Tobacco and Vapes Bill
Public Bill Committee, 1 May 2024.
Siobhain McDonagh (Labour, Mitcham and Morden)
Good morning everybody. I call the Government Whip to move an amendment to the programme order.
Examination of Witnesses
Siobhain McDonagh (Labour, Mitcham and Morden)
Q103 We now move to our first panel this morning, where we will hear from Professor Sir Chris Whitty, chief medical officer for England; Sir Francis Atherton, chief medical officer for Wales; Professor Sir Michael McBride, chief medical officer for Northern Ireland, via Zoom; and Professor Sir Gregor Ian Smith, chief medical officer for Scotland, also via Zoom. We have until 10.25 am for this panel. You can introduce yourselves, if you would like.
Siobhain McDonagh (Labour, Mitcham and Morden)
That would be great.
Siobhain McDonagh (Labour, Mitcham and Morden)
Q I think everybody would say that that was a very clear rebuttal. Would any other members of the panel like to introduce themselves before we open the floor to questions?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
We have heard compelling evidence, and we will hear again from the health sector today. Lots of people will say that the Bill could essentially just raise the age of sale from 18 to 21, but we have heard good evidence for why that is not the case. For the record, what would you say to the people who think we will not be able to do the age verification, which we know already exists in Scotland?Q
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Do you want to say anything about age verification?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q One facet of the Khan review recommendations that was touched on a little yesterday is the measures to protect pregnant women and unborn babies. What will be the impact of the Bill on pregnant women and unborn babies, and when do you think the target could be met?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Finally from me, and this question is for Frank and Michael, the latest ONS figures in 2022 show smoking prevalence in Wales and Northern Ireland remaining constant rather than continuing to fall in the way that it did in England and Scotland. Do you think Wales and Northern Ireland have specific challenges related to smoking prevalence?
Andrea Leadsom (Conservative, South Northamptonshire)
Q I thank all you chief medical officers for being here; we appreciate it. You will understand that your witness evidence is crucial to easing the passage of the Bill. I would like to get you on the record talking, first, about the start of life. The shadow Minister has just asked about pregnancy and, only this week, I was talking to a neonatal nursing lead, who said of the pregnancies of women who smoke that the children had a low birth weight and go on to have severe learning difficulties throughout their lives. That is heartbreaking, but also has significant implications for NHS and educational services, and for whole-life costs to the taxpayer. I would be grateful for your comments on that.
At the other end of the age range, elderly people who have smoked all their lives end up with decades of ill health brought on by a lifetime of smoking. I would be grateful, too, if you talked about some of the health outcomes for those who have smoked all their lives—some of the horrors of that. Sir Chris, you told me an anecdote of when you were a young vascular surgeon. For the record, it is important to talk about some of the heartbreak for those who wish they could stop smoking.
Kirsten Oswald (Scottish National Party, East Renfrewshire)
I will continue on the theme of marketing. Do you have thoughts about the measures relating to the product restriction of vapes in the Bill? Are they robust enough, in your mind, to prevent the harm that is caused by vapes, particularly to young people? I am thinking of the study that came out yesterday that, concerningly, suggested a risk to teenagers who vape of exposure to toxic metals, potentially harming their organ and brain development.Q
As a follow-on from that, I am concerned about the advertising of vape companies on sports kits, which is profoundly unhelpful. When we look at sporting figures who young people can admire, that has absolutely no place. I wonder what your views are on that.
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q Can I press you, Professor Sir Gregor, on the issue of sports marketing? Do you think it is acceptable that big football teams, for instance, are advertising vape companies on their strips?
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q Does putting it on a football shirt do that?
Rachael Maskell (Labour/Co-operative, York Central)
Thank you to all the CMOs. I would like to press that point a little further. Should the advertising of vapes be in alignment with that of tobacco products, for simplicity and understanding? Should the rules on where people can vape be in alignment with those for tobacco products, so not in indoor spaces or in cars transporting children? Are we missing an opportunity, in the light of the opening comments about the addiction to nicotine, to create a nicotine-free generation, as opposed to a tobacco-free generationQ ?
Nickie Aiken (Conservative, Cities of London and Westminster)
I want to go back to the vapes point. As we have all agreed and you have highlighted, vaping was, for all intents and purposes, a product to help people off tobacco, but it has become a product marketed in its own right. What are your personal and professional views on the Bill as it stands? It would stop people selling vapes to under-18s and stop members of the public or family members buying them on behalf of under-18s. Should we ban under-18s from using vapes full stop? Also, should we move vapes on to a prescription basis to ensure that they are aimed at people who want to give up smokingQ ?
Bob Blackman (Conservative, Harrow East)
I think the whole panel have said they are 100% behind the Bill. It is great that the whole medical fraternity is going together, but are there any tweaks that you would like to see in the Bill that could make it stronger—for example, making age verification the same in England as it is in Scotland? One of our concerns is that we have a chance to get primary legislation in only once every 10 years or so, and doing it now would be far better than waitingQ .
Bob Blackman (Conservative, Harrow East)
Q The other issue is that the medical evidence is very clear on the damage that tobacco smoking does to people’s health, but on vaping, medical evidence is emerging. Sir Chris, could you lay out your concerns about vaping, the delivery mechanism and the chemicals in vapes?
Siobhain McDonagh (Labour, Mitcham and Morden)
I inform Committee members that we have 14 minutes to go and three people who have not yet spoken and would like to. I want to bring in the Minister and the shadow Minister at the end. I notice that there is huge unanimity among our panel members. Could I also ask you to be brief and perhaps get one of your number to answer a question so that we get everybody in? Bambos Charalambous is next.
Bambos Charalambous (Independent, Enfield, Southgate)
Sir Chris, you mentioned tobacco-related diseases. I want to focus on the impact that that has on the NHS. How would the Bill help the NHS in the short term and then in the long termQ ?
Trudy Harrison (Conservative, Copeland)
Bearing in mind what the Chair just said about being brief, can the panel explain the stages of addiction—the physiological, psychological, biological impacts of addiction—and perhaps comment on the frequently heard statement that this is a free country, people should have choice and then use disciplineQ ?
Trudy Harrison (Conservative, Copeland)
Q It was more about the biological impact—how nicotine affects your body and makes it so very difficult to give up and be disciplined. It was about the biological impacts that nicotine has on the body, or the psychological impacts.
Mary Foy (Labour, City of Durham)
I thank the panellists for being here. I want to go back to clause 62 and the issue of vapes and flavouring. In the interest of brevity, would you say that if we ban all flavours there is a risk that some ex-smokers will be dissuaded from continuing to vape?Q
Mary Foy (Labour, City of Durham)
Q I have seen a product that is just a plain bottle with “vape” and a number written on it, which is exactly the same flavour as the one that is clearly marketed to children with a teddy bear on it. If we get rid of that packaging and advertising, could we still use some flavours?
Angela Richardson (Conservative, Guildford)
I have just looked online and found the top influencers on social media for vaping. I know the Government sometimes use influencers in order to change behaviour. Has the NHS been involved in paying influencers for vaping? Related to that, a lot of young people and children feel under pressure a certain way, and nicotine is known as an appetite suppressant. What message do you have for young people on that basis?Q
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q We should all be concerned about the increase in the use of vapes by young children, so it is important that the Bill will ban the sale of vapes to under-18s. It will also close the loopholes for under-16s, because we know that vapes are being marketed and given out for free. That is the issue we must address. My concern with the Office for Health Improvement and Disparities being disbanded is on public health messaging. Parents and families are really concerned that some of their children are going through a number of these vapes per day or per week, and they do not know what is a safe amount.
There is a growing illicit vape market, but how would parents know what is illicit or what the Medicines and Healthcare products Regulatory Agency has notified as being compliant? Where is the public health messaging to support schools? We heard really good evidence yesterday from the union. This is my concern: where can people access support and information? We already have a generation of kids addicted to vapes that are marketed as having 0% nicotine, but we know that there is nicotine contained in them. What would you say to that?
Andrea Leadsom (Conservative, South Northamptonshire)
Q I think we might be out of time, but I have one more question. In the passage of the Bill, there is a concern that some may wish to fix flavours on the face of the Bill, rather than allow the powers. Sir Chris, can we have a comment on the record on how damaging that would be?
Siobhain McDonagh (Labour, Mitcham and Morden)
I am afraid this brings us to the end of the time allotted for the Committee to ask questions. I thank all the witnesses, because you answered a huge number of questions and provided great information.
Siobhain McDonagh (Labour, Mitcham and Morden)
Q We have until 10.55 am for this session. Would the witnesses like to introduce themselves briefly?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q You have raised concerns about the rise in youth vaping. You have said that this needs to be nipped in the bud. Do you think the measures in the Bill will lead to decreased rates of youth vaping?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q You have mentioned the smoking cessation services we already have within the NHS, but there is no equivalent for vapes. Do you think there could be a case for these schemes to be made available for young people or pregnant women?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q There is a growing industry in illicit substances, in terms of the vapes available in the market. Is that where you are seeing some of the impact with children in terms of hospital admissions? Have you seen any adverse reactions?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Would you like to say anything about admissions of young people in relation to smoking?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you so much for being here today. As I said to the chief medical officers, you will appreciate that your words can be very helpful in smoothing the passage of this very important Bill. I would like to talk to Kate, please, about the impact of smoking on mothers who are pregnant. What is the impact on their babies, on the delivery of the baby, and on the baby’s health outcomes? If you could give us an outline, that would be very helpful.
Andrea Leadsom (Conservative, South Northamptonshire)
Q That is very harrowing to hear. Could you further expand on the impact on families of losing a baby due to stillbirth as a result of smoking? How does that impact on their mental health? As you said, parents will do everything they can to protect their baby, but the addiction to cigarettes is so strong that for many it must lead to them blaming themselves for the death of their baby.
Steve Tuckwell (Conservative, Uxbridge and South Ruislip)
Thank you for coming to address us this morning. We heard compelling insight from the chief medical officers earlier. Will you update the Committee on how you see this Bill supporting the NHS in the long term and the short termQ ?
Rachael Maskell (Labour/Co-operative, York Central)
Q As you have just set out, we understand the harmful impact of tobacco, but I want to look at vaping. Is there any evidence of the impact on individuals who vape, or of a secondary impact, such as on triggering asthma or NHS admissions, or of an impact on admissions from the contents of vapes? We often talk about vapes, which are a delivery mechanism for substances. How should we regulate so that people understand what they are vaping, not least because it is now moving to an illicit market?
Angela Richardson (Conservative, Guildford)
Q My question is for Kate. I think we all fully accept that vaping is a great smoking cessation tool. About a year ago, the NHS was helping women who smoked to transfer to vaping while they were pregnant. We know that nicotine crosses through the placental barrier, and earlier you outlined the difficulties that mothers and their children have in terms of health outcomes.
How much do we know about the difference between the impacts of smoking and vaping? Thinking of the impact of vaping on babies, is vaping still an okay thing for pregnant women to be doing? Do we need to specifically address the impacts of vaping and smoking on pregnant people in the Bill?
Angela Richardson (Conservative, Guildford)
Q Can I follow up quickly? Nicotine is having an impact on babies; we heard from teachers about nicotine having an impact on young children when they are in school. Obviously, other substances are involved in tobacco smoking. Do those other substances cross through the placental barrier, or is it just the nicotine?
Mary Glindon (Labour, North Tyneside)
We hope that this really important Bill will prevent future generations from smoking. In your professional opinion, what impact can the Bill have on that stubborn figure of 6.4 million people who currently smoke? What in the Bill can help those people? It is such a high figure; when you describe the kinds of illnesses and what happens to pregnant women who smoke, it is horrifyingQ .
Trudy Harrison (Conservative, Copeland)
Q Thank you both for powerfully and poignantly outlining the preventable impacts of smoking-related disease and illness on adults. I want to ask about pregnant women. In Cumbria, 12.3% of women at the point of giving birth say that they are smoking. Given the evidence-based proof, why is that still the case? I am left asking why we have we left it so long to have these conversations and bring the Bill forward.
I would like to understand the power of addiction to be able to make the point that this is a pro-choice Bill. It will give women more choice against that addiction that they are enduring at the most important point of their lives, when they are unable to make that choice for themselves.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
I want to ask you about vaping, particularly among children and pregnant women. First, to Kate, are you aware of any research into which chemicals from vaping may be transported from the mother’s blood through the placenta and into the baby, and whether that has any effect, or is the research too early to be able to tell us that information? For Professor Stephen Powis, could you tell me what research NHS England is supporting into the effects of vaping on childrenQ ?
Siobhain McDonagh (Labour, Mitcham and Morden)
Thank you. That is a good point at which to say that this session has ended and to thank our witnesses for all the information they have provided.
Siobhain McDonagh (Labour, Mitcham and Morden)
Q We now hear from Professor Kamila Hawthorne, chair of the council of the Royal College of General Practitioners, and Professor Steve Turner, president of the Royal College of Paediatrics and Child Health. We have until 11.25 am for this session. Before I call the first questioner, would the panel members like to introduce themselves?
Siobhain McDonagh (Labour, Mitcham and Morden)
I call Dr Caroline Johnson.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
As a declaration of interest, I am an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health.
Siobhain McDonagh (Labour, Mitcham and Morden)
Thank you. I call Preet Kaur Gill.
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q The point of this Bill is to call time on a system that privatises the profit from nicotine addiction but socialises the social costs. What is the impact that you see on your profession, which we know is already stretched on the frontline in terms of managing long-term chronic illness associated with smoking?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Do you think that the Bill goes far enough to protect young people from the harmful effects of smoking and vaping?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Finally, what are the harms of vaping to those who have never smoked?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q There seems to be an issue around what is contained in illicit vapes, which we know include things like lead, nickel and high levels of nicotine, versus other vapes that have gone through a notification process. Do you feel that the research on the impacts of illicit vapes is not there, or is it the impact of vapes that have gone through a compliant process?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you both so much for being here. As I said to the other medical professionals, your words today will be incredibly valuable in ensuring the smooth passage of the Bill. Professor Turner, could you explain to us what happens to a baby born addicted to nicotine in terms of the withdrawal symptoms and the impact on its health and development?
Andrea Leadsom (Conservative, South Northamptonshire)
Professor Hawthorne, from a GP’s perspective, could you talk us through the impact of second-hand smoking on childhood asthma and how that presents in terms of the innocence of the child and the impact of something being done to them?Q
Andrea Leadsom (Conservative, South Northamptonshire)
Q We know that it takes up to 30 quit attempts to actually give up smoking. Can both of you give us a clue as to what is it about the 30th attempt that finally gets people over the line? Specifically to Professor Turner, is it being pregnant or having a partner who is pregnant? Is that the thing that makes people finally achieve their goal?
Andrea Leadsom (Conservative, South Northamptonshire)
Q And is that related to their declining health?
Andrea Leadsom (Conservative, South Northamptonshire)
Thank you.
Andrea Leadsom (Conservative, South Northamptonshire)
Thank you very much. One last question: do you think the financial incentives for pregnant women and their partners would help?
Rachael Maskell (Labour/Co-operative, York Central)
Q We have already heard how addictive nicotine is, but do we have an understanding of the dosage of nicotine that people inhale through vaping versus through smoking? Secondly, are we missing an opportunity not to introduce a nicotine-free generation?
Rachael Maskell (Labour/Co-operative, York Central)
Q Just to come back on that, I said a nicotine-free generation.
Siobhain McDonagh (Labour, Mitcham and Morden)
I just want to advise the panel that we have about 13 or 14 minutes to go, and four Members want to ask questions, so be kind to your colleagues.
Steve Tuckwell (Conservative, Uxbridge and South Ruislip)
Q Thank you for coming along this morning. I am really interested to know whether you think there is a risk that the Bill’s restriction on vapes will lead to an increased use of illicit vapes.
Mary Foy (Labour, City of Durham)
Q This question is particularly for Professor Hawthorne. From your experience, can you tell us what impact smoking tobacco has on our most deprived communities?
Nickie Aiken (Conservative, Cities of London and Westminster)
Q Vapes—or e-cigarettes, whatever you want to call them—were introduced to help people to stop smoking. Professor Hawthorne, I would be particularly interested in your view on this, as a GP. We know that vaping has been turned into a massive industry now, but if the whole point of vapes, or e-cigarettes, is to get people to stop smoking tobacco, what is your view about vapes being prescribed?
Nickie Aiken (Conservative, Cities of London and Westminster)
Yes, rather than having them sold as they are at the moment.
Siobhain McDonagh (Labour, Mitcham and Morden)
I call Dr Caroline Johnson—you have all been so kind to one another, we are now ahead of time.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Professor Turner, Dr Helen Stewart from the Royal College of Paediatrics and Child Health gave evidence last summer to the Health and Social Care Committee, of which I am a member. She talked about some of the passive effects of vaping on children, such as in the toilets on school premises, where many children had been vaping in an enclosed environment, and children with asthma and other lung conditions were frightened to go into those toilets because their conditions were triggered by being in the presence of second-hand vaping.
Do children breathe in second-hand chemicals when they are proximal to adults vaping, or in an enclosed environment? If they do, what effect does that have on children’s lungs? Would you, or the royal college, support a ban on vaping in public places in a similar way that we currently ban smoking?
Siobhain McDonagh (Labour, Mitcham and Morden)
If there are no further questions, I thank the witnesses for their evidence. That brings the morning’s session to an end. The Committee will meet again at 2 pm this afternoon, here in the Boothroyd Room, to continue taking oral evidence.
(Afternoon)
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Before we begin, Dr Johnson wants to declare an interest.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
I am a consultant paediatrician in the NHS and a member of the Royal College of Paediatrics and Child Health, and one of the witnesses this afternoon—Mark Rowland—is known to me.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
If anyone else wants to declare an interest, please do so now.
Mary Glindon (Labour, North Tyneside)
I declare an interest as a member of the responsible vaping all-party parliamentary group.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Thank you.
Examination of Witnesses
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Q154 We will now hear from Professor Sanjay Agrawal, the Royal College of Physicians specialist adviser on tobacco, and Tim Mitchell, president of the Royal College of Surgeons We have until 2.40 pm for this panel. Would the witnesses please introduce themselves for the record?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Tim, coming to you first, from a surgeon’s perspective, why do you think that it is important to decrease the rates of smoking and vaping?Q
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Sanjay, the Royal College of Physicians has called for regulation to protect young people from vaping while still allowing smokers to use e-cigarettes to quit. Do you think that the Bill strikes the right balance in that regard?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q The Royal College of Physicians has also called for manufacturers to limit the production of toxic substances from vapes and for the Medicines and Healthcare products Regulatory Agency to be required to independently verify the contents of e-cigarettes. That is something I have taken a real interest in—you make a really good point. Whereas the notification scheme for tobacco tests products, the vaping scheme does not. Do you think we need to do more in the Bill to address that?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you both so much for being here today. As you will know, what witnesses are providing are the words and the arguments to enable the smooth passage of the Bill. Professor Agrawal, you have just said that you want this to go through smoothly, as do all of us here, so what you say is incredibly important.
As physicians and surgeons, what would you not have to do if people were not smoking? Could we say you would be writing yourselves out of a job? What are some of the things that are specifically on your day-to-day list that you think would be removed if people were not smoking?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you both. You have alluded to the fact that this is not a choice, but an addiction. Can you explain how that impacts on your patients? What do they say when you tell them, “I’m sorry, you are going to die.” How do they respond? Do they feel, “This was my choice and therefore it is great for me”?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Mr Mitchell, what do patients say to you when you tell them, “I am very sorry, but you’re going to die”?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Could I ask you both to agree that it is therefore not a matter of free choice? This is an addiction that removes people’s choice; would you both be willing to agree with that?
Kirsten Oswald (Scottish National Party, East Renfrewshire)
I know that the Royal College of Physicians has called for regulation to protect young people from vaping. I thought that what Professor Agrawal said about the importance of helping people to stop smoking was very interesting. At the same time, that balance is really important.Q
I am interested, however, in the harms of vaping to those who have never smoked, particularly young people, and the challenges we have heard about with them being advertised to in various ways, including on sports kits and in online spaces. What are your thoughts on how we best deal with that?
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q Do you have anything to add?
Nickie Aiken (Conservative, Cities of London and Westminster)
I absolutely accept what you both have said about wanting to get the Bill through as quickly as possible with no amendments. However, is there anything in the Bill that you think we have missed and that you would like, if this was possible—I am not saying it is—to add in? What have we missed, if anything?Q
Nickie Aiken (Conservative, Cities of London and Westminster)
Mr Mitchell?
Nickie Aiken (Conservative, Cities of London and Westminster)
Excellent.
Mary Glindon (Labour, North Tyneside)
Q There are still 6.4 million people who smoke. With this Bill, how do we prevent future generations from smoking and become a smoke-free country? What incentive is there in this Bill for persistent smokers to stop smoking now? Are there physical health benefits for long-term smokers to quit that could be an incentive if they have not tipped over the edge and have an incurable disease?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Professor, you talked about choice, and about business and the need to maintain profits by addicting a new generation of people to a nicotine-based product that will be hard for them to quit. That applies to vaping as much as it does to smoking, although one may be more harmful than the other. Could you talk about the effects of vaping on those who have never smoked—particularly things such as e-cigarette or vaping use-associated lung injury, and the effects of nicotine on their lungs?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Do you have any more details about the medical effects of vaping on non-smokers?
Mary Foy (Labour, City of Durham)
Good afternoon to you both. You have explained to us the horrors and the multitude of harms that tobacco smoke can have on an adult who smokes. Can you explain a bit about the effects that second-hand tobacco smoke has on children, who have even less choice in the matter?Q
Rachael Maskell (Labour/Co-operative, York Central)
Are we missing an opportunity to create a nicotine-free generation, alongside a smoke-free generation? We heard earlier that GPs were not able to prescribe vapes. Would that help your practice and help people quit, if you had those tools in your hands when seeing your patients, to encourage them to transition from smoking, which is so dangerous, to vapingQ ?
Rachael Maskell (Labour/Co-operative, York Central)
It was about a nicotine-free generation.
Rachael Maskell (Labour/Co-operative, York Central)
Q It will rise in line with the smoke-free generation. These would be people who are non-smokers, because they would be children born after 1 January 2009.
Rachael Maskell (Labour/Co-operative, York Central)
About prescribing.
Andrea Leadsom (Conservative, South Northamptonshire)
Q Further to that, I would like to probe a bit on that, because it has been put forward that some colleagues would prefer prescription-only vapes. However, from speaking to vapers myself and having done some visits to meet with enforcement officers and so on, it seems that users of vapes like the variety. They say, “I don’t want to vape tobacco flavour; I want to vape strawberry flavour.” There is another side to this argument, which is that you should keep different flavours in order to avoid people who are smokers going back to smoking because they are not getting enough choice. You just said that it would be good to have prescription-only vapes, but would that not fly in the face of how people use them? That is why that is not in the Bill at the moment. I do not want to set hares running where, in fact, the practical reason for not saying that vapes should be prescription-only is exactly that of consumer choice and trying to avoid people going back to smoking.
Andrea Leadsom (Conservative, South Northamptonshire)
Q The chief medical officer said earlier that he would encourage the vaping sector to perhaps try for registration for a particular vape for prescription. Nobody has done that as yet, because it is a complete free-for-all out there. We are all really keen to see better, safer products and help adult quitters to quit. The CMO said that they could be prescription-only for people who are both in poverty and deprivation and trying to quit smoking, but not to in effect prescribe in a Bill such as this, “You shall now have only prescription vapes.” Would you agree with the CMO?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q In order to be a prescribable drug, an e-cigarette or vape would need to go through an awful lot of testing to demonstrate its effectiveness in what it does, the safety of its components and the safety of the product as a whole. Are you aware of any vape that has gone through the safety testing to demonstrate that it is safe in that way that can currently be prescribed?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q So you think vapes are available that could be prescribable in the United Kingdom.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Why do you think that is?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
If there are no further questions, can I thank the witnesses? We will move on to the next panel.
Examination of Witness
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
We will now hear from Mark Rowland, chief executive of the Mental Health Foundation. We have until 3 pm for this panel. Would the witness please introduce himself for the record?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q In popular culture, there is this pervasive myth that smoking relieves stress and anxiety, when we all know that it does not. We know how damaging thinking like that has been. There was a school in my constituency that decided to give a young person a leaflet about how to address anxiety, which I was quite dismayed to see said, “smoke a cigarette”. Do you think that this Bill addresses those concerns?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Thank you. It is an amendment that I tabled based on the concerns raised by young people in a school near me. There is a generation of children who are addicted to nicotine, because there have been clear loopholes on marketing and giving free vapes. Do you think that there is enough support within communities to help children who are addicted to quit? Does that actually exist for young people?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Nicotine, whether by smoking or vapes.
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you so much for being here this afternoon. It is incredibly helpful. Can I ask you the chicken-and-egg question? Does smoking make you depressed, does depression cause you to smoke or is it both? I think you are possibly saying both.
Andrea Leadsom (Conservative, South Northamptonshire)
Q We have seen that the number of 11 to 17-year-olds vaping has trebled in the last three years, which is terrifying. We have also seen the mental health of young people fall off a cliff. A lot of people would argue that that is to do with social media and the act of scrolling and what that does to the brain and so on, but would you say that smoking is another factor that should be taken into the mix of what is happening to young people’s mental health, or would you say that it is not proven yet?
Andrea Leadsom (Conservative, South Northamptonshire)
Very specifically the increase in children vaping, which is nicotine as well. It is the same addiction.
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q I am interested in the exchange that has just taken place. You have said that all addiction is bad for us, which makes sense to me. We heard evidence yesterday about the impact of young people vaping in schools. Some of that impact is the disruption to education and the challenge for young people if they a need to go out of the classroom to vape because the pull of the addiction is so strong. I wonder what your thoughts are on the mental health impact of the addiction in the education setting. I would also welcome your thoughts on the connections with sports; I am particularly interested in sports organisations advertising vapes, which I think is a poor choice. I think sport should have a positive impact on the mental health of young people, but I am not sure that connects properly when these vapes are being advertised.
Lisa Cameron (Conservative, East Kilbride, Strathaven and Lesmahagow)
When I worked in mental health servicesQ , we often found that there was an association between people who were smoking cigarettes and also cannabis and having aggravated psychotic symptoms. Do you think that the measures in the Bill will help people to avoid smoking in general and therefore be less likely to move on to smoking cannabis as well and aggravating those psychotic episodes?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
If there are no further questions, can I thank the witness? We will move on to the next panel.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Q We will now hear from Dr Laura Squire, the chief healthcare quality and access officer for the Medicines and Healthcare products Regulatory Agency. We have until 3.25 pm for this session. Will the witness please introduce herself for the record?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Can you briefly describe the regulatory approach taken by the MHRA regarding vaping products? Will this Bill change anything that you currently do?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Just on that point, the notification scheme is essentially a paper-based process, so anyone sitting in Germany, say, or anywhere in the world, if they want to supply the United Kingdom, simply has to fill out a form, send you a notification form and pay the fee. No physical products are examined or tested to make sure that they are compliant with what is required before they can be sold. Do you think the MHRA should be given the powers to use the notification fee for more than just the administration of the scheme, and request some sampling and testing of products—of course, not all—before they go on the market? I say that because we have seen the evidence of the increase in illicit vapes and we have heard from trading standards as well on that volume increase.
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q In terms of your notification process as a regulator, of course there is enforcement, with trading standards removing products, but do you have the powers, and have you used your powers, to remove products from that notification process?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q It seems to me that there needs to be some sort of triangulation between trading standards’ enforcing and removing illicit products from the market and your register. Surely, given your role, you should have the powers to be able to pull that product off the register.
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q If a product is not compliant—if it is illicit, illegal and so on—does it stay on your register? What happens?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Does that mean that you communicate with every trading standards department in the country and get them to go out and remove the product? Is that how it is done?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you very much for being here this afternoon. Can you talk us through the work you do with some vape companies in order to take non-compliant vapes off the market?
Andrea Leadsom (Conservative, South Northamptonshire)
Q So you do not work directly with vape companies?
Andrea Leadsom (Conservative, South Northamptonshire)
Q I think there is still some slight confusion among colleagues about the exact relationship between the MHRA and trading standards vis-à-vis the huge rise in illicit vapes. Could you have another go at explaining it from start to finish? You get a—well, you do not get a request through if it is an illicit vape, presumably.
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you—that is clear. Can you also explain the process? You said that you published some guidance for vape companies that want to produce a prescription-only type of vape. You said that one was produced, but then was not marketed in England. Do you know why that is, and whether that might change in the future?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Would it be reasonable for those of us who are suspicious about, for example, the marketing of vapes to children to suspect that the reason we do not see vape companies coming forward to try to license a medicinal prescription vape is that the products and the manufacturing processes are not good enough, and it would be very hard to meet the bar for a medicinal product, or would that be unfair?
Rachael Maskell (Labour/Co-operative, York Central)
Q I have just one question, which is a particular concern of mine. Vapes are a delivery product for a liquid. I am concerned about the illicit market, which is now utilising vapes for Spice, cannabis and a new generation of synthetics as well. Is there work going on to produce testing kits, so that the liquid can be tested? I understand that testing kits would have to go through a regulatory process with you as well. If not, why not? Surely we need to get ahead of the curve in keeping people safe from a new generation of illicit drugs.
Rachael Maskell (Labour/Co-operative, York Central)
Q But the testing kit would have to come through you?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q I want to make sure I have it clear in my head. If someone wants to license something as a medicine or a medical product, they have to go through the more complicated, more expensive process and show you that it is safe, properly made and works as it says it will, and that the risks are outweighed by the benefits of the product. If they want to list something as a product for sale, do they just tell you that they are going to do it and you do not test any of those things?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Would they count as listed with and notified to the MHRA?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q I understand that. Do you think that it is the right authority to do that? Could it be misleading to members of the public, who see that the vaping devices they buy have been listed by the MHRA and presume, because the MHRA is the medicines and healthcare products regulatory authority, that somehow you have tested them? Might it be more practical to say that this has been notified and we call the competent authority something else, to make what you have actually done with the product more transparent to the public?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Could you clarify something else? If I were a vape manufacturer wanting to get full registration as a medical product for one of my vapes, and I did an apple flavour and a gummy bear flavour, would I have to put those products through separately because the apple flavour is a different chemical to the gummy bear flavour?
Bambos Charalambous (Independent, Enfield, Southgate)
I ask more for clarification, if a GP wanted to offer a patient a vape as a means of reducing smoking, would that have to be licensed by the MHRA as a medical device? Would it have to be licensed through your organisation?Q
Bambos Charalambous (Independent, Enfield, Southgate)
Q So they would just suggest that someone go and buy a vape in a shop to help them to reduce their smoking, rather than suggest one that had been through your rigorous process?
Bambos Charalambous (Independent, Enfield, Southgate)
Q So there is no obligation on the vape manufacturers to come to you to check the vape?
Trudy Harrison (Conservative, Copeland)
We have heard various accounts of the impacts of vapes on children and young people—that there are limited direct consequences of vaping on children and young people’s bodies, but plentiful and multiple different indirect impacts of that behaviour in schools and such like. I am starting to hear that it almost feels like an unbearable choice between whether we protect children and young people from vaping, or prevent older people from being able to stop smoking through the use of vapes. I am struggling with making that choice; I can see both sides of the argument. Do you have a view? Could you help the parliamentarians here to understand the choice we are faced with?Q
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q How many products that have gone through the notification process have been deemed illicit and have therefore been removed by trading standards?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q It is the process that we are trying to understand. You have a register and a notification process—
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
But because we are not testing a product before it comes to the market, we are allowing a lot of illicit substances to come in and flood the market. Do you think that companies submit data about their products and say, “Yes, they will meet the regulations,” so that they can get their European community identification, but then actually send to the market products that are potentially illicit and have high nicotine strengths?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Do you think those exceptions are strong enough?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Have you ever asked a Secretary of State to use powers to recall or remove products from the register?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Yes.
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Where you were given the role of being the register in the notification process, it says that the powers can sit with the Secretary of State, and I am just wondering, given that we have a growing number of illicit substances, how that information has been shared with the Secretary of State so that they can utilise those powers. I appreciate that we have in the Bill the opportunity to try to look at whether we should be testing products. I suppose my other question to you is this: what happens if, after a product has been notified, the company decides to send notifications of other products? Is it allowed to do so even though it has already supplied illicit substances?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Thank you.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
If there are no further questions, I thank our witness. We will move on to the next panel.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
We will now hear from David Lawson, director of Inter Scientific Ltd. We have until 3.45 pm for this session. Will the witness please introduce himself?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q In 2023, your company identified shops selling vapes with illegal capacities and nicotine strengths. What have you found through some of your work?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Were those vapes being marketed to children or to adults, or was it a mixture?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q In your opinion, does the Bill do enough to address the sale of vapes with illegal capacities and nicotine strengths? Will it give Government the powers they need to address future trends in this area?
Trudy Harrison (Conservative, Copeland)
Q I am the very proud mum of four daughters, aged between 21 and 25. When I think back to them as teenagers, I do not think they would have found a unicorn, a cartoon character or a bubble gum flavour particularly trendy—when they were four or five, yes—so I do not buy the idea that teenagers are attracted to such things. I worry that whatever we manage to do to avoid cartoon characters or bubble gum flavours being prevalent just will not work. For example, cigarettes are still attracting many young people, which is why the Bill is needed. I think they taste absolutely revolting, but that is not putting children off. What are your thoughts on what needs to be done to prevent teenagers from finding vapes attractive?
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q To extend that conversation a bit, the issue of youth vaping is particularly concerning to me and obviously to many others around the table. You spoke to the Committee about how easy it is to buy products that are illegal but that may look to the unexpert eye as if they are legal products—even to the shopkeepers, one presumes. That must be much more difficult for children and young people—even people who are at the lower age of legally buying vapes—so I wonder what your thoughts are on how that might be acted upon. I also wonder whether you think that vape manufacturing is likely to be impacted by the measures in the Bill.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Mr Lawson, you talked about how many of these products exceed the level, and those figures you presented were quite shocking, but how do people tell? You might think that if you went to a reputable major supermarket, the products there would be the right thing to buy, but we know that in February last year, Elf Bars were removed from Tesco, Morrisons and Sainsbury’s because their products—the Elf Bar 600s, I believe—were found to contain over 50% more than the legal limit of nicotine liquid.
I have three questions: how can a consumer tell if they are buying a legal product? How can a shop, particularly a smaller shop with fewer resources, tell that they are buying a legal product—as we have already heard, the MHRA does not actually test them? And are the penalties for getting this wrong enough?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q The final part of that question was whether you think the penalties are enough of a deterrent, and whether you think the Bill does anything that will really resolve this.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q Do you think the penalties should fall on the person who sold the good, rather than the person who produced and made the illegal product and released it for sale?
Mary Glindon (Labour, North Tyneside)
Q The UK Vaping Industry Association, which represents the vaping sector but not any of the tobacco companies that produce vapes—I note that John Dunne, the CEO, is in the Gallery today —has suggested that the Government should include a vape retailer and distributor licensing scheme in the Bill. The industry has itself developed a comprehensive framework for such a scheme, which it claims is designed to, once and for all, deal effectively with the issue of underage and illicit vaping sales. Would that be a big step forward to cut out illicit vape sales?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q You mentioned that your company is doing testing of products. One of the things that we heard just before your evidence was that what comes into the UK market obviously is not tested before it comes out, and we know that the illicit and non-compliant market is growing hugely. Can you talk us through what you do when you test your product? Where does it go?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q How are those products coming into the market?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Are they imported illegally in bulk?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q We heard yesterday that with tobacco, you have track and trace. Do you foresee that if we had a track and trace system for vapes, it should largely address some of this?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you very much for coming today. Would you support an excise duty on vapes?
Andrea Leadsom (Conservative, South Northamptonshire)
Q But in terms of behaviour, you have been talking about the targeting of children and so on, so I am asking you for your opinion. Are you also employed by the vaping industry?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Okay, but obviously an excise duty then enables more enforcement and the track and trace scheme to which the hon. Member for Birmingham, Edgbaston referred to come into play for vapes, which could then mean better knowledge of which are legal and which are illicit. Would that be true?
Mary Foy (Labour, City of Durham)
Q To follow on from Andrea, most of the experts we have heard from to date have been from the NHS or the medical profession—people with skin in the game and promoting good health and tobacco cessation. Who funds you to do your work?
Mary Foy (Labour, City of Durham)
Q So it is self-funded.
Mary Foy (Labour, City of Durham)
Q And you work with trading standards in the local authority?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
If there are no more questions, we thank you for coming. We will move on to the next panel.
Examination of Witnesses
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
We will now hear from Professor Allison Ford from the University of Stirling; Dr Rob Branston, senior lecturer at the University of Bath; and Professor Anna Gilmore, professor of public health at the University of Bath, who will talk to us via Zoom. We have until 4.25 pm for this session. Will the witnesses introduce themselves for the record?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q My question is to you, Anna. You and your colleagues have examined the ways in which what you term “unhealthy commodity industries”, such as tobacco companies, achieve their aims. Can you tell us a bit more about that, and how it relates to the measures in the Bill?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q On that, do you think that Government regulation in the Bill is sufficient, and will it improve public health?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
That is great—thank you.
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you all very much for being here today. Are any of you able to talk through the economics of the smoking industry, the vaping industry and, in particular, the illicit vaping industry? Do any of you have information on that?
Andrea Leadsom (Conservative, South Northamptonshire)
Q That is helpful. Do you have any information—a guestimate—of what the illicit vape industry is worth?
Andrea Leadsom (Conservative, South Northamptonshire)
Q We have seen youth vaping treble between the ages of 11 and 17 in just the last three years. It has already been mentioned that the vaping and tobacco industry seeks to prevaricate and keep hold of its young customers in a number of ways. Can you tell us some of the ways in which it will argue during the passage of the Bill? Do not forget that we are trying to get you on record today giving us some answers that we can then put to colleagues who challenge us because the sector has given them some lines to take. What should we be looking out for, and what should we be saying to our colleagues?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Professor Ford, do you want to add anything on what we should be looking out for?
Kirsten Oswald (Scottish National Party, East Renfrewshire)
Q I have a question for Professor Ford. Can you describe for us how the packaging of vapes attracts young people to purchase them, and how the visuals advertising vaping that young people might see on social media or sports kits, for instance, might attract them and influence their desire to purchase them?
Nickie Aiken (Conservative, Cities of London and Westminster)
Q Are they the ones that you put on your gums?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q This is very interesting evidence. I want to ask you about flavours. I note that more recently we have started to see flavours among the nicotine pouches that you have just described. I introduced a ten-minute rule Bill last year to ban disposable vapes, because I am concerned about their attractiveness to children and their environmental impact. As part of that, I met representatives of the vaping industry, who told me that the reason they have flavours is essentially to maintain an addiction.
If a person uses a standard stop smoking device, such as a nicotine patch or nicotine gum, the natural history is that they smoke, they use the said gum or patch, they wean themselves off the gum or patch, and then they are no longer a customer providing the industry with revenue. If a person uses vapes, however, they have a choice of flavours that help to maintain the addiction. One thing we have seen with the Bill, which contains powers for the Government to potentially regulate the flavours, is that people are using the argument that it will prevent smokers from stopping smoking. They are trying to argue that flavours do not attract children, but the evidence says otherwise. Do any of you have any comments on that?
Rachael Maskell (Labour/Co-operative, York Central)
Q I want to come back to the point about advertising. Should the legislation bring tobacco advertising and vaping advertising into line so that the same standards are applied across all products?
Rachael Maskell (Labour/Co-operative, York Central)
Q You have talked about alternative products. We know that the industry is very adept at switching products to avoid regulation. Should we be creating a nicotine-free generation alongside a smoke-free generation, so that people who have never smoked will also not have access to nicotine products?
Rachael Maskell (Labour/Co-operative, York Central)
Q But these people have never smoked, because, having been born from 1 January 2009, they would not have been introduced to smoking. That would be unlawful.
Mary Foy (Labour, City of Durham)
Q I think a lot of people will be quite shocked at the statistics that you have just outlined to us on the profits big tobacco is making and the shocking tactics it uses to keep users addicted, ultimately killing half the people who buy its products. I know that this is not in the Bill, but would you support a “polluter pays” levy, so that at least the tobacco industry could give something back to society for the harm it is causing at an individual level, by killing people, and at the societal level, at the expense of our NHS? Do you think that that could be added to the Bill? I do not want to put you on the spot with that question, but in principle would you support a levy on the tobacco industry?
Trudy Harrison (Conservative, Copeland)
Q Has anybody on the panel made any assessment of any kind of business association between the tobacco companies and the vaping companies, and also the ultra-processed food companies? The common denominator seems to be addiction. Is there any connection between those three industries, and perhaps even the pharmaceutical companies, which may be part of the solution for people who have become addicted to those three products?
Rachael Maskell (Labour/Co-operative, York Central)
Q I would like to ask one further question, if time will allow, about the locations where people can vape. Smoking has now been banned in indoor places, cars travelling and cars with children present. Would the same impact around deterring people from vaping occur if the same statutory requirements were put in place?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
There are no further questions. I thank the witnesses on behalf of Committee members.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Q We will now hear from Professor Ann McNeill from King’s College London and Professor Robert West from University College London. Before we begin, I thank the witnesses for their flexibility in accommodating our rearranged schedule. We have until 4.55 pm. Would the witnesses please introduce themselves for the record?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Robert, can you talk about the UCL smoking and alcohol toolkit studies’ findings on public views on smoking cessation and measures in the Bill?
Preet Kaur Gill (Labour/Co-operative, Birmingham, Edgbaston)
Q Ann, do the measures in the Bill equitably benefit all people affected by tobacco and vaping products?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you both very much for being here. As I have said to other health professionals, what you say can be incredibly helpful in allowing the Bill to pass through smoothly, because people make some very big challenges, namely that this is all just about freedom of choice, vaping is fine and there is nothing wrong with it. With that in mind, I would be grateful if you could try to ensure that you give us material with which to address some of those challenges.
Professor McNeill, we heard earlier that there is no evidence on what happens to a baby born addicted to nicotine or what the impacts are for that baby. I was advised that you might have a view on that.
Andrea Leadsom (Conservative, South Northamptonshire)
Q To push back slightly, we know that babies are born addicted to crack cocaine or heroin. Does nicotine pass through as an addiction for the newborn baby in the same way?
Andrea Leadsom (Conservative, South Northamptonshire)
Q So it is other damage from smoking that is caused to newborn babies. For the record, it is important to say, in answer to those who say smoking is about freedom of choice, that a newborn baby does not choose to be impacted, or killed indeed—stillborn. What thoughts do you have about that argument of freedom of choice versus freedom of addiction?
Andrea Leadsom (Conservative, South Northamptonshire)
Q Thank you; that is very helpful. Professor McNeill, may I ask you again about the vape flavours? The Bill takes powers to restrict packaging, location in store, and flavours. I would like to get your views on the record. Some say, “Let’s choose and put the actual flavours on the face of the Bill,” while other medics say, “No, you can’t do that, because you will never stay ahead of the vape industry.” What would your view be?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q I want to ask about this tension that you have kept coming back to throughout the past couple of days. Particularly on flavours, it is the idea that we need to help grown-ups who may have made the choice, have the conviction, and have some purpose to quit—bearing in mind that we know the average person takes 30 times in total to quit, so they are likely to relapse at some point—versus the need to prevent children from starting to vape. We know, and we have heard today and yesterday, that they are particularly vulnerable to addiction in their mid-teens, and that those who develop addiction to nicotine in their mid-teens—whether that be vaping or smoking—are highly likely to get their choice removed, because they will be unable to stop it. We also heard that some of those who vape will then go on to smoke. If the Government are to choose, and it may be that we have to make a choice in this matter, do you think it is more important to prevent relapse to smoking in adult smokers, or to protect children from starting on a lifetime of nicotine addiction?
Caroline Johnson (Conservative, Sleaford and North Hykeham)
That is what we heard from the doctors earlier.
Caroline Johnson (Conservative, Sleaford and North Hykeham)
Q I find what you say about the disposables interesting. A year ago last February I proposed a ten-minute rule Bill to ban disposable vapes to protect the environment and children, and the Government now have a statutory instrument to do just that. I heard today from representatives who have been to those meetings that the industry is already working around those many pages of regulations to find a way to create something that just sneaks in under the balance.
Trudy Harrison (Conservative, Copeland)
Q Professor West, I found your introduction on addiction absolutely fascinating. One of the things that people have said to me—I am sure it has been said to all of us here—is that could be a slippery slope, the thin end of the wedge, because there are other addictive things in society, such as alcohol, ultra-processed foods or gambling. Where do we start? What is it about tobacco products, uniquely, that gives such a compelling reason for the Bill being so necessary?
Mary Glindon (Labour, North Tyneside)
Q We know that in deprived areas there is high incidence of smoking. Professor West, you have been talking about the fact that disposable vapes becoming more readily available has perhaps made more people vape. Is that in any way linked to people in deprived areas being able to afford vaping more than they could if they have to buy a unit, vials, batteries and everything else? Although the Bill does not ban disposable vapes, how valuable and important is the economic value to people in deprived areas of being able to vape cheaply as opposed to smoking?
Lisa Cameron (Conservative, East Kilbride, Strathaven and Lesmahagow)
Q I am interested in the psychology of vaping. Do you see that as being somewhat different, particularly for younger people, from smoking? Is it seen as more fashionable because of the packaging and the social media around it, perhaps because of the flavours and so on, or is the psychology for both much the same?
Lisa Cameron (Conservative, East Kilbride, Strathaven and Lesmahagow)
Q But is it more fashionable to use vapes for young people than to smoke?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Rachel Maskell. Yours will probably be the last question.
Rachael Maskell (Labour/Co-operative, York Central)
Q I want to follow on from that theme on advertising and to take your opinion about advertising, promotion and sponsorship. We have seen the vaping industry very much following the lines of how the tobacco industry evolved in the way that it is very adept at promoting its products. Should there be a ban on advertising as there is for tobacco? First, for simplicity, so everyone knows what the rules are, and secondly, for effectiveness—that is, to discourage a new generation of vapers?
Rachael Maskell (Labour/Co-operative, York Central)
Q They are on football shirts. When we pressed a company that came to our Select Committee, they said, “This is a public health message.” They did not have “do not smoke” on the shirts, so I did not buy that, because they are trying the same tactics.
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
Mary Kelly Foy has the final question.
Mary Foy (Labour, City of Durham)
Q When I was first involved in tobacco control over a decade ago, at the advent of vapes it was said, “This is shocking. It’s awful. It will keep that normalisation of smoking, because it is that habit of putting something in your mouth and it is cool. Let’s not use vapes.” But over time I have come to learn that that habit is great for people who are trying to quit smoking, so vapes are seen as a positive tool. Has that put back the denormalisation of smoking for young people? I do not think they would go around saying “Let’s get a nicotine patch”. You have not seen any aspect of that? It has not slowed down that denormalisation?
Gordon Henderson (Conservative, Sittingbourne and Sheppey)
On behalf of the Committee, thank you. That brings us to the end of this afternoon’s sitting.