use, as raised by my hon. Friend. As Professor Chris Whitty, the chief medical officer, said:

“If you smoke, vaping is much safer;
if you don’t smoke, don’t vape”.

Last month, the Prime Minister announced several new measures to tackle youth vaping, including taking steps to close the loophole in our laws that allows the vaping industry to give out free samples of vapes to under-18s. Recent data suggests that 2% of 11 to 15-year-old ever vapers—approximately 20,000 of them—said that they were given it by a vape company, so we will stop that.

Secondly, the Prime Minister announced that we will update the health education curriculum to teach kids about the risks of vaping, as called for by my hon. Friend, just as schools do for the risks of smoking and excessive drinking. To support that, the Office for Health Improvement and Disparities is producing a new resource pack for schools on vaping for the start of the new academic year. The resources have been informed by research with teachers and young people. The activities will feature films made with young people in which they will talk in their own words about the issues around vaping, as well as a clear presentation of the latest evidence. Those resources build on other content we have already produced for young people, including on the Frank and Better Health websites, and input into educational resources produced by partners including the Personal, Social, Health and Economic Education Association.

The Prime Minister also announced that we will review the rules on selling nicotine-free vapes to under-18s, to ensure that our rules keep pace with what is happening in the industry, and review the rules on issuing fines to shops selling vapes to under-18s, to allow local trading standards to issue on-the-spot fines and fixed penalty notices more easily. That will complement existing fine and penalty procedures and cover both illegal and underage sales for vapes and tobacco. Those steps build on measures we are already undertaking.

Earlier this year, in April, I announced new measures to step up our efforts to stop kids getting hooked on vaping. First, we launched a call for evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products, and to explore where Government can go further. That explored a range of issues, several of which were touched on by my hon. Friend, including the appearance and characteristics of vapes, the marketing and promotion of vapes, and the role of social media, as touched on by the hon. Member for Paisley and Renfrewshire North. It sought to better understand the vape market, looking at issues such as the price of low-cost products, mentioned by my hon. Friend, and the environmental impact of vapes. The call for evidence closed on 6 June, and Department of Health and Social Care officials have begun to carefully examine the responses. We will be publishing our response in early autumn, identifying and outlining areas where we can go further.

I also announced in April that we are going further to enforce the existing rules on vaping. I announced a specialised illicit vaping enforcement squad, which is a dedicated team to tackle underage vape sales and the illicit products that young people have access to. That will hold companies to account and enforce our current rules. We are providing an extra £3 million to trading standards, which will help share knowledge and intelligence across the country. It will undertake test purchasing, disrupt illicit supply, including from organised crime gangs, and remove illegal products from shelves at our borders, which will tackle the horrifying issue raised by my hon. Friend about the content of some illicit vapes. There will be more testing to ensure compliance with our rules, and we will be bolstering the training capacity of trading standards too.

Companies failing to comply with the law will absolutely be held to account. In some cases, we have already got companies to withdraw products from their shelves if they have not met our rules. I am pleased to announce that National Trading Standards has begun setting up the operation, gathering intelligence, training staff and bolstering capacity to begin field work later this summer.

I absolutely appreciate the calls for single-use vapes to be banned due to their environmental impact, and also because of their appeal to young people. In 2022, about 52% of young people who vaped used disposable products, compared with just 8% in 2021. We are concerned by the increasing use of these products and their improper disposal, for the reasons my hon. Friend mentioned. We are exploring a whole range of options to address this through the youth vaping call for evidence.

This is absolutely not a reason for not doing anything, but one of the issues we will have to deal with is the nature of the industry, which is based in Shenzhen, is highly nimble and manufactures lots of different things. It will be a challenge to address issues specific to disposable vapes, because the industry will try to get around them by saying, “This is potentially refillable.” In theory, my biro is refillable, but in practice, and if it was cheap, it can simply be thrown away. Careful consideration needs to be given to the question of what is and is not disposable, if we are going to put some weight on it. I am not in any way arguing that nothing can be done, but extremely careful thought is required to ensure that the actions we take are highly effective.

All vapes, including single-use vapes, fall within the scope of the UK’s Waste Electrical and Electronic Equipment Regulations 2013, which require importers and manufacturers of vapes to finance the cost of collection and proper treatment of all equipment that is disposed of via local authority household waste sites and returned to retailers and internet sellers. From an environmental perspective, the starting point must be to assist businesses to understand their obligations and bring them into compliance. If we can achieve that, the environmental impacts can be reduced. The Department for Environment, Food and Rural Affairs will shortly be consulting on reforming the WEEE Regulations to ensure that more of this material is properly recycled.

We are committed to doing all we can to prevent children from starting vaping, and we are already taking robust action in a range of areas. We are also looking closely at how we can go further. As I mentioned, early this autumn we will publish the response to the youth vaping call for evidence and outline our next steps, and we want to move fast.

Photo of Craig Whittaker Craig Whittaker Assistant Whip

Before the Minister concludes, does he have any thoughts on the World Health Organisation forum in Panama this November and whether the UK will be subscribing to the WHO requests or pursuing our own policies as a sovereign nation?

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care

My right hon. Friend asks an important question. We will set out our position for that conference of the parties in due course. On the question of heat-not-vape products, they are, as far as one can see from the evidence, more dangerous and contain more toxic chemicals than vapes, so there is a concern about the use of those products. When I was on the Science and Technology Committee, I remember looking at all these different products and the new things on the market. There is a substantial gap in terms of safety. It may be that they are safer than smoking, but there are serious concerns about the health effects of heat-not-burn products—even more significant than those about vapes, which have been raised in this debate.

I end as I began by paying tribute to my hon. Friend the Member for Sleaford and North Hykeham for all the work she has done to drive this important debate. As constituency MPs, we all see this important and growing issue in our schools and through talking to young people. We are moving at pace and will continue to do so to address these challenges. It is important that we calibrate our approach correctly so that it is effective. We have already done a number of things, and we stand ready to do more to tackle this extremely important issue.

Photo of Dr Caroline Johnson Dr Caroline Johnson Conservative, Sleaford and North Hykeham 2:20, 29 June 2023

I thank everyone who has contributed to this debate. It was interesting to hear that my right hon. Friend Craig Whittaker has given up smoking, on which I congratulate him. I hope he will soon be able to give up heated tobacco as well; I am sure his health will benefit.

I also thank the SNP spokesperson, Gavin Newlands, and the Opposition spokesperson, Wes Streeting, for their support. I think I am correct in saying that there was support from all corners of the House for doing everything possible to ensure that children cannot get their hands on vapes.

I welcome the measures in the Minister’s speech, particularly those on education, preventing the distribution of free vapes, the introduction of the enforcement team and nicotine-free vapes. I also welcome the consultation, but we need to be quick about this because more children are vaping every day. That means that every day more children are becoming addicted and developing a nicotine habit that they will find difficult to break.

One of the challenges of quitting smoking is giving up nicotine, and giving up the nicotine in vapes is no different; in fact, it may be more difficult. I urge the Minister to look very closely at banning disposables and at marketing. He did not mention this in his speech, but I do not think that vapes should be advertised on the kits of any sports team. In shops, vapes are often positioned in the front of display cabinets where children can see them. I have seen advertisements for vapes on taxis and things like that—they should not be there.

The Minister’s review should look closely at flavours and colours, because I do not think they are necessary for stop-smoking devices. He should regulate where they can be sold and increase the penalties for those that break the rules. The Minister did not mention tax. I appreciate that that is a matter for the Treasury, but vaping companies should be taxed heavily to lift their pocket money. That is the right way to go.

As well as education, children need support. A huge number of children are already addicted to vaping products, and they need support. When they realise and are educated about the harms and wish to quit, they will need support and help to do so.

Perhaps my most important ask of the Minister is for him to look at the latest evidence. The 95% safer approach was predicated on evidence that is not terribly robust and on a study that is nearly 10 years old. It was based on an apparent absence of evidence of harm, but we are now seeing evidence of harm. I urge him to review the evidence. We are in a situation in which our headteachers are telling us that children must be able to vape so that they can discuss the flavours to fit in with their peer group, and we must get away from that. This issue is urgent and I urge the Minister to act quickly.

Question put and agreed to.


That this House
has considered electronic cigarette use.

Sitting suspended.