Parliament: 7th Report of the Science and Technology Committee and the Government Response
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Parliament: 7th Report of the Science and Technology Committee and the Government Response

November 22, 2019

thank you Sir Henry can I stay right
at the very start it is a pleasure to serve under your chairmanship for the very
first time in my last appearance in this particular room and as my next-door
neighbour for the last 18 years it’s been a pleasure and I’m pleased to move the
motion I beg to move that this house has considered the seventh report of
session 2017 to 19 of the Science and Technology Committee on e-cigarettes and
the government’s response now I’m pleased to have secured this debate to discuss
this really important work undertaken by my committee before this Parliament
draws to a close and it’s great that we’ve been able to hold this debate in the month of “Stoptober” which is the big anti-smoking initiative
which is I think being a successful initiative and which I remember
launching in my time as a minister back in the day now in England statistics
released by the Office of National Statistics showed that in 2018 fourteen
point four percent of adults smoked and that in itself is a very significant
achievement and advance in reducing the prevalence rate of smoking in our
country ONS figures from 2011 onwards showed
that smoking rates in England have fallen every year since then it is
important to make one exception which I will come back to and that is mental
health something that I care a lot about but we know that people with severe
and enduring mental ill-health tend to die much younger than other people and
it can be as much as 20 years earlier than others and one of the key reasons
for that is the prevalence rate of smoking which is around 40% so whereas
we’ve been very successful in reducing smoking rates in the population as a
whole we have not been successful in terms of those with mental
ill health and I will return to that and in Great Britain in 2018 there were
approximately 3.2 million vapors 6.3 percent of the population and this in
itself marks a significant increase in the number of vapors which in 2014 was
three point seven percent so significant increase over the last four years but
why does this matter now the Tobacco Control Plan stated
that and I quote tobacco is the deadliest commercial available product
commercially available product in England it’s really important to hold on
to those words the deadliest commercially available product in
England that’s from the government with tobacco regulation serving to safeguard
people particularly children and young people from the avoidable premature
death and disease tobacco use causes indeed in the recent
prevention green paper clearly clearly articulated some people are
disproportionately more likely to smoke smokers are disproportionately located
in areas of high deprivation something I think we should all be deeply
uncomfortable with in Blackpool one in four pregnant women smoke in Westminster
it’s one in 50 what an extraordinary contrast that deprivation is causing and
that causing that significant risk to mother’s health and to her baby’s health
and according to Public Health England and I quote vaping is at least 95
percent less harmful than smoking close quote this does not mean this does not
mean that vaping is safe and it certainly does not mean that we should
be encouraging non-smokers to start vaping but compared to smoking vaping on
all of the evidence we have so far is considerably less harmful (I will) I’m grateful to the chair of the Science and
Technology Committee and I’d like to put on record my thanks for his tireless
chairing it has been an interesting period where we’ve got into great detail
and I think effectively on many subjects but he mentioned NHS England and I was
annoyed that NHS England who have the time to put out quite often crass and
obvious statements on health did not have the time to come and give us their
advice on e-cigarettes which is as the Honorable Gentleman is saying is one
of the ways of getting people to stop smoking well I thank my honourable
friend I will say because I’m demob happy and I don’t care about the rules first of all it’s been a great pleasure to work on the committee with him but I also share
his concern there given that the government’s own control plan tobacco
control plan describes it as the deadliest commercially available product
in England one would have hoped that the body that runs the NHS in England would show
a very clear and strong commitment to confronting that potential
or that clear risk but despite the fact that it is very clear on all of the
evidence available that vaping is very significantly less harmful than smoking
I nonetheless absolutely encourage research to continue in this area
because we should always be alert to anything that indicates a potential risk
and that’s exactly what our committee incidentally recommended now
e-cigarettes are not only less harmful but they appear to be an effective stop
smoking tool as the Honorable member made clear a study published earlier
this year in the New England Journal of Medicine randomly assigned adults
attending UK National Health Service stop smoking services to either
nicotine replacement products of their choice including product combinations
provided for up to three months or an e-cigarette starter pack that study of
886 participants found that the one year abstinence rate was 18 percent in the
e-cigarette group compared with nine point nine percent in the nicotine
replacement group that is a really significant difference and we need to
make sure that we act upon that difference now we have the knowledge of
its effectiveness as a stop smoking tool – now results from a 2019 survey carried
out by YouGov for action on smoking and health
known as ASH found that and I quote the three main reasons for vaping remain as
an aid to quitting 22 percent preventing relapse 16 percent and to save money
because people who vape spend much less money than people who smoke 14 percent
demonstrating that users perceive e-cigarettes as a stop smoking tool therefore
e-cigarettes are likely to be helping the government to meet its ambition
announced in the government’s prevention green paper for England to be smoke-free
by 2030 nonetheless I accept as I’ve already said that further research is
needed on the effectiveness of e-cigarettes as a stop smoking tool
so I’d like to ask the minister will the government or one of its agencies
request further independent research on the effectiveness of e-cigarettes as a
stop smoking tool now an issue we highlighted in our report was smoking
cessation in the NHS recent research from Cancer Research UK has highlighted
that primary care clinicians face barriers in discussing e-cigarettes with
patients who smoke one in three clinicians this is extraordinary I find
I have to say Sir Henry one in three clinicians are unsure if e-cigarettes are safe enough to recommend now given the death toll from smoking
it’s extraordinary that it appears as if clinicians are unaware
of the clear advice from public health England in that regard to (I will) I’m very grateful to the honourable gentleman for giving way I agree with everything he said actually in his speech
thus far would he agree with me that one of the ways that the government can
reach its ambitious target that’s been alluded to by the right honourable gentleman is by
actually embracing vaping by getting more information out there to the
clinicians that he’s spoken about and working through the law particularly
post brexit to ensure that people who want to give up smoking have full
information they require in order to take up vaping instead well I thank the honourable
member for the intervention and I totally agree with the point he makes
these statistics that I’m quoting make the point that raising awareness even
amongst clinicians we thought it was just the general public who needed to
understand better the relative risk but clearly clinicians also need to
understand the relative risks so that they can advise their patients more
effectively two in five feel uncomfortable recommending e-cigarettes
to their patients who smoke again an extraordinary finding fewer than three
in ten agreed that their current knowledge is enough for advising
patients about e-cigarettes extraordinary data there and recognizing
I think a clear need for the raising awareness that the Honourable
member mentions so what assessment has the minister made of the number of
smoking cessation services in the NHS that are actively promoting e-cigarettes
as alternatives to conventional cigarettes it ought to be every single
one across the country but are they actually doing it do we know secondly
can the minister tell us what work they are doing with NHS England on increasing
knowledge amongst clinicians of the uses benefits and risks of e-cigarettes for
current smokers now we recommended in our report that NHS England should
create a post for someone who is responsible for implementing the
government’s tobacco control plan while the government said in its response that
it broadly accepts this recommendation no specific steps to implement our
recommendation were set out we pursued this with NHS England who told me in
January that and I quote it is our intention to appoint an individual with
lead responsibility for this role this will be an important part of our
delivery program for the NHS long-term plan close quote
now we would all assume that that person has been appointed a long time ago and
that there is active work now underway to pursue this vital agenda which will
save lives but I would like the minister to confirm
that NHS england has created this post and if they have is someone
actually in post doing the job and in the government’s long-term plan provision
was made for and I quote all smokers who are admitted to hospital being offered
support to stop smoking close quote this is not due to be fully
implemented until 2023/24 again given the extraordinary health benefits of
stopping people smoking I would have hoped for a tighter timescale than
23/24 to implement that but can the minister tell us how implementation of this
proposal is going and whether consideration is being given to fully
implementing this before 2023/24 now we also recommended in our report that
the NHS should have a clear policy on e-cigarettes in mental health facilities
which establishes a default of allowing e-cigarette use by patients now this
comes back to my point that 40% of those with severe and enduring mental
ill-health approximately still smoke and so the attitude and culture within
mental health trusts is critically important if we’re to enable people with
severe and enduring mental ill-health to help them give up smoking so we said that this should be the
default that e-cigarettes should be made available in mental health facilities
unless there are clear evidence-based reasons for not doing so in its response
the government said that I quote NHS England will provide guidance to mental
health trusts that sets out that existing vapers should be permitted to
use e-cigarettes as part of smoking cessation programs and tobacco smokers
should be supported and I quote to stop smoking through smoking cessation
programs so can the minister tell us has this guidance been issued I very much
hope it has if not when will it be issued and what’s the reason for the
delay in issuing such important guidance and if yes what assessment has been made
of how it is working now Sir Henry the UK is making good progress in getting
people to stop smoking and use e-cigarettes to achieve this but this is
currently at risk from recent concerns about e-cigarette use particularly in
other countries we’ve put these concerns to public health England now to
summarize first of all the claim deaths in the US have been linked to the
use of e-cigarettes and vaping products now the reality is that the US
operates first of all in a totally different regulatory context and that I
quote illicit products were implicated in this outbreak including vaping
cannabis derivatives this is from NH from public health England public health
England has also explained that the suddenness of the outbreak across many
USA states in just a few months suggests that this is not a gradual effect of
long term use but because of a specific agent coming into use in the affected
population close quote next concerns have been
expressed that flavored e-cigarettes are luring children into vaping now public
health England’s response explained that data that they had so far was reassuring
that e-cigarettes were not renormalizing smoking further that the UK and the US
have different rules on first of all advertising on nicotine concentration
and on education on vaping which explains why flavors in e-cigarettes are less impactful in the UK compared to
the United States next the introduction of a ban in India on the production
import and sale of e-cigarettes due to concerns about the risks they pose to
health and the young this was an assertion that has been made which again
is at risk of infecting the debate that we have in this country but public
health England explained that and I quote India is one of several countries
that appears to be responding to the outbreak of lung disease amongst
cannabis vapors by proposing a ban on nicotine inhalers and explained that
smoking is far more prevalent in India and causes 7 million
deaths a year in India yes I give way I’m grateful to the honourable member for giving way isn’t it true that India have a massive vested public interest in the tobacco industry well I suspect that the Honorable member
knows better than I do but I note the point that he makes
but it’s my view based on the evidence that we heard as a committee that the
action taken by India is not based on evidence and it’s likely to result in
more people dying of lung cancer and I think that that’s rather shameful now I
would encourage all honorable and right honourable members to read the helpful
and comprehensive reply we received from public health England which we’ve
published on these issues and others so that anyone can delve into the
detail now I’m reassured that public health England is in close dialog with a
range of international partners and I agree with public health England that
and I quote it is no exaggeration to say that inflating fears about e-cigarettes
could cost lives I also incidentally have concerns about the attitude at the
World Health Organization which doesn’t take the same evidence-based approach as
far as I can see as this country has done which again has implications for
the potential loss of life of millions of people across the globe and it seems
to me that people often conflate the fact that we don’t have all of the
long-term evidence of vaping impact with an assertion that that should
lead us to conclude that we shouldn’t be recommending vaping as an alternative to
smoking but frankly that is stupid as a public policy approach because we know
that smoking is killing I think over 70,000 people in England every year and
all of the evidence so far shows that nothing like that
is happening with vaping and according to public health England that it’s 95
percent less dangerous than smoking so the clear public health advice has to be
that vaping is an appropriate way to help people to give up smoking of course
the best of all is to not vape and not smoke but if that’s not possible for
someone the clear public health advice needs to be that vaping is better than
smoking can the minister set out what contact the government or other
ministers have had with other countries on international approaches to
e-cigarettes what are they doing in particular at the World Health
Organization to encourage a more enlightened approach what assessment has
the government made on the effects of these international approaches on public
perception in the UK of e-cigarettes what steps will the minister take to
ensure that this misinformation on e-cigarettes is challenged now in
conclusion Sir Henry e-cigarettes (oh happy to give way) I’m grateful to my honourable friend it’s not just the World Health
Organization that is not using evidence for it’s advice it’s also the
EU their directive both on the size of the bowls used and the amount of
substance put in there is not based on evidence and is likely to mean that
those people who are getting a nicotine kick much less dangerous than cigarettes
don’t find the products satisfactory and will go back to smoking
well I thank my honourable friend for that intervention again and I think I have exactly the same concern as
he does about the directive and the prescriptive rules relating to vaping
which don’t appear to me to be sufficiently evidence based e-cigarettes
are positive in helping current smokers to stop smoking and they are
significantly less harmful than smoking conventional cigarettes yes there are
unknowns about long term risks and we need to maintain research on
e-cigarettes but doing nothing is not an option
when people’s well-being and lives are at risk and I really look forward to the
contribution of other honorable and right honourable members and to the
minister’s reply thank you very much indeed thank you very much indeed the question is this house
has considered the seventh report of the Science and Technology Committee
e-cigarettes House of Commons 505 2017/18 and the government’s response command paper
9738 2017/19 and I now call Bill Grant
thank you very much Sir Henry it’s a pleasure to serve under your chairmanship this very afternoon and I would like to congratulate my right honourable friend the member for North Norfolk in securing this important debate
e-cigarette use in the UK has followed a gently rising trend over
the last few years and last year ONS statistics showed 6.3 percent of those over
16 were indeed regular users a rise of less than 1% over five years in our
August report in 2018 the committee concluded
that e-cigarettes should not be viewed in the same way as conventional
cigarettes they are an effective stop smoking aid and should be formally
considered as such and its response to the letter sent on behalf of the
committee by the chair public health England confirmed they believed as the
committee did that e-cigarettes are around 95% less
harmful than conventional smoking as our committee found and I quote a medically
licensed e-cigarette could assist smoking cessation efforts by making it easier
for medical professionals to discuss and recommend them as a stop smoking
treatment for their patients existing smokers would be encouraged to give up
but if that is not possible you should switch to e-cigarettes as a
considerably less harmful alternative we must acknowledge that there are
uncertainties about longer term health effects of e-cigarettes e-cigarettes
have not been in circulation for long enough for any scientific research to be
certain and that there also has been concerns raised in the United States as
was said earlier about an isolated outbreak of serious lung injury linked
to illicit vaping products but I suspect as my honourable friend said there may be
other factors at play in those instances however we have not seen this
replicated in the United Kingdom largely I believe because as Action on
Smoking & Health confirms we have a strong regulatory system which is not yet the
case in the United States the government mandates strict conditions namely a
minimum age of sale a ban on advertising in broadcast media
print or internet and a stipulation that products containing over twenty
milligrams per milliliter of nicotine need a medicinal licensed products must
also be child resistant and tamper evident and packs must carry a health warning
covering I believe up to or over 30% of the surface area moreover to be balanced any judgment on the future of e-cigarettes must take account of human nature and the most likely alternative to vaping namely
returning to conventional or harmful conventional cigarettes which we know
have proven and serious serious health risks over time while some groups who
prefer the firmest possible line Cancer Research UK
for instance is pressing for a tobacco-free
UK within the decade most groups agree that e-cigarette can provide a useful
route towards quitting the harmful conventional cigarettes we have seen
clear evidence that e-cigarettes are an effective quitting aid for adult smokers
and crucially the percentage of young smokers trying e-cigarettes in Britain is
indeed small with continued use smaller still so they flirt with e-cigarettes
but fail to continue on with it there is little evidence to suggest such
products act as a gateway to conventional smoking in other words the e-cigarette
is not as some would suggest a stepping-stone to conventional smoking
far from it and figures show that almost 3 million people in the UK today are
using e-cigarettes as an aid to quitting conventional and harmful cigarettes
unfortunately the committee found that some aspects of the regulatory system for
e-cigarettes are holding back their use as a stop smoking measure
restrictions on the strength of refills and maximum tank size have led some users
to move away from e-cigarettes and return sadly and most regrettably to
conventional smoking there seems to be little scientific basis for these limits
and I’m pleased that the government in response to the report
intends to consider these anomalies and how best to address them it is good see
that the government also agrees with our conclusion and I quote there should be a
shift to a more risk appropriate regulatory environment where regulations
advertising rules and tax duties reflect the evidence of the relative harms of
the various e-cigarettes and tobacco products available such a move might well
bring about the welcome improvements in health that we as a society so
desperately seek particularly from lung cancers and other aspects or byproducts
if you like of unintended consequences of smoking that’s proven
beyond belief smoking or conventional smoking is harmful I would look forward
to seeing some of these changes implemented and if I might take this opportunity to speak to directly to conventional smokers and
despite being a fire officer for 31 years sadly I was a 50 a day smoker for many years though long
since stopped and believe me being a smoker was costly
smelly and unhealthy mistake in my life and I only realized this afterwards and
yes like the smoker today I enjoyed them then as you do know and even in my
time in the fire service when you left the fire with your breathing apparatus on and you pulled the face mask on some kindly colleague would
have a pre-lit cigarette for you if that was madness well it was certainly
madness at the time and I indulged in it it’s not easy to smoke but anything
that this good is not always easy believe me it can be done so my plea to
those who do smoke you can stop if you put your mind to it and it is absolutely worthwhile Can I just say that he kept that information very quiet on the committee thank you for that intervention it’s
neither something to be proud or ashamed of it was a culture of it’s time I was
part of that culture and I am delighted at two things in life I’ve never
regretted doing was marrying my wife Agnes and given up smoking so equally wonderful
in closing I’ve had the pleasure to serve on the Science and
Technology Committee since shortly after selected to this House and it has been the most fascinating and inspiring journey and I’m incredibly proud of the work we have undertaken as a committee ably assisted by a very fine
Secretariat and I wish to put on record my thanks to them for their
support indeed as my right honourable friend the member for North Norfolk and I
both intend to retire at the forthcoming election this will be our last our final debate together and I wish to thank him for his fine stewardship over the two years thank you very much Sir Henry Kevin Barron Thank you Sir Henry I’m really happy
to be here this afternoon and give you my last speech in Westminster Hall as
well I’ve been looking forward to it for quite a considerable length of time sime
something happened in 2016 which I don’t want to mention but nonetheless I’d just
like to say first of all that I’ve been quite active in
smoking cessation over many years in this Parliament that this is a good
report well sourced and well evidenced about where we should be moving in the
future now to reduce and protect our fellow citizens could I admit two things
one it’s a little confessional over forty years ago since I stopped but I
used to smoke cigarettes as well I was quite addicted to it the other
confessions I ought to say although there’s no money in this that I’m an honourary
fellow of the Royal College of Physicians so I just want to mention
that what the report says is quite clear that the e-cigarettes have proven
to be a unique opportunity to increase the decline of smoking rates in this
country and in comparison to conventional tobacco cigarettes
e-cigarettes lack the dangerous tar and carbon monoxide components subsequently
e-cigarettes are as public health England say 95 percent safer than smoking
cigarettes and it should also be noted that e-cigarettes secondhand vapor is
substantially less dangerous than in tobacco cigarettes as well and e-cigarettes do as I think we all know now could and currently do operate as a
pathway from conventional smoking to quitting smoking altogether and at
present there’s somewhere in the region of 2.9 million Britons use e-cigarettes as
a pathway towards quitting with tens of thousands successfully stopping each
year I think we were all surprised not in the current tobacco plan but the one
before that we went well below the target that was set for adult smoking to
be below 16 percent now which is an extraordinary thing sadly it wasn’t a
part because e cigarettes were put into smoking cessation programs but my view is
that should be the future but it was because millions of our fellow citizens
were buying these products themselves and going down that road as well and
that is no mean feat to get to adult smoking to below 16 percent in
this country that said I think it is worth mentioning as well there’s still
over 80 thousand of our fellow citizens die premature deaths each year from
using tobacco and we should never forget those types of statistics anything else
that was taking lives in this country at that level on an annual basis we
would be up in arms about them if anything at all
this house would have been operating more than it has done in the past in trying to
stop that the brief for this report from Cancer UK recommends that e-cigarettes
are utilized as a tool to aid smokers who wish to quit to achieve their goal and
as it rightly points out in the chairman said so as well that unfortunately the
surveys have shown that 40% of clinicians are uncomfortable
recommending e-cigarettes to their patients with a further third being
unsure if they’re safe to recommend in the first place notwithstanding what public
health England says about these products moreover just 30 percent feel that their
knowledge is sufficient enough to advise patients on vaping health care
professionals must be made aware of the benefits of e-cigarettes in aiding
people to quit and the reality is that vaping whilst not being completely
risk-free is significantly safer than smoking conventional cigarettes and they
do want to say that health care professionals must be made fully aware
of this to ensure that their patients have the strongest chance of quitting
smoking now it is very difficult it’s not going to be necessarily something
that hopefully new doctors or doctors in training will be looking at
things like this but I say to this if any health professionals are either
in this room or any health professionals read this debate they could do worse
certainly a GP a general practitioner could do worse than just go round to the
local vaping shops on the high street and go in and talk to the people who
use who sell the products in there and ask them they trace their patients they
know their patients it might have been on 50 cigarettes a day and they down to
none they know their patients that were on higher hits of nicotine in the
product and it’s lower and lower now I know people will still vape but there’s
no nicotine in the product at all so they’re not satisfying an addiction
anymore but what they are is just a habit and using hands etc and that’s
what we ought to be doing and it’s quite true to say that there’s no
long-term evidence as it wasn’t when they first had a heart transplant
in South Africa but it’s pretty clear that
is evidence out there in our communities and what we need to be doing is getting
the health professionals to go and talk to these people who have been dealing with
probably their patients as well over a length of time naturally many people
have raised deep concerns over whether vaping can operate as a gateway
into the smoking of conventional tobacco cigarettes but there is no evidence that
that is taking place at the moment it suggests that this phenomenon hasn’t
materialized in any meaningful demonstrative way and I’ve been very
active with Action on Smoking & Health over decades now in this country and
they are watching this on an annual basis about what’s happening particularly
around young children as well there’s no evidence that this form of
addiction is actually bringing people into nicotine addiction and passing
them further on to cigarettes themselves and I have to say that some
of the evidence we’ve had about vaping in America some of this
stuff is Class A drugs that they’re putting into these things this is why we’re
having deaths it is true to say and I know this from going to America from
time to time I’ve got two step-grandchildren out there about going from
America time to time one of the companies who shall be nameless for this
debate have been promoting vaping to young children
flavors and everything else like that not necessarily nicotine addiction
they’ll be promoting it to young children you talk to the schools about
that they’re up in arms about the nuisance and the litter that these
things take place so there is something but we shouldn’t be too scared of it I
just want to finish really on two more things now although there are
advertising restrictions and regulations on vaping they are less stringent than
that apply to tobacco products and that is true earlier this year the House of
Commons library published a briefing paper in June an advertising paper on
e-cigarettes it’s well worth reading that to find out I first started on anti
tobacco in the 93/94 session when I ran a private member’s bill to ban tobacco
advertising and promotion and we’ve moved on in a long way down the
road from that now but there are still lessons to be learned from that paper in
relation to how these products are advertised and as the committee said they
recommended that cigarette packet inserts could be utilized to refer
smokers to e-cigarettes as a healthier alternative and unfortunately at the moment Minister the present standardized packaging of tobacco products
regulations bans actually this happening and I think that we need to have some
quick thoughts about this these are the people who are addicted to cigarettes who are
going into shops who are buying these cigarettes in there and they’re the
people that we should be targeting and I know we can do it on websites and things
like that it should be targeted to these people who are going in there and I think
that we could change that I can’t because I’m off but we could change that
regulation in this country in super quick time so that we’re in a position
to get to these people who are still addicted and I just want to finish on
this it has been mentioned about smoking cessation programs and I think that it
needs to be endorsed now that these products should be a mainstream in
smoking cessation programs I’ve visited Leicester smoking cessation programs
about three years ago now who’ve been at the forefront of using these different
products they got a wonderful scheme led by a nurse at the time where pregnant
women were being on the vaping for at least for the time of that pregnancy
the life chance that that has for that child it is greatly greatly enhanced
in terms of healthier life and everything else because at that time
there’s no reason that we shouldn’t be doing that mainstream now and are we
going to refer people who smoke when they go to hospital now into community pharmacy
and I say that’s a good thing as well but nonetheless we should be looking at
specific interventions with these products they’re for people who are
vulnerable and like unborn children who are clearly vulnerable as well and just to
finish and say this Minister we ought to be funded directly from the tobacco
industries into smoking cessation programs and I know that will be an issue
for the Treasury you need to talk to that but we often talk about pollution
about polluter pays and everything else tobacco companies should be paying for our
smoking cessation programs and sadly and we’ve said this in debates before that
some of them are just fading away now and there’s some parts of this country where
there’s still heavy intense smoking by adults who have no smoking cessation
programs at all and it is wrong and over eighty thousand deaths a year it
should be stopped Gareth Johnson Thank you Sir Henry unlike the last three speakers I rather hope
this is not my last speech in Westminster Hall but it’s up to the people of Dartford not up to myself directly I’m very pleased to be able to
contribute to this debate actually because I feel very very strongly the vaping is
something that we should be embracing as a country you know we’ve heard mention
about public health England saying that vaping is 95 percent risk-free which is a
really significant statement but it’s not just public health England that have
made these statements ww’ve had cancer research that said that there is
significant benefits from vaping compared with the consumption of tobacco
we’ve had ASH we’ve had the British Heart Foundation the British Lung
Foundation these are people who traditionally frown on anything
associated with smoking and understandably so but they have
recognized the fact that vaping saves lives and that is what we’re talking
about here and the sooner we recognize as a country that look we have this
product this invention and that could save thousands and thousands of lives
just in the UK let alone around the rest of the world the sooner that we
recognize that as a country the sooner we can start saving the maximum number
of lives possible and it is therefore with great regret that we’ve heard these
stories coming out of the United States it’s only when we started drilling down into
those stories and we saw that this is linked to potentially linked to acetate
and to cannabis oil and so on and that is actually the irritant that is causing
those deaths that we recognize that that we shouldn’t therefore allow those
tragic circumstances to cloud people’s image of vaping because it’s absolutely
right it’s not just clinicians who are unsure as to whether or not they can recommend
vaping to patients but it’s also the general public who are unsure whether or
not vaping is as safe as some of the experts have
said about vaping we need to ensure that we educate people and say that there is
this well-known knowledge a well-known fact that tobacco is seriously damaging
to your health it is highly risky however we have
vaping there where the risks are substantially less no one is suggesting
in this debate or anywhere at all in the House of Commons that I’m aware of that
people who do not smoke should start taking up vaping no one is suggesting
that what the suggestion is is that people who smoke people who actually are addicted to
tobacco addicted to nicotine they are the people that will benefit from this
there are still risks associated with pretty much anything and vaping is no
exception and so therefore the message is loud and clear people who do not
smoke should not start vaping however people who do smoke may wish to try the
alternative of vaping as a very effective way of actually either
reducing their tobacco consumption or completely coming off of tobacco in
totality and so therefore I actually welcome what we have seen from some
tobacco companies where they have embraced vaping they are realizing the
potential that vaping has there is a company JTI that have highlighted to me
about some of the dangers associated with the products that do not contain
nicotine and therefore do not come under the tobacco related products regulations
and therefore can be targeted at children they can be marketed to look
like food to look like something that’s trendy that’s something that people want
to get involved with and yet they do not have to comply with regulations and
therefore it’s not known what the ingredients are of those products and
that is something that we need to look at the tobacco related product
regulations which I know the committee that chaired by the right honourable
gentleman has looked into has some serious flaws with it for a start it
should not be lumping vaping and tobacco products together there should be
separate regulations for the products that would enable
an end to the ridiculous situation where someone can buy a vaping product that has
no nicotine in it whatsoever but it has to be a warning on the front of that
product that says this product contains nicotine when it doesn’t and and yet if
they don’t put that warning on there they fall foul of those regulations but if
they do put the product on they fall foul of other regulations and you have
this crazy situation that is grown up we also need to look at whether it’s right
to have more advertising I believe that it is the regulations seem to prevent
that I think it’s right that we enable people to be educated and aware of the
products that are available and the potential benefits from it so I don’t
want to make this debate turn into a debate on brexit but there’s no getting
away from the fact that once we leave the European Union we will as a country
be able to look at the regulations ourselves and see what best suits our
needs and what is sensible as an approach to people vaping and where we
can ensure that people are aware of this when people can benefit from vaping we
should ensure that that actually takes place you know I have met with a number
of organizations that are trying to push forward a change in vaping regulations
Imperial Tobacco as I know are doing a lot the company called Blu I know are
pioneering in the products that they are producing now and that is part of the
key to this they’re putting a lot of investment into producing products that
will be attractive to smokers in so much as that they will satisfy them and
therefore feel less necessity to smoke cigarettes you know I don’t want to
demonize smokers in all of this if an adult knowing the risks of smoking
chooses themselves to smoke that is their decision but it is I think incumbent
upon the government to ensure that people are aware of the alternatives
aware of the risks of smoking and the comparatively less risk associated with
vaping and so the government is rightly now pursuing a target of reducing the
number of people and then eliminating the number of people who are going to be
smoking in this country it is a very very ambitious target and I think in
order to achieve that target it is necessary to introduce
people to vaping through GPs (certainly I’ll give way) this issue about that smoking is an adult thing very few people start smoking once they get to the age of 21 if you look
at the hard reality it comes when they’re quite young I think I was about 11
or 12 when I started getting addicted to nicotine so I think we have to be very
careful about that it’s not really an adult choice it’s just something
adults do from the very early age I totally agree that whilst we do not I
think I take the view that if adults want to smoke and if that’s their decision
knowing the risk then that’s that’s up to them but there is a duty of care on
the government to ensure that tobacco products are not consumed by children
that is absolutely clear and I think he’s right that we keep the age of 18 to
those people who are allowed to vape as well we do not want to be seeing vaping
products targeted at children either no responsible vaping company
would do that and has done that in my experience and so if I can conclude Sir
Henry I do think that there is a sensible approach here from the
government I do believe that they can embrace the potential that we have here
to save lives through vaping there is so much potential through a taxation system
through advertising through education through making people aware of these
products to make these products more accessible and just recognizing the fact
that for the first time in my life there is genuinely something that it helped
people to get off of smoking tobacco that is effective that works if you look
at a graph of the number of people who smoke in this country and a number of
vapors in this country there’s a direct correlation between those two figures
the more people have been vaping the less people have been smoking and that
is something that we need to be highlighting we need to be celebrating
that and it’s something that the government should take forward I haven’t got my card but I would like to say a few words
yes indeed Jane Dodds that’s right thank you
I really just wanted to draw attention to the correlation
between people who have mental health difficulties and their attitude to smoke
and I would at this point just like to pay tribute to my friend and colleague
Norman Lamb who has really championed the cause of mental health throughout
the time that you’ve been here and I hope that the committee won’t mind that
indulgence thank you so much Sir Norman for
everything you’ve done and this issue I know relates to England and I’m a Welsh
MP but I would just like to draw attention to the issue of cross-border
healthcare many residents from Wales if they have a need for a residential
mental health unit have to travel to England and of course there’s a complete
disparity there between the practice in Wales and that in residential units in
England and I’d just like some thought from the committee I do realise that
this is not within your brief totally but some comments about how there could
be some marrying up of the policies around mental health units in England
and how they have these particular rules and regulations around the access
to e-cigarettes to those in Wales there are significant differences we talked
earlier about International learning from international bodies and countries
around the world but actually there is a need in my view to look at the whole of
the UK and how we can get some parity across the nations thank you very much
[something in Welsh] Sharon Hodgson Thank you very much Sir Henry it’s a pleasure to serve under your chairmanship this afternoon and I do apologize that I sound a bit croaky because
I’ve got a cold which I think is going around and hopefully I’ll get rid
of that for what’s to come over the next few weeks and so I’d like to start by
thanking the Honorable gentleman for North Norfolk for introducing this
debate and for his characteristically well-informed speech it’s sad to think
that that could very well be his last speech as an MP in what has been an
illustrious career but I’m sure it won’t be his last speech as a campaigner
or indeed an activist and I’d also like to congratulate him for his work
chairing the Science and Technology Committee and for this excellent report
I’d also like to thank all the other honourable members who spoke the
member for Ayr Carrick & Cumnock Rother Valley another and honorable
friend who I’ve enjoyed working with over many years and who has also had an
illustrious career was an excellent chair of the House Select Committee for
a number of years he will be sorely missed in this place and there were
other speeches also from the members for Dartford and and the honorable lady
who’s just spoken and I didn’t catch her constituency excellent very good thank
you so as we’ve heard there is some uncertainty still around the use of
e-cigarettes they’ve only entered the market the UK market 12 years ago and
this technology is still so young that we don’t really know for certain
its long-term impact on health but what we do know is that e-cigarettes are
around ninety five percent less harmful than conventional cigarettes and because
of that an estimated 2.9 million people in the UK are using e-cigarettes to stop
smoking and each year tens of thousands of people are successfully using
e-cigarettes to quit smoking a randomized control trial published in
the New England Journal of Medicine earlier this year found e-cigarettes used
in a stop smoking service to be nearly twice as effective as licensed nicotine
replacement therapies like patches and gum and the importance of e-cigarettes
as a smoking cessation tool should therefore not be dismissed however this
must come with the caveat I think everyone’s making this point that using
an e-cigarette is not completely risk-free we have seen recently in the
US an outbreak of serious lung injury linked to vaping however this has not
been replicated here in the UK there are 3.6 million current vapors in the UK yet
the number of cases of severe respiratory pathology associated with
vaping is low and diverse with reports over a long period of time so I agree
with the recommendations by ASH that e-cigarette users should only buy
vaping products including a liquid from mainstream suppliers who are selling
regulated products because using black market products may potentially carry
lethal risks they should report any adverse effects from e-cigarettes they
using to the MHRA using the yellow card scheme and if they are
experiencing serious adverse effects which they think are due to vaping they
should immediately stop vaping and get advice from their doctor so has the
minister considered launching an e-cigarette safety education program
that will ensure that e-cigarette users know the risks and what to do in case anything goes wrong if they manifest any of these symptoms this may help lessen
the possibility of manifesting the same patterns that we are seeing in the US
with lung injuries linked to e-cigarettes I’d now like to return to
recommendation 4 of the committee’s report summary the Committee recommends that NHS England should issue e-cigarette guidance to all mental health trusts
with the default of allowing e-cigarette use by patients now as we’ve heard
people with mental health issues smoke significantly more than the rest of the
population and could therefore benefit significantly by using e-cigarettes
to stop smoking and encouraging and allowing patients in mental health units
who are smokers to switch to e-cigarettes as a means of smoking
cessation means that they could continue to engage with their treatment sessions
within the facilities without the interruption of smoking breaks however a
third of the 50 NHS trusts who responded to the committee survey banned the use
of e-cigarettes so the government has agreed to issue guidance to NHS
trusts about e-cigarettes but it is yet to be published so can the minister
please tell us when she anticipates the guidance to be published I know she
might have to rush it over the next couple of days but she might have a
magic wand to be able to do that doing so could mean that patients in mental
health units can engage more fully in their treatment and this could improve
outcomes as the committee has found therefore e-cigarettes do have a role to play
in our society in the government’s commitment to achieving a smoke-free
generation however we must ensure that advice on the safety of a cigarettes
both short and long term is updated regularly and publicly so that
users have the most relevant and up-to-date information available to them
the government must also consider the role that e-cigarettes play in mental
health services as we’ve heard and improving patient outcomes across the
NHS every contact does count especially when it comes to smoking cessation and none of them should be missed however I have to say again due to the
government’s public health budget cuts since 2013 which I know this Minister
isn’t personally responsible for smoking cessation services have suffered leaving
the most vulnerable smokers behind and without any support to quit smoking so
that must change once again I ask the government to reverse these public
health budget cuts so that local authorities can provide the smoking
cessation services that their local communities need and deserve so with those brief few comments Sir Henry I look forward to the minister’s response Thank you very much indeed
Minister Jo Churchill to reply to the debate thank you very much Mr. Bellingham
and it’s a pleasure to serve under your chairmanship I would like to
firstly start by congratulating the right honourable member for North
Norfolk for securing this debate and thank the whole committee for the report
the tone of the report and the intelligent way in which it’s approached
what is a difficult subject when you’re trying to stop behavior in a way that is
detrimental to an individual and at the outset smoking is by far and away
something that we want to see reducing down to zero and us being smoke-free by
2030 it’s a very ambitious program but it’s one that actually affects the
benefit of many more than those individuals who just smoke themselves it
affects others around them so I would like to thank him as I’ve always highly
respected him for the important work leading the Science and Technology
Committee but as well as the broader health work on the health agenda that
he’s done and although this might be his last debate in this place today I hope
it’s not the last time that I hear him waxing lyrical on the airwaves on this
subject and I would actually say I would like to say the same for the Honorable
the right honourable gentleman for Rother Valley who really has both with
the Health Select Committee but also with his work with the APPG on smoking
and health really been quite formative in this area so it’s timely we’re having
this discussion at the very end of this year’s Stoptober campaign and I pay
tribute again to the Honorable gentleman for his work here and starting it
there’s never a better time to stop smoking and I encourage everybody who’s
thinking about it to visit their local stop smoking service or online and
consider all the options available that can help them quit I am really proud of
the tobacco control work that has taken place over the last two
decades and of the progress made we have been recognized internationally for this
according to the European cancer league’s tobacco control scale the UK
has been rated consistently as having the most comprehensive tobacco
control program in Europe and as we’ve heard from the numbers discussed it’s
working but we’re not there yet we know that smoking remains one of the leading
causes of preventable illness and premature death with over 78,000 deaths
a year this is not only a waste but also a very personal tragedy for all those
families affected and we’re determined that we should do more as set out in the
tobacco control plan the NHS long-term plan and the
prevention green paper which did only conclude on the 14th of this month but I
am looking forward to seeing what the results of that
consultation is because our ambition is to be smoke-free by 2030 we know we need
to work harder within certain groups including pregnant women and those with
mental health issues like him I was struck by the extremely high prevalence
you the right honourable gentleman mentioned Blackpool but it’s actually
and as he himself knows having a coastal region it’s actually there’s a very high
prevalence in many coastal areas of pregnant women who are smoking they
interact with a lot of health care professionals during what should be the
enjoyable exciting time when they’re expecting a baby we should make sure
that we use every single one of those interactions to help them quit during
this time so I have asked officials already to look at whether there are
other forms of being able to message to this particular group in a way that
constantly helps them understand the risks but also be aware of what things
are there to help them I also listened to his point for those with enduring mental
health issues facilities should help allowing e-cigarettes and support more
it’s an ongoing part of the agenda but if I may I would like to write to Sir
Simon Stephens and see where we are and actually let the committee know (yes of
course) Thanks for giving way and I thank her for her very kind comments and I’m pleased she’s going to write to Simon Stevens because I think
pressure from government ministers to NHS England to recognize the
significance of this subject it’s really important but could she also I’m conscious I asked quite a lot of questions in my contribution and she may well not be
able to answer all of the questions but can she try to write to me before
Parliament rises next week if at all possible to answer those questions that
she’s able to answer so that we get that on the record I’d like to thank the right
honourable gentleman I will do my very best and I hope that you will have that
answer winging its way to you on Monday if there’s anything that I haven’t
covered the government’s absolutely clear that quitting smoking and nicotine use entirely is the very best way for people
to improve their health we recognize that e-cigarettes are not risk free as
has been said stated by everybody who contributed however they can play an
exceedingly important role in helping smokers quit for good particularly when
combined with stop smoking services it is an addiction and a step change
through your practices and through your behaviors is what we’re trying to
achieve to enable people to cease and quit entirely Mr. Chair we don’t know
the long-term harms for e-cigarette use and no authorities in the UK assert that
they are harmless however based on current evidence public health England
and the Royal College of Physicians estimate e-cigarettes are
considerably less harmful than smoking because of the reduction in levels of
exposure to toxicants in e-cigarettes aerosols compared to tobacco smoke but
again I would like to reiterate that quitting smoking is your best option it
would be fair to say that opinions are divided in the UK and globally on
e-cigarettes and it’s important that we listen to concerns while looking
objectively and seek to build further the evidence base which I think is the
point the right honourable member was making
on the question of research I would like to assure him that there is a NHS
dedicated lead a director for prevention in place overseeing the NHS long-term
plan commitments I note my right honourable friend’s comments about India
and making decisions perhaps too quickly not based on the research that is
available out there which also has unintended consequences as the house is
aware in the UK we have introduced measures to regulate e-cigarettes to
reduce the risk of harm to children protect them against acting as a gateway
to starting smoking which again was an important point made to provide
assurance on relative safety and to give business legal certainty as far as what
has happened in the United States of America we take those concerns seriously
we’re aware of the tragic deaths associated with vaping in the United
States and are monitoring it carefully but public health England and the medicines
and Healthcare Products regulatory agency are in close contact with the
United States agencies investigations are ongoing and they’re not able to yet
confirm definitively the cause of deaths although it does appear that the
majority of those who have died have used illicit CBD with the THC products
which has led to these unfortunate deaths to date there are no known deaths
from e-cigarette used here in the UK the MHRA Yellowcard reporting system is in
place to report any adverse effects it’s been running for three years and to date
around 85 individual cases have been notified and these have been minor and
none have been considered to be life-threatening however I’d like to
assure both the right honourable gentleman but everyone who has
contributed to this debate that we remain extremely vigilant on the issue
and are very grateful for all research done in the area including that as my
honourable friend from Dartford alluded to those within the charity sector
that do a great deal of this work to actually look at the harms caused we
made strong commitments in our tobacco control plan to monitor the
impact of regulation and policy on e-cigarettes and novel tobacco products
to inform future policy we’re looking closely at the evidence on safety uptake
and health impact and the effectiveness of these products as smoking cessation
aids public health England will continue to update its evidence base on
e-cigarettes and other novel nicotine delivery systems if the effort (my
apologies) then coming on to use by young people
which was mentioned by the Honourable member for Rother Valley and again for
the Honourable member for Dartford firstly the use by the young this
currently remains low at 2% and we haven’t seen the rise that has occurred
in the United States of America however we will closely monitor the data
to ensure regular use doesn’t increase and it isn’t seen as that gateway to
tobacco use somewhat linked to the second we will also keep a close eye
on any new evidence on the long term harms caused by flavorings if the
evidence shows that we need to address either or both of these issues we will
consider taking action including where necessary further regulatory action I
would like to see stronger leadership from the industry on areas of
e-cigarette product naming and design in particular to ensure that they don’t
appeal to young people some of the naming does appear to be leaning on the
side of appealing to youngsters so in conclusion in the future we will have
the opportunity to reappraise current tobacco and e-cigarette regulation
to ensure it continues to protect the nation’s health and to conclude I would
like to thank all members who’ve spoken here today in particular the right
honourable member for North Norfolk who will be leaving this house but as we’ve
seen it’s been a bit of a goodbye party from the Honourable member for Ayr who I’m staggered by the revelation that he smoked fifty a day I wondered that he
had time to do very much else let alone run around being a fireman so who will
be the and my honorable friend the member for Rother Valley but will also
but I’m sure all of them will also undoubtedly continue to work in
this area Mr. Chair I would like to reiterate the government’s commitment to
helping people quit smoking which is ultimately the very best course of
action and to seek evidence on reduced risk products we will continue to
be driven by that evidence whilst we are able to celebrate that adult smoking in
England’s fallen by a quarter and regular smoking amongst children has
fallen by a half I personally and I’m sure all those here will truly be able
to celebrate if we are like the report aims for and like the government is
aiming for we are smoke-free by 2030 Norman Lamb to wind up thank you very much
indeed Sir Henry and I thank the Minister for her response to the debate
and for her kind comments what’s striking is that there’s been a remarkable
consensus in this debate over the action that we’re taking in this country and
the need for it to be evidence-based and it’s clear that the United Kingdom is
ahead of the game internationally in terms of smoking cessation work and
that’s something we should celebrate but we should never be in any way allow
ourselves to feel that we’ve done the job because we have so much still
to do particularly given the number as the Honorable member for Rother Valley made clear in his contribution the number of people who still die every year from
smoking the carnage the death toll is just enormous
and so the work needs to continue we’ve had wonderful admissions and I can I
just say that by two honorable friends who’ve admitted to smoking heavily in
the past are both wonderful living examples of life after smoking and
and a good example (less coughing please) but a wonderful
example to others about the potential value of giving up smoking and can I
also wish both of them are very happy retirement from this place I just
want to pick up very quickly one or two points I totally agree with the Honourable member for Rother Valley and we made this point in the in the report that
inserts in packs is a very good way of targeting a really important public
health message directly at the people who need to hear that message and who
need to be reassured that giving up smoking and vaping instead is going to
help their health secondly I also agree with the Honorable member for Rother Valley about the case for the tobacco industry making a contribution towards
the cost of smoking cessation services on the basic principle of
the polluter paying my Honorable friend the member for Brecon Radner who has had to leave the debate made some very important points about cross-border
health issues I applaud her for championing access to mental health
support in Wales incredibly important but the point in
this debate is that every mental health facility every in -patient mental health
facility in particular whether in England or Wales or Scotland there
should be the same access to vaping and support to enable people to give up
smoking and using vaping as the mechanism to do so because we will see
significant significant gains in life expectancy but also in their mental
health by giving up smoking smoking harms your mental health as well as
killing you earlier the Honourable member for Dartford and the Honourable
member for for Blackley and Broughton both made the
point about the need for regulations always to be evidence-based and that
hasn’t been the case it’s not the case with the directive from the European
Union and it’s certainly not the case internationally with
the debate we’ve had about the World Health Organization and the approach
that’s taken in America but in this country we want our regulations to be
evidence-based to give people the best chance of giving up smoking and having a
healthier life on a personal basis I stress that this is not in my role as
chair of the Select Committee I do agree with the Shadow Minister that investment
in public health is really important there is so much evidence that investing
in early prevention work of all sorts and investment in public mental health
as well in very brutal economic terms gives you a return on your investment
but also changes lives and so the plea for whoever becomes the government after
the 12th of December is make the investment in public health because we
will all benefit from that and on that note I thank you Sir Henry again for
your stewardship of this debate and I wish everyone well for the next few
weeks I’m just very relieved that I’m not fighting to retain my seat in the middle
of winter thank you the question is of his house is
considered a 7th report of a Science and Technology Committee he cigarettes HC
505 2017 18 and the government responds
come on paper 97 38 2017 19 as many of that opinion say aye of the contrary no I think the ayes
have it the ayes have it order order

Only registered users can comment.

  1. Absolutely fantastic. I just wish the USA government would watch this and learn something..# keep vaping and live longer.

  2. Norman Lamb was a great champion:- he will be sorely missed when he steps down from Parliament and will not seek re-election

  3. Vaping is very effective as a way of helping people with mental health issues to quit smoking. The vaping industry is reactive and will always try to make it ever safer by removing any chemcals that pose an unnecessary risk such as certain flavourings, the use of certain metals in coil materials, practices in using rebuildable devices, battery safety in use, charging and storage of batteries. Vapers always want to make things better and safer. As a hobbyist vaper I spend time and money on researching how to make all aspects of vaping safer. I think too few people understand how important flavours are in how effective vaping is (Most Ex smokers don't want to taste tobacco) and vapers often like the flavours from their childhoods, or desserts in preference to mint or menthol (though a cooling agent in a dessert flavour is often enjoyable)
    I support new vapers and those who have tried without any support then lapsed by giving help and advice to try again, generally I have found those I helped have not relapsed with several quitting both completely.
    I started vaping almost 9 years ago and quit smoking completely over 6 years ago, prior to becoming a vaper I could not manage this in part due to serious mental health issues

  4. I think it could be useful to GPs surgeries to try to bring longer term vapers and hobbyist vapers into surgeries to offer advice and help to stop smoking clinics as a lot of hobbyist vapers have a lot of knowledge and understanding of different devices and e-liquids that can and do help smokers to quit.

  5. Great Job, I Liked it a lot, See this New Album 'Monish Jasbird – Death Blow', channel link , you might like 🙂

  6. Thanks for sharing this Report. Thank god i don't live in India where more smoker's die each year then anywhere else on the planet 😥 We just need to bin the TPD here in the UK and most of all the 20mg nicotine limit 🙏

  7. They call it "debate", but it is an example of kindness, consense and agreement.
    Remarkable: The minister (under-secratary Jo Churchill) speeks out
    "the majority of those who have died have used illicit CBD with the THC-products".
    It is not exactly "substances (vitamin-E-acetate or Myclobutanil) in illicit THC-oil-cartridges/-pods", but okay.

  8. I so wish some of these ministers could come into Canada and speak to the various governments that are trying to enforce flavor bans or all-out vaping products bans, making false claims about vaping products being dangerous, and calling them "tobacco." I love their attitudes of the need to have doctors urge patients, as well as mental health patients, to adopt vaping products if they have trouble quitting smoking. Canada is too much like the USA's little sister and follows what they do. Lungs are no different in the UK than they are in North America. Vaping saves smokers' lives for those that fully switch to vaping products. They are not perfect, but they 95% safer than continued smoking of combustible tobacco products. Of course, I love that they endorse them as quit aid!

  9. Watch all three episodes and you'll know why the US attacks vaping and it's NOT about health or children.

  10. I will be 10 months 🚭 because I switched to vaping. If it weren’t for the fruity, cookie flavors,
    I would never be a non smoker. I will ‘diy’ before I ever smoke another cigarette.

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