video link http://parliamentlive.tv/event/index/bdc036a8-925c-494c-907b-7f7f06f04da6?in=16:29:45
Huge Parliamentary Support for E-Cigs
11 May
Yesterday saw an extraordinary debate in the House of Lords which was hugely helpful for vaping. Thank you to Ian Gregory of Abzed and The 100k Campaign for providing this summary, note and transcript.
Executive Summary
Backbenchers: Seven backbench peers spoke. All opposed the TPD and cited extracts from reports by Public Health England and the Royal College of Physicians along with the Department of Health’s Impact Assessment.
Shadow Minister: A few years ago the opposition front bench wanted compulsory medicinal regulation. However yesterday the shadow health minister described opposition to e-cigarettes as “bonkers” and said he didn’t understand why e-cigarettes were included in the TPD. He remarked of the regulations that “It is pretty obvious that the Government themselves do not support them because of the amelioration that they have attempted in transposing the directive.”
Health Minister: For his part the government’s health minister said that the arguments made against the TPD had “been very powerful”. He made two concessions requested by Viscount Ridley: the first was to make a strong statement of support for e-cigarettes: The minister said “I can say unequivocally that we are in favour of it as a means for people to come off smoking cigarettes. There is absolutely no question about that.” The second was to say that the TPD’s advertising ban might create “a strong case for a public information campaign” to promote e-cigarettes.
His officials will have been painfully aware of their minister’s lack of enthusiasm for the TPD. He spoke of it potentially backfiring on anti-smoking objectives. He went so far as to suggest that enforcement efforts on the TPD should be minimal saying that he hoped: “that enforcement will be more Italian than traditionally British.”
After the debate peers I spoke to also pointed out how the minister distanced himself from TPD with the words “Officials are persuaded that after this directive comes through there will still be many products on the market.” The minister was highly critical of his Department’s early approach to e-cigarettes saying “I am not sure whether if we had been left to our own devices we might not have come out with something far worse.”
Transcript and video link
Tobacco and Related Products Regulations 2016
10 May 2016
Video of Debate
Motion to Take Note
4.30 pm
Moved by
Viscount Ridley
That the Grand Committee takes note of the Tobacco and Related Products Regulations 2016 (SI 2016/507).
Viscount Ridley (Con)
My Lords, first, I apologise for springing this debate on my noble friend the Minister, in particular, at such short notice right at the end of a Session, but he will appreciate why this is an urgent matter. In 10 days’ time, the EU tobacco products directive may become law through a negative statutory instrument recently laid before this House. I emphasise right at the start that I have no problem with most of the regulations—just the parts relating to e-cigarettes and vaping, which are essentially Parts 6 and 7. My Motion is a little vague on that; the original draft was a little more specific.
As noble Lords will know, it has long been my view that the directive scores an own goal by bringing in measures that would discourage the take-up of vaping and thereby drive people back to cigarettes or prevent them quitting. However, it is not just I who take that view. Increasingly, it is the view of Public Health England and of the Royal College of Physicians, whose recent report on this topic is, I think, a game-changer in this debate. So I am here, at the 11th hour, to help my noble friend prevent a historic mistake being made, or at least to raise the issue. In passing, I note that I have nothing to declare: I own no shares and take no income from anything related to vaping or smoking.
The horrific death toll from smoking—100,000 of our citizens die every year—has, I suspect, touched the lives of many in this Room. It is the biggest cause of preventable death on a scale that is hard to comprehend: it is a Hillsborough every eight hours. It is a scourge that deserves the very best of technical ingenuity and policy-making skills to solve.
Vaping offers, as the Royal College of Physicians said, a great opportunity to apply to smoking the principle of harm reduction—an idea pioneered in this country. When people behave in harmful ways, how do you stop them? You can punish them in the hope of deterrence, as we do with murder and fraud; you can hector them, as we do with alcohol and sugar; or you can try to offer safer alternatives, which is how we tackled HIV infection and heroin addiction in this country in particular, and it is how I believe we should now deal with tobacco. In the case of addictions, where people find it genuinely very hard to resist temptation, harm reduction surely makes sense.
Britain is probably the world’s leading vaping nation. Virtually all of South America has banned the practice entirely, at the behest of the tobacco industry. In America, it is largely demonised and quite a lot of people do not know what it is. Almost all the 2.6 million vapers in Britain are smokers or ex-smokers, and the quit rate for those who try vaping is faster and greater than it is with nicotine replacement therapies or cold-turkey cessation. In other words, this is a public health revolution, and it is costing the taxpayer nothing. By saving smokers a fortune, rewarding entrepreneurs and averting ill health, it is boosting the economy.
However, we have before us a piece of legislation that strangles that breakthrough in red tape. It is the product of big-company lobbying and back-room deals in Brussels. It is legislation which last month the Department of Health admitted, in its impact assessment, risks increasing, not reducing, the amount of smoking. I hope in his remarks today that the Minister will be fully candid and accept that this part of the directive is a mess which does not deserve defending but does need ameliorating. I have alerted him already to three specific matters on which I seek clarity.
First, given that the Royal College of Physicians last month told the Government that they should promote vaping to smokers “as widely as possible”, what new, emphatic and unambiguous statement will the Minister make in support of vaping?
Secondly, given that the department estimates that the tobacco products directive rules will ban 90% of advertising that would have helped to promote switching, what budget has the department specifically set aside for a public information campaign to encourage smokers to move to vaping, as the royal college and Public Health England both want?
Thirdly, given that the regulatory burden that the department is about to place on the industry is so extreme that his officials estimate—at least, this is the only estimate in the impact assessment—that the number of notifiable products will be reduced by 96%, from 25,000 to possibly as low as 1,000, what expenditure will the department make specifically to reduce the cost of the onerous testing regime on the industry?
I would ask the Minister to avoid repeating the erroneous suggestion his officials have been making that any of the £13 billion of public health benefits that his department surmises will come from the tobacco products directive would be the result of Article 20, or Parts 6 and 7 of these regulations. In the table set out on page 45 of the impact assessment, the department has not been able to quantify a single benefit from vaping regulation.
Let me put this in a little context. At the beginning of this decade, attempts to reduce smoking were stalling. We had taxed the habit to the point where the main beneficiaries were black market traders, we had barred smoking from every public building, and nicotine patches were proving unpopular with smokers. Then along comes a technical breakthrough, thanks to a man named who I have met named Hon Lik, working in central China. It was something that gives a nicotine hit in the same fashion as smoking but is far safer and cleaner. It is a fantastic piece of luck, or rather ingenuity. As the Prime Minister told the other place in December, vaping has now helped more than 1 million people in this country to stop smoking altogether.
How safe is vaping? We know that concentrations of harmful and potentially harmful constituents such as carbonyl compounds, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons and other constituents are in the order of 1,500 times higher in cigarette smoke than in vapour. A well-controlled trial has recently been carried out by Dr Grant O’Connell and colleagues working for the vaping manufacturer Fontem Ventures. They asked 15 smokers to give up altogether for five days, 15 to vape only for five days, and another 15 to mix vaping and smoking for five days. They measured the harmful and potentially harmful constituents in the urine, blood and breath of each group, and the results were striking. After five days, the vapers’ carboxyhaemoglobin levels—an indication of how much carbon monoxide they had in their systems—had dropped by 83%, which was an even bigger drop than in the cold-turkey cessation group, whose levels dropped by 75%. Even the dual users had seen a drop of 23%. The amount of carbon monoxide they exhaled had halved in both the vapers and the cessation group. Much the same was true for all the other biomarkers except, of course, for nicotine.
In other words, in terms of harmful constituents vaping is almost indistinguishable from not smoking at all. Both Public Health England and the Royal College of Physicians agree that it is much safer than smoking. As far as we can tell, nicotine addiction without smoking is about as dangerous as caffeine addiction.
Vaping is therefore a public health triumph that the Department of Health has, to its extreme shame, done its utmost to block. In 2010, the department’s medicines regulator, the MHRA, tried to ban vaping devices completely. In 2013, the agency—which is financed largely by the pharmaceutical industry—tried to insist that every e-cigarette should be licensed as a medicine. This would again have amounted to a de facto ban. After six years of trying, the agency has so far only managed to license one e-cigarette, which is still not available to the public. If the Department of Health had had its way, there would not be 25,000 varieties of vaping product on the market today, but zero. The only winners of the Department of Health’s policy prescriptions would be undertakers.
Thankfully—and my noble friends will know how painful it is for me to say this—the European Parliament voted down the folly of exclusive medicinal regulation, but it did not vote down the rest of Article 20 of the tobacco products directive which, in that wonderfully undemocratic way, is now being forced upon us. The truth is that these regulations were scripted in Brussels by pharmaceutical companies desperately trying to protect the sales of their widely unloved nicotine replacement therapies. What we have before the House is still a piece of legislation that is not fit for purpose. When even the Department of Health says that it risks increasing smoking, we know that we are facing a moral responsibility as legislators to review this in great detail. It most certainly should not just be nodded through.
It is no defence to say that some regulation is required. No sensible person would argue against us knowing what is going into e-liquids and what comes out in vapour. Potential toxins should be tested, as happens with food, cosmetics and other consumer products. But as the department admitted in an Answer to a Written Question, far more adverse incidents are reported by doctors about pharmaceutical nicotine replacement therapies than e-cigarettes. At most, a bit of tidying up of the testing process was needed.
Let me put three more questions to the Minister. The Royal College of Physicians describes the big warning labels that will deter smokers from using vaping devices as “illogical”. Does the Minister agree with the royal college on this?
Secondly, the ban on stronger vaping devices—the ones most likely to wean heavy smokers into vaping—was criticised two years ago by a dozen scientists writing to the Commission, which ignored their advice. Economists now predict that 105,000 extra deaths every year across Europe will result from the ban on stronger devices. Does the Minister agree with this estimate? If not, what is his estimate?
Thirdly, the directive proposes that, to cut down the risks of children starting smoking, it is necessary to create a minimum cigarette packet size of 20, yet it imposes a maximum size for vaping devices. This miniaturisation will raise prices and generate more packaging waste. Where is the logic in making the most successful substitute to tobacco more difficult to use?
The Minister has a choice. He can blame Brussels and say this is now a good reason to quit the EU in order to help people quit smoking—a lot of the country’s vapers, who are natural libertarians, are beginning to take that view and to dream of the day after Brexit when Britain abolishes the tobacco products directive and goes back to pioneering the virtual elimination of smoking and its replacement by something much less harmful. Or, if the Minister does not wish to turn this into a referendum issue, he can have a quick rethink and try to alter the implementation of the directive. We have a statutory instrument before us, about a third of which is devoted to stifling an exciting innovation that is saving lives. I beg to move.
Lord Brabazon of Tara (Con)
My Lords, I thank my noble friend Lord Ridley for raising this issue today. Like him, I intend to concentrate solely upon e-cigarettes and vaping. I have no views whatever on the rest of the directive.
Unlike my noble friend, I must declare a major interest in this subject, in that I smoked 20 cigarettes, a packet, a day for the best part of 50 years. I tried a number of different ways of giving up—patches, chewing gum and will-power, none of which worked—until two years ago when I took up using an e-cigarette. I have not had a cigarette since. I am pleased to hear of the health benefits my noble friend has described, which I hope I am now enjoying. I am also pleased that I now have the endorsement of the Royal College of Physicians and Public Health England in my course of action. It is, I believe, recognised by the Department of Health as the number No. 1 tool for helping smokers give up.
I do not know whether my noble friend has the figures—I do not—but I would estimate that 99% of people who smoke e-cigarettes are those who are trying to give up, or have given up, smoking real cigarettes. I cannot believe that anyone would start using an e-cigarette if they had not smoked an ordinary cigarette beforehand. Maybe some people have, but I do not know.
I can also tell the Committee that it is extremely good for the pocket, as well as the health, in that 20 cigarettes now cost something like £9 a packet, a large amount of which goes to the Treasury of course. I was spending £9 a day on cigarettes, whereas now I use a nicotine liquid, which comes in a 10 millilitre bottle, costs £5 and lasts me a whole week. So it is very good for my pocket.
I understand that nowadays a large proportion of cigarette smokers come from the lower-income categories of people and therefore it would be of great benefit to them if they were able to give up smoking cigarettes. I hope my noble friend can confirm that the type of nicotine liquid I use—which is 1.1% in 10 millilitre plastic bottles—will not be banned by this new regulation.
This directive was dreamt up in 2012, quite a long time ago before I—and, I suspect, most people—had heard of e-cigarettes. Like a lot of things that come from Brussels, it has not been adapted to the facts, including the fact that e-cigarettes are now recognised as a good thing. I hope my noble friend can assure me that he will do all he can to limit the damage that this directive might have on people who are trying to give up smoking.
4.45 pm
Lord Callanan (Con)
My Lords, I, too, pay tribute to my noble friend for introducing this debate. I have a great sense of déjà vu because I was one of the people in the European Parliament that he referred to, who helped achieve the original decision against this directive’s restrictions on e-cigarettes. I was also the shadow rapporteur for my group and part of the European Parliament negotiating team that sat until about 11.30 pm in the Berlaymont, with the Commission chairing the meeting and the Council on the other side of the table, thrashing out the messy compromise that we see before us now in the tobacco products directive. Again, I have no difficulties with the vast majority of the directive; my concern was with the articles on e-cigarettes.
Before I started working on this, I had no particular knowledge of the subject. But when any dossier is placed before you, the first thing you do is read the various publications available and listen to all the lobbying and advice and you are also contacted by constituents. I was first alerted to the issue when my email inbox started filling up with literally hundreds of emails from people all over the country—and, indeed, Europe—concerned that these magical devices they had used to give up smoking were going to be banned or severely restricted. Together with a number of MEPs from all sides—including members of both the Liberal Democrats and the Labour Party in the UK—we started a campaign to improve the directive.
I have to say that we were not particularly helped by Department of Health officials. I tried to speak to Ministers many times to find out who was behind the restrictions and why there was such a campaign against something which so self-evidently provides great public health benefits and harm-reduction measures, but I never got a clear answer. I was pointed to a recording of a former public health Minister appearing in front of the European Scrutiny Committee of the House of Commons. When she was asked why she voted for this directive on behalf of the Government, she turned to her officials and said “I think the e-cigarette provisions were removed from it, weren’t they?”—which showed a worrying lack of understanding of what she was voting for on behalf of the Government.
Nevertheless, we ended up with this directive. It was a messy compromise and it is very badly worded, but it is a lot better than it could have been had we not campaigned on it. My noble friend Lord Ridley is quite right to point out the somewhat murky role of various pharmaceutical interests in the production of the directive. When I asked questions in the Commission and the Council—it seemed to me self-evident that these devices were brilliant for reducing tobacco smoking, which I thought was what we all wanted—I asked why they were even in the directive in the first place, given that it is called a tobacco products directive and e-cigarettes are not tobacco products in any sense of the word. The answer I received many times was that this was argued for by the pharmaceutical industry, which would have an awful lot to lose if e-cigarettes supplanted or replaced nicotine patches and gum. I do not know the truth of that, but it seems that it was very successful in getting what it wanted.
I completely agree with all the points made by my noble friends, but I have two additional points to make. First, on advertising, the Royal College of Physicians has a proud history at the heart of tobacco control. Since its first report, Smoking and Health, in 1962, it has been an intellectual leader in the field and is worth listening to. When the headline on the press release on its latest report states in bold,
“Promote e-cigarettes widely as substitute for smoking”,
one would hope that the Government would get the message that its 21 world-renowned authors are trying to put across. But we would be wrong if we thought that, for the regulations that the department wants us to approve are not about the promotion of e-cigarettes but about the suppression of information about them.
Paragraph 176 of the department’s impact assessment forecasts that the EU rules will reduce e-cigarette advertising by 90%. How are smokers supposed to hear about e-cigarettes? In paragraph 167, the department nonchalantly claims that cutting advertising will in fact not reduce the number of smokers switching to e-cigarettes. We have heard this old argument many times before—not from health officials but from tobacco company executives trying to pretend that advertising smoking would somehow not increase the amount of smoking.
The messages that we give really matter. In the complex decisions that smokers make every day about whether to smoke or consume nicotine through much cleaner forms, their perceptions of the relative risks of these products are crucial. The Royal College of Physicians, Public Health England and Action on Smoking and Health have all raised deep concerns about how smokers perceive e-cigarettes to be much more risky than they actually are. It is very interesting that Action on Smoking and Health should now say that, because I recall that that was not the message that it was giving when we dealt with the directive.
We are certainly not going to give that message by banning 90% of advertising, nor by insisting on e-cigarette packaging carrying big health warnings, which is what the Government are asking us to approve in these regulations. The Royal College of Physicians described the imposition of these warnings as “illogical”, bearing in mind that nicotine patch boxes do not have to warn of the dangers of nicotine.
Much of the problem stems from media reporting of junk science. The worst example was a headline in the Telegraph in December, which screamed:
“E-cigarettes are no safer than smoking tobacco”.
It was a nonsense report based on, as I said, junk science.
The second point that I want to raise concerns novel tobacco products. A number of new products have been introduced in this category, particularly products called “heat-not-burn”. These are very interesting developments, and a range of other alternative products is also in development. Some of the ones coming to market contain tobacco, but they work by heating it and not burning it. The absence of combustion is key. We all know that, as my noble friend Lord Ridley has said, harm from smoking comes primarily through the toxins produced by the burning of tobacco. In 1976, Professor Michael Russell wrote:
“People smoke for the nicotine but they die from the tar”.
That was reflected in the title of the recent study by the Royal College of Physicians on e-cigarettes, Nicotine without Smoke. With such technological developments, and a new regulatory basis with the introduction of the TPD, are the Government looking at the opportunities to be had from the available range of products, in addition to e-cigarettes, as part of a harm reduction agenda in the new tobacco control plan?
This is truly a terrible piece of legislation, and I plead guilty for the part I played in helping to produce it in the first place. However, it is not too late to undo some of that harm and to help encourage the taking up of e-cigarettes and, consequently, a reduction in tobacco consumption. Instead of trying to restrict e-cigarettes, the Government should in fact be trying positively to encourage them.
Earl Cathcart (Con)
My Lords, these regulations, or the directive, directly affect me, my health and indeed my well-being. I started smoking before I was a teenager, building up to about 50 cigarettes a day. I tried every trick in the book to kick the habit, but nothing seemed to work. I knew that it would kill me—that I would be gathered by the grim reaper before my time—but I just could not stop. I could not kick the habit.
Then, two summers ago, I was in a taxi in a traffic jam. I was chatting to the driver and at one point I said, “I do wish we could hurry up because I’m dying for a fag”. He turned round with an e-cigarette in his hand and said, “Have you tried one of these?”. I said, “No. What is it?”. He explained that he had tried them and had not smoked a cigarette since. He kindly wrote down the details for me to google, but he insisted that if I tried e-cigarettes I must try the strongest ones I could get because, if I did not, I would not get the necessary nicotine hit and would be back on fags in no time at all. I took his advice about using the strongest nicotine—2.4%—and I have not looked back. I have not had one puff of tobacco since two summers ago, rather like my noble friend Lord Brabazon. So they do work and they do help people to stop smoking.
As we have been told, there are 2.6 million people vaping in the UK. Of those, 40% are, like me, ex-smokers and 59% are dual users who both vape and smoke. The Committee will agree that a single vape is better than a single drag on a fag. Interestingly, only 0.2% of under-18 year-old non-smokers have tried vaping, although continued use is negligible. Research conducted by Cancer Research UK found that smokers who vape are 60% more likely to quit than those who use will-power or over-the-counter nicotine products. These statistics demonstrate that vaping is used almost entirely—99%—by current and ex-smokers. Sixty-one per cent of them say that the sole reason for vaping is to stop using traditional tobacco products.
So why have we got this directive and these regulations? Our masters in Brussels believe that vaping could provide a gateway to smoking and that these tough new laws are necessary to protect non-smokers, particularly children, from using e-cigarettes. However, as I have tried to explain, there is no evidence of this. Ninety-nine per cent of those vaping are current or ex-smokers like me. As to children, as I said earlier, only 0.2% of under-18 year-old non-smokers have tried vaping. There is no evidence that vaping is a gateway to tobacco and no evidence that vaping products influence children.
As vaping is estimated to be 95% safer than smoking, you would think Brussels would want to encourage it. Where does Brussels get its evidence that vaping is harmful? I do not know. Has it been got at by the tobacco lobbyists, who have seen their sales of traditional tobacco fall, or by the pharmaceutical industry, as my noble friends Lord Callanan and Lord Ridley have already suggested?
Brussels is banning advertising; e-cigarettes must carry health warnings; and nicotine strengths are to be restricted. To my mind, restricting nicotine strength to 2% will be particularly damaging, but I would say that, as I still use the 2.4%—as do about a quarter of e-cigarette users. By taking up vaping, I hope to keep the grim reaper at bay for a little longer. I hope that when I run out of my 2.4% nicotine supply and I am forced to use the weaker nicotine, I do not switch back to smoking. That is the danger for many e-cigarette users. Perhaps by the time I run out of my 2.4% nicotine supply, stronger nicotine may be available on the black market, with all the dangers that that will entail.
I would like to use one or two quotes to back up my previous assertions. The Office for National Statistics has said:
“E-cigarettes are almost exclusively used by smokers and ex-smokers … and almost none of those who had never smoked cigarettes”,
were e-cigarette users. Public Health England has said:
“There is a need to publicise the current best estimate that using EC is … 95% safer than smoking”.
It went on to say that:
“Encouraging smokers who cannot or do not want to stop smoking to switch to EC could help reduce smoking related disease, death and health inequalities”.
This was backed by the Royal College of Physicians, which said:
“On the basis of the available evidence, the RCP believes that e-cigarettes could lead to significant falls in the prevalence of smoking in the UK, prevent many deaths and episodes of serious illness”.
Even the Prime Minister, last December, said:
“We need to be guided by the experts, and we should look at the report from Public Health England, but it is promising that over 1 million people are estimated to have used e-cigarettes to help them quit or have replaced smoking with e-cigarettes completely. We should be making it clear that this a very legitimate path for many people to improve their health and therefore the health of the nation”.—[Official Report, Commons, 16/12/15; col. 1548.]
Quite so.
I do not know what my noble friend the Minister is going to say when he responds, but I expect him to support the regulations and the EU directive. There is very little else he can do. Our masters in Brussels have told us to jump and, sadly, the only thing that the British Government can do is jump—until 24 June, of course.
5.00 pm
Lord Stoddart of Swindon (Ind Lab)
My Lords, I first declare an interest, because this is a tobacco and related products order and I am an associate member of the Houses of Parliament Pipe and Cigar Smokers’ Club. I am an associate member because I am a non-smoker, so they tolerate me. I am pleased to be a member of that club because I believe that the attitude towards smoking has been quite absurd in many respects. Measures have been taken against the smoking population—I am talking about the adult smoking population—that are not appropriate in a democratic society, which should allow adults to make choices about their lifestyle and not be dictated to by government.
However, we are not talking about tobacco today. I only just saw the Prayer from the noble Viscount, Lord Ridley—if it is a Prayer—for the debate that he has instituted today, and I think that he and other noble Lords have really put the case. As far as I am concerned, there is probably nothing else to say, except to give them support in resisting the Government’s, and of course the EU’s, decisions to restrict a product that is going to assist others in giving up tobacco smoking. That is almost impossible to believe: that a Government who have been so anti-smoking, and who have themselves brought in so many anti-smoking measures over the years—I have been involved with them for at least 25 years—should now, when we are on the brink of assisting people to give up tobacco smoking, put these very stringent restrictions upon them. Why on earth are they banning the advertising of them if they are a health benefit to people who smoke and the Government think that people ought to give up smoking? To me, that seems to be an absolutely absurd position.
Have there been consultations with the producers of what are called e-cigarettes, but perhaps that was a mistake because they are not cigarettes? Anyone who mentions cigarettes is immediately jumped on by the Government and the department, so it may have been a mistake to label them as cigarettes since they clearly are not and should not be treated as such. Have Ministers had discussions with these producers? I ask that question because the department and Ministers refuse even to meet and have discussions with the tobacco companies. Perhaps that is understandable because the World Health Organization recommends that they should not be given a voice. However, in this case it is something that will help people to give up tobacco. Again, have they had discussions with the people who produce e-cigarettes? I should like to know the answer to that.
The only other thing I have to say is this. I hope that the Government will listen to this debate, although in fact there is not much hope of that because in the past trying to get the Government to listen to reason is like banging your head against a brick wall. It does not matter what you say. They have their policies, but when they get into Government, they often change them. I can remember sitting on the other side of the Moses Room and listening to a former health Minister speaking—not voting—against some of the measures that were being introduced by the Labour Party. An example of those was the hiding of cigarettes behind blinds. He was against that, and indeed I well remember him meeting with retailers and saying how a Conservative Government would see that that was repealed. But of course they are in Government now and so they are in favour of it, and they have brought forward this legislation. It is not about banning a dangerous product like cigarettes; it is about a product which helps people to stop smoking.
So I hope that the Minister will listen carefully to the experiences of those who have spoken in this debate. I should add that I have met many people, including a relative of mine, who had been heavy smokers but were weaned off smoking by using e-cigarettes. I am obliged to the noble Viscount, Lord Ridley, for seeing to it that we have had a proper debate and I hope that the Government will listen to it.
Lord Snape (Lab)
My Lords, I should start by apologising to the noble Viscount, Lord Ridley, for missing the first few minutes of his speech. I appear to be a dupe to the railway industry at the moment. Today’s excuse for the cancellation of my train was a broken windscreen, which I thought was pretty unique. It was a 125 mile-an-hour Pendolino, so I suppose that the windscreen ought to be intact for the whole of the journey.
I agree very much with what has been said from both sides. I do not have any financial or personal interests to declare, although at the age of 74 I know that my generation are habitual smokers. I was surrounded by smokers. Both my parents smoked and, when I went to work for the railway industry, virtually everybody I worked with smoked. However, unlike the noble Lord, Lord Brabazon, or the noble Earl, Lord Cathcart, I managed to find the will-power to give up about 30 years ago. I did it purely by terrifying myself. It became apparent that smoking was synonymous with lung cancer. I convinced myself that every cigarette I lit was the one that was going to give me lung cancer, so eventually I terrified myself into stopping.
However, I do not understand the purpose of this SI or the fact that we are going to ban products that will help people to give up smoking. Like other speakers, I do not believe that someone who is currently a non-smoker will move from vaping to tobacco. Surely it has been proved, or is obvious enough, that people move the other way—from tobacco to vaping—and I cannot understand why the Government are so ready to accept this SI. That is not to say that I am getting involved in what is going to happen on 23 June.
There is a group of people whom the Government ought to be concerned about regarding smoking in the future. As I go round the country, I am concerned about the number of young people who smoke, particularly the number of young women, many of whom believe that smoking helps them to stay fairly slim—I was going to say “fit”, although obviously it does not do that. Anything that would help them to come off tobacco would be good. I have no doubt that the two medical doctors who will reply for both sides will tell us that there is no scientific evidence that smoking keeps you trim. However, I again quote my own experience. I put on a stone and a half quite quickly when I gave up smoking. There was no medical reason for that. It is a fact that smokers are anxious to put down their knives and forks and head for the door to have a cigarette immediately after the main course. Once I gave up smoking, I stayed for the ice cream and puddings and so on. So I want to know from the medical profession, from both sides of the Room, which will kill me first—smoking or my spare tyre. Understandably, I have been warned about both.
Mention was made by the noble Lord, Lord Callanan, of the reduced-risk tobacco products, such as the “heat-not-burn” products, which I understand the industry is currently looking at. I understand that the Chancellor mentioned these products in his recent Budget. I would be interested to know from the Minister what the Government’s intentions are. I fear that if the Treasury acts in the way that it usually acts under any Government, it will be another excuse to tax something as heavily as possible. However, if we are serious—which we are—about weaning people off the demon that is tobacco, then banning alternative products which are proven to be less dangerous is a far from sensible way forward, and I would be interested to hear from both Front Benches why they are apparently supporting this SI.
The Earl of Erroll (CB)
My Lords, I want to say just a couple of words about this. First, I do not really have an interest to declare. I have a wife who is a very heavy chain-smoker, but I do not smoke—I let her go on smoking because it keeps her slightly calmer and liveable-with, and it is probably better than her going on to Valium. Personally, I am a chocoholic, which is a different problem altogether.
I think that we should separate out in our minds the difference between the harm done by the burning of substances which we inhale and the harm, or not, from a particular drug within it—nicotine. If you separate those as two different issues, you realise that this is not the right directive, because this is about tobacco, which at the end of the day is a herbaceous substance which we dry and burn. That is what it is meant to be about; it is not about whether or not nicotine is a beneficial drug.
I do not know much about this because I am not a doctor. I read things in the press which say, for instance, that it can help with Alzheimer’s and dementia, and I read other things which say that that is rubbish. I agree with the noble Lord, Lord Snape, that nicotine definitely used to be an appetite suppressant. One thing that I predicted when tobacco was cracked down on was that we would have an obesity crisis. It is one of the few things that I have been right about and it happened very quickly. If we wanted to prevent all the problems with people being overweight, we could perhaps recommend smoking—it is a question of which way you go.
The calming effect is well known for people who are quite nervous and tense; again, I think that is from the nicotine rather than the burning part of it. We also now have signs over the motorways saying, “Tiredness kills—take a break”. In the old days, you had a cigarette when you were driving and felt tired. I know that you should take a break but sometimes it is 30 miles to the next place where you can stop or you have a deadline, so a nicotine hit was a perfectly acceptable way of keeping yourself awake. Maybe vaping would do that, but the point I really want to make is that we should not be confusing the two things.
5.15 pm
The point made by the noble Lord, Lord Stoddart of Swindon, was also apt and very good: “What’s in a name?”. They should never have been called e-cigarettes because they are not cigarettes. This goes back to the point of the noble Viscount, Lord Ridley, about having to separate the two issues. He was absolutely right there.
I have two things to finish on. One is that this is a directive which we are trying to implement into UK law, not a regulation, which would mean that it was directly applicable in the UK. You should be able to modify the purpose of a directive slightly, in light of the local circumstances, while still trying to comply with its spirit. I have not read the directive at all, so I do not know whether there should be some room for manoeuvre. If we feel that it would be better for the UK population to write it into our local laws in a different way, I hope that such an amount of latitude exists within the directive—and within the EU—to allow us to do that.
The final thing is that wonderful conspiracy theory: that the Treasury gets huge amounts of tax from the smokers but not from the vapers, so the Treasury may rather see us smoking than see vaping take off, and that the Government have a vested interest in making sure that this directive goes through unchanged to prevent vaping. Maybe they should declare that every time they try to promote the directive.
Lord Hunt of Kings Heath (Lab) (Shadow Health Minister)
My Lords, this has been a great debate and I am grateful to the noble Viscount, Lord Ridley, for once again bringing our attention to this matter. It is a pity that we are in Grand Committee and not in the Chamber, but I can understand the reason for that. I should declare my presidency of the Royal Society for Public Health, which has of course produced documentary evidence on electronic cigarettes.
It is tempting to debate Europe—and I look forward to the view of the noble Lord, Lord Prior, on that, as it clearly seems to be part of our debate—and it looks as if we have quite a long time to wait this evening. I am in favour of remaining in the EU, but I would remark that this directive does not seem to show much evidence of the Prime Minister’s claim to have negotiated a new concordat and relationship with the EU.
I am very doubtful about the argument that, if we were outside the EU, we would not be doing this. The fact is—I speak as president of the RSPH—that some elements in the public health world were prejudiced from the start against e-cigarettes. That clearly influenced the Department of Health and is the reason why it has taken such a mealy-mouthed approach to e-cigarettes, which is simply not based on evidence at all. It is interesting that, if you look at some of the papers produced by public health bodies, there are some weaselly words around this issue: “We still don’t know and we need to be very careful”. They are really trying to find a legitimisation for the initial very negative reaction, which I am afraid has laid the foundations for where we are today, because this is bonkers. It is simply madness. Here we have a product which is clearly of benefit to smokers and there is no evidence whatever that it will be used by non-smokers, which is where all this nonsense has come from. Why would a non-smoker take up these e-cigarettes?
The noble Lord, Lord Stoddart, and I have debated tobacco issues for many years, and he will know that I have been strongly in favour of very strong legislation. I moved the amendment to ban the smoking of tobacco in cars with children only a year or two ago, so I am not at all worried about being very tough on smoking, but e-cigarettes are completely different. I do not understand why they are part of the directive at all or classified in the same way.
The evidence is abundantly clear that e-cigarettes are almost wholly beneficial. My concern is that it is also clear that the public are, at the moment, confused. RSPH research revealed that 90% of the public still regard nicotine itself as harmful. Going back to September 2015, Public Health England issued a joint statement with other UK health organisations, saying:
“And yet, millions of smokers have the impression that e-cigarettes are at least as harmful as tobacco”.
It seems to me that one of the real adverse consequences of this is that, as it becomes known that there are going to be major restrictions on the promotion of e-cigarettes, all that will do is emphasise the belief that they are harmful. I have seen the RIA, but I could not see there any analysis of the impact that that could have on reducing the uptake of e-cigarettes among smokers. However, it is a very important point.
I want to put three points to the Minister. First, the noble Viscount, Lord Ridley, asked him what would happen to the investment in smoking cessation services. My understanding is that, as a result of the Government’s cut to the grant to local authorities for public health, smoking cessation services investment is going down. Will the Minister confirm that and say what he is doing to reverse the pattern?
The second point is that, clearly, this directive will go through, because there is no Motion to stop it. What monitoring will take place, and how soon will the Government undertake an assessment of the impact? Assuming that we are still in the EU, is the Minister prepared to go back to the EU if evidence becomes clear that this is having an adverse impact on smokers giving up smoking? I hope he can give some reassurance on that.
The third issue relates to enforcement. In the statutory instrument, regulation 53 makes it clear that:
“It is the duty of each weights and measures authority in Great Britain and each district council in Northern Ireland to enforce these Regulations within their area”.
What guidance is going to be given to the weights and measures authorities about taking a light-handed approach to enforcement?
It is quite clear that these provisions are not supported. It is pretty obvious that the Government themselves do not support them because of the amelioration that they have attempted in transposing the directive. At the very least, one could expect a message to be given to weights and measures authorities that the Government expect enforcement to be proportionate, minimalist and certainly light touch.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con) (Government Health Minister)
My Lords, I do not know whether to thank my noble friend Lord Ridley for bringing this debate here today or not. The arguments that have been put have been very powerful and it would be obtuse of me to say otherwise.
Perhaps I can start by going back to the opening words of my noble friend Lord Ridley, who said that there are three ways of trying to influence the behaviour of people doing things that do harm: you can punish them; you can hector them; or you can try to offer safer alternatives. In the article he wrote in the Times some time ago, he used the example of methadone as something that is not desirable in itself but is used as a means of treating people with heroin addiction.
In the case of tobacco we have tried all three things. We have penalised people through taxation, we have hectored them incessantly for years, and having tried nicotine replacement therapies, in a sense vaping is a way of encouraging people to use something that is considerably less harmful than smoking. Actually, most people would agree that we have been hugely successful in reducing the consumption of tobacco in England. I was asked for a statement of the Government’s view on vaping; I think I can say unequivocally that we are in favour of it as a means for people to come off smoking cigarettes. There is absolutely no question about that. The reports produced by Public Health England and most recently and very powerfully by the Royal College of Physicians entirely endorse that view. The president of the Royal College of Physicians, Professor Jane Dacre, said in response to the report:
“With careful management and proportionate regulation, harm reduction provides an opportunity to improve the lives of millions of people”.
I pick that out because she used the words “proportionate regulation”, and that is really what we are discussing today. It is not about whether we are in favour of vaping or not, it is about what kind of regulation should be around it.
On the European element, given that the noble Lord, Lord Hunt, could not resist throwing that in as one of his questions, I am not sure whether if we had been left to our own devices we might not have come out with something far worse several years ago. The noble Lord was kind enough to mention the original views of PHE and the MHRA, so we may well have brought in a licensing system or even have banned them altogether. I am not sure that one can lay this at the door of Brussels or indeed our own Government. We have been far too quick to resort to regulation in many areas and as a rule I am wholly in sympathy with less regulation. That is the best place to start. What we are discussing today is whether this regulation is proportionate, what damage it could do or what the directive’s unintended consequences might be.
I should just mention while I have it to hand, to put the concerns of my noble friend Lord Brabazon of Tara to rest, that the concentration which he is taking it at will not be affected. It will not have to be licensed by the MHRA, but sadly I cannot say the same to my noble friend Lord Cathcart, who at 2.4% is higher than 2%, which is the cut-off point for licensing. But I shall come to that in more detail in a minute, if I can.
Perhaps I may pick up on a few of the fears that noble Lords have expressed about the directive and see whether I can allay their minds today. It has been said that the directive will ban flavourings in e-liquids. I should make it clear that it will not do so. What it does say is that flavourings which pose a risk to human health should not be used; we could probably all agree that that is a sensible rule. There is an additive called diacetyl, which I think is also used in the making of popcorn, and there are other flavourings where there is some evidence that airways can be inflamed. The noble Lord appears to be questioning that, but I think the RCP report cites evidence that some flavourings can cause damage.
It has also been said that the directive will ban all advertising and prevent shop owners communicating with their customers. It does not do that. The new rules do not prevent information being provided to customers either online or in physical retail outlets, nor does it ban online forums, independently compiled reviews or blogs. Some advertising will also be allowed, such as point-of-sale, billboards and leaflets, subject to the rules set out in existing advertising codes to ensure that these do not appeal to people aged under 18 or non-users. There will therefore remain a wide range of information on the products available to smokers who wish to buy these products.
Lord Stoddart of Swindon
I take it that they will not be allowed to advertise on television—am I right about that? I see television adverts from the pharmaceutical companies for Nicorette and that sort of thing, so why on earth should these products be treated differently?
5.30 pm
Lord Prior of Brampton
What the directive is trying to do, though it may not be doing it well, is to differentiate between smokers and non-smokers, particularly non-smokers under the age of 18. It wants to encourage information being given to smokers but does not want to risk the unintended consequence of normalizing vaping so that people who do not smoke start doing so. That is the purpose behind it.
The noble Viscount, Lord Ridley, asked how much money would be spent on public information. If there is evidence that the impact on advertising is such that smokers are not getting the right information about switching to e-cigarettes or vaping then there will be a strong case for a public information campaign to correct that, but we will have to wait and see what impact the directive has. It has also been said that the directive will ban certain types of products and make those that are available less effective. No current type of e-cigarette will be banned. In addition, it is worth noting that this is a fast-growing, highly disruptive and innovative market—I read somewhere that Goldman Sachs has put vaping down as one of the eight most disruptive products being marketed worldwide at the moment. Although we do not know how many products there are in this new and dynamic market, there may be as many as 25,000. Officials are persuaded that after this directive comes through there will still be many products on the market.
Concerns have been raised about the cost of notification for products that are below 20 milligrams per millilitre. The MHRA has announced that the fee for notification will be £150 per product and has been leading work with our partners in other member states and UK industry to develop and publish pragmatic guidance on the reporting requirements to minimise the burden on business. So, we will have to wait and see but I do not think it is right to assume that there will be a significant diminution of the number of products in the market.
Lastly, concerns have been expressed that the limit of 20 milligrams per millilitre will not meet the needs of smokers who are most addicted and that they will be unable to benefit from the harm reduction potential of these products. Again, this is not the case. Higher strength products can still access the market after 20 May, but they will need a medicines licence. Indeed, the Government would welcome a wider range of applications for licensed products. The noble Viscount, Lord Ridley, said that there is only one at the moment—which is true—and that it has not been properly marketed. But the Government would welcome more products in this space so that they can be made available to those such as the noble Earl, Lord Cathcart, who need and would benefit from them.
We know that the most commonly purchased products are below 20 milligrams per millilitre, though we do not know the exact number above that limit. We also know that at this strength or below, it meets the demands of the majority of current users and balances the risk of exposure of nicotine to children with the needs of users. Last week the European court agreed with this assessment, ruling that the provisions set out in the tobacco products directive, including those limiting strengths, were proportionate and valid.
It would be a massive unintended consequence if, as a result of this directive, fewer people gave up smoking.
Lord Lawson of Blaby (Con)
It may well be unintended. I would not know the intentions of the curious people who devised this measure, but it is certainly an inevitable consequence, and it is the consequence that matters, not the intention.
Lord Prior of Brampton
The intention of the regulations is to make vaping safer and less variable than it currently is. The intention of the directive is to make it a better product and to cause more people to use it. If it does indeed result in smokers not giving up smoking, then it will have achieved the reverse of what the Government wish to do. The Government’s view is clear: we wish people to quit altogether but if, as a way of quitting, they can give up smoking and take up vaping, that is something that we wish to encourage. Of course, I understand that nothing I can say today will satisfy my noble friends and other noble Lords, but I have done my best to put our case forward.
Lord Hunt of Kings Heath
The Minister is very gracious to keep giving way. It is interesting that he used those terms. There is a reluctance to promote vaping. Even in the words that he used there was a qualification. The Government would prefer everyone to give up smoking but it sounds as though they are half-hearted about this. I understand why they are in that position but the issue that I raised with the Minister is that the evidence is that the public are confused. My concern is that if weights and measures authorities enforce this in a heavy-handed way, it will confirm the public’s view that there is something wrong with vaping. For goodness’ sake, if we could persuade all smokers to vape, it would be a fantastic public health movement. Why is there this hesitation? I do not understand it.
Lord Prior of Brampton
I think that the hesitation comes because for a number of years the evidence around vaping was not clear. Many distinguished scientists felt that it was potentially harmful; it was not just the tobacco lobby. It is now absolutely clear, as I said earlier—I am unequivocal about this—that vaping is far more preferable to smoking. That does not alter the fact that quitting altogether, either smoking or vaping, is probably the best outcome.
Lord Snape
The noble Lord, Lord Callanan, and I mentioned the “heat-not-burn” products. I know that strictly speaking they are not covered by the SI but, as I understand it, they are covered by the legislation emanating from Brussels as a whole. As the Chancellor mentioned in his Budget that he was looking at an alternative to cigarettes, I wonder whether the Minister can comment on the Government’s future intentions.
Lord Prior of Brampton
If that is on the taxation point, I am not aware of any intentions to tax these products. I will find out more about that question and write to the noble Lord but, as things stand, I am not aware of any intention to do so.
Earl Cathcart
My Lords, the noble Lord, Lord Hunt, has twice mentioned weights and measures authorities enforcing this in a heavy-handed or a light-touch way. Can the Minister comment on which he thinks they will do?
Lord Prior of Brampton
I certainly hope that enforcement will be more Italian than traditionally British, if I may put it that way.
Lord Stoddart of Swindon
I am obliged to the Minister for giving way yet again. I understand that he has no power over taxation but, as a member of the department, he has the opportunity to make recommendations to the Treasury. Would he be prepared to ask his department to recommend to the Treasury that it should not put any tax, other than VAT, on this product?
Lord Prior of Brampton
My Lords, I am not responsible for public health in the Department of Health but I will talk to my honourable friend Jane Ellison, who is the Minister for Public Health and will put that view to her very strongly.
Viscount Ridley
My Lords, I will be brief because I know that other noble Lords are waiting to start the next debate. I am most grateful to all those who have spoken in the debate: my noble friends Lord Brabazon, Lord Callanan and Lord Cathcart; the noble Lords, Lord Stoddart, Lord Hunt and Lord Snape; the noble Earl, Lord Erroll; and my noble friend Lord Prior. I say to the noble Lord, Lord Snape, that he looks in extremely good shape. He did not get the advice he was looking for about his health and I am not medically qualified, but he looks fine to me.
Lord Snape
I apologise for interrupting, but what are his medical qualifications in reassuring me?
Viscount Ridley
I withdraw the advice.
I agree with the noble Lord, Lord Stoddart, and the noble Earl, Lord Erroll, that we need to change the vocabulary in this area. Indeed, I myself now use the phrase vaping device rather than e-cigarette whenever possible because it makes more sense and it is a shorter term. I was also fascinated to recall when listening to the noble Earl, Lord Erroll, how one kept awake on motorways before Red Bull was invented. I did not realise that cigarettes had that effect. The noble Lord, Lord Hunt, has put his finger on it. There is still a real issue of public confusion, which we have seen reflected in recent opinion polls. Over the past couple of years, people’s suspicions about these products have increased because of the misinformation in the studies that were cited by others. The issue of harm is a tricky one to get across to the public because you cannot say that vaping is absolutely safe or that it is good for you. Vaping devices are certainly good for smokers, but in absolute terms they are not good. However, that is not the point. The point is relative harm and harm reduction.
I had originally wanted to put down a regret Motion to express stronger dissatisfaction with the directive and the way it is being brought into law, but the best chance of getting a debate before the end of the Session was through a take note Motion. I am sure that the Grand Committee wants to take note. Perhaps I may make a couple of other brief points. My noble friend Lord Brabazon mentioned that smoking is very regressive at the moment: it bears down much more heavily in terms of cost and suffering on poorer people than richer people. It is no longer an equal opportunity killer, if I can put it that way.
I am most grateful to my noble friend the Minister for the very different tone in his response from that of his predecessor, when we first debated this matter some two years ago in this Room, and for his unequivocal statement that it is a good thing for smokers to take up vaping. I was also encouraged to hear him make the point, and I will press him on it as we go forward, that although the directive prevents advertising, it does not prevent public information campaigns to get the point across to smokers. With that, and the promise of Italian light-style implementation, I beg to move.
Motion agreed.
Author:About James Dunworth
Main blogger at the Ashtray Blog, co-author of a University of Alberta study of "Electronic cigarettes as potential harm reduction products", co-author of the book: "Electronic Cigarettes: What the Experts Say." Works at ecigarettedirect.co.uk.
source: http://www.ecigarettedirect.co.uk/ashtray-blog/2016/05/huge-parliamentary-support-for-e-cigs.html
Huge Parliamentary Support for E-Cigs
Yesterday saw an extraordinary debate in the House of Lords which was hugely helpful for vaping. Thank you to Ian Gregory of Abzed and The 100k Campaign for providing this summary, note and transcript.
Executive Summary
- Political support for the TPD among Westminster politicians has close to disappeared. All that is left is the legal shell
- This creates an unintended problem. The lack of any political will for enforcement risks the black market taking market share and reducing trust in the category
- With DH officials shell-shocked by the political unanimity against the TPD we should consider how the industry can help those officials achieve uniform enforcement of those parts of the legislation that matter and uniform laxity towards those which don’t
- We should leverage this momentum internationally
Backbenchers: Seven backbench peers spoke. All opposed the TPD and cited extracts from reports by Public Health England and the Royal College of Physicians along with the Department of Health’s Impact Assessment.
Shadow Minister: A few years ago the opposition front bench wanted compulsory medicinal regulation. However yesterday the shadow health minister described opposition to e-cigarettes as “bonkers” and said he didn’t understand why e-cigarettes were included in the TPD. He remarked of the regulations that “It is pretty obvious that the Government themselves do not support them because of the amelioration that they have attempted in transposing the directive.”
Health Minister: For his part the government’s health minister said that the arguments made against the TPD had “been very powerful”. He made two concessions requested by Viscount Ridley: the first was to make a strong statement of support for e-cigarettes: The minister said “I can say unequivocally that we are in favour of it as a means for people to come off smoking cigarettes. There is absolutely no question about that.” The second was to say that the TPD’s advertising ban might create “a strong case for a public information campaign” to promote e-cigarettes.
His officials will have been painfully aware of their minister’s lack of enthusiasm for the TPD. He spoke of it potentially backfiring on anti-smoking objectives. He went so far as to suggest that enforcement efforts on the TPD should be minimal saying that he hoped: “that enforcement will be more Italian than traditionally British.”
After the debate peers I spoke to also pointed out how the minister distanced himself from TPD with the words “Officials are persuaded that after this directive comes through there will still be many products on the market.” The minister was highly critical of his Department’s early approach to e-cigarettes saying “I am not sure whether if we had been left to our own devices we might not have come out with something far worse.”
Transcript and video link
Tobacco and Related Products Regulations 2016
10 May 2016
Video of Debate
Motion to Take Note
4.30 pm
Moved by
Viscount Ridley
That the Grand Committee takes note of the Tobacco and Related Products Regulations 2016 (SI 2016/507).
Viscount Ridley (Con)
My Lords, first, I apologise for springing this debate on my noble friend the Minister, in particular, at such short notice right at the end of a Session, but he will appreciate why this is an urgent matter. In 10 days’ time, the EU tobacco products directive may become law through a negative statutory instrument recently laid before this House. I emphasise right at the start that I have no problem with most of the regulations—just the parts relating to e-cigarettes and vaping, which are essentially Parts 6 and 7. My Motion is a little vague on that; the original draft was a little more specific.
As noble Lords will know, it has long been my view that the directive scores an own goal by bringing in measures that would discourage the take-up of vaping and thereby drive people back to cigarettes or prevent them quitting. However, it is not just I who take that view. Increasingly, it is the view of Public Health England and of the Royal College of Physicians, whose recent report on this topic is, I think, a game-changer in this debate. So I am here, at the 11th hour, to help my noble friend prevent a historic mistake being made, or at least to raise the issue. In passing, I note that I have nothing to declare: I own no shares and take no income from anything related to vaping or smoking.
The horrific death toll from smoking—100,000 of our citizens die every year—has, I suspect, touched the lives of many in this Room. It is the biggest cause of preventable death on a scale that is hard to comprehend: it is a Hillsborough every eight hours. It is a scourge that deserves the very best of technical ingenuity and policy-making skills to solve.
Vaping offers, as the Royal College of Physicians said, a great opportunity to apply to smoking the principle of harm reduction—an idea pioneered in this country. When people behave in harmful ways, how do you stop them? You can punish them in the hope of deterrence, as we do with murder and fraud; you can hector them, as we do with alcohol and sugar; or you can try to offer safer alternatives, which is how we tackled HIV infection and heroin addiction in this country in particular, and it is how I believe we should now deal with tobacco. In the case of addictions, where people find it genuinely very hard to resist temptation, harm reduction surely makes sense.
Britain is probably the world’s leading vaping nation. Virtually all of South America has banned the practice entirely, at the behest of the tobacco industry. In America, it is largely demonised and quite a lot of people do not know what it is. Almost all the 2.6 million vapers in Britain are smokers or ex-smokers, and the quit rate for those who try vaping is faster and greater than it is with nicotine replacement therapies or cold-turkey cessation. In other words, this is a public health revolution, and it is costing the taxpayer nothing. By saving smokers a fortune, rewarding entrepreneurs and averting ill health, it is boosting the economy.
However, we have before us a piece of legislation that strangles that breakthrough in red tape. It is the product of big-company lobbying and back-room deals in Brussels. It is legislation which last month the Department of Health admitted, in its impact assessment, risks increasing, not reducing, the amount of smoking. I hope in his remarks today that the Minister will be fully candid and accept that this part of the directive is a mess which does not deserve defending but does need ameliorating. I have alerted him already to three specific matters on which I seek clarity.
First, given that the Royal College of Physicians last month told the Government that they should promote vaping to smokers “as widely as possible”, what new, emphatic and unambiguous statement will the Minister make in support of vaping?
Secondly, given that the department estimates that the tobacco products directive rules will ban 90% of advertising that would have helped to promote switching, what budget has the department specifically set aside for a public information campaign to encourage smokers to move to vaping, as the royal college and Public Health England both want?
Thirdly, given that the regulatory burden that the department is about to place on the industry is so extreme that his officials estimate—at least, this is the only estimate in the impact assessment—that the number of notifiable products will be reduced by 96%, from 25,000 to possibly as low as 1,000, what expenditure will the department make specifically to reduce the cost of the onerous testing regime on the industry?
I would ask the Minister to avoid repeating the erroneous suggestion his officials have been making that any of the £13 billion of public health benefits that his department surmises will come from the tobacco products directive would be the result of Article 20, or Parts 6 and 7 of these regulations. In the table set out on page 45 of the impact assessment, the department has not been able to quantify a single benefit from vaping regulation.
Let me put this in a little context. At the beginning of this decade, attempts to reduce smoking were stalling. We had taxed the habit to the point where the main beneficiaries were black market traders, we had barred smoking from every public building, and nicotine patches were proving unpopular with smokers. Then along comes a technical breakthrough, thanks to a man named who I have met named Hon Lik, working in central China. It was something that gives a nicotine hit in the same fashion as smoking but is far safer and cleaner. It is a fantastic piece of luck, or rather ingenuity. As the Prime Minister told the other place in December, vaping has now helped more than 1 million people in this country to stop smoking altogether.
How safe is vaping? We know that concentrations of harmful and potentially harmful constituents such as carbonyl compounds, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons and other constituents are in the order of 1,500 times higher in cigarette smoke than in vapour. A well-controlled trial has recently been carried out by Dr Grant O’Connell and colleagues working for the vaping manufacturer Fontem Ventures. They asked 15 smokers to give up altogether for five days, 15 to vape only for five days, and another 15 to mix vaping and smoking for five days. They measured the harmful and potentially harmful constituents in the urine, blood and breath of each group, and the results were striking. After five days, the vapers’ carboxyhaemoglobin levels—an indication of how much carbon monoxide they had in their systems—had dropped by 83%, which was an even bigger drop than in the cold-turkey cessation group, whose levels dropped by 75%. Even the dual users had seen a drop of 23%. The amount of carbon monoxide they exhaled had halved in both the vapers and the cessation group. Much the same was true for all the other biomarkers except, of course, for nicotine.
In other words, in terms of harmful constituents vaping is almost indistinguishable from not smoking at all. Both Public Health England and the Royal College of Physicians agree that it is much safer than smoking. As far as we can tell, nicotine addiction without smoking is about as dangerous as caffeine addiction.
Vaping is therefore a public health triumph that the Department of Health has, to its extreme shame, done its utmost to block. In 2010, the department’s medicines regulator, the MHRA, tried to ban vaping devices completely. In 2013, the agency—which is financed largely by the pharmaceutical industry—tried to insist that every e-cigarette should be licensed as a medicine. This would again have amounted to a de facto ban. After six years of trying, the agency has so far only managed to license one e-cigarette, which is still not available to the public. If the Department of Health had had its way, there would not be 25,000 varieties of vaping product on the market today, but zero. The only winners of the Department of Health’s policy prescriptions would be undertakers.
Thankfully—and my noble friends will know how painful it is for me to say this—the European Parliament voted down the folly of exclusive medicinal regulation, but it did not vote down the rest of Article 20 of the tobacco products directive which, in that wonderfully undemocratic way, is now being forced upon us. The truth is that these regulations were scripted in Brussels by pharmaceutical companies desperately trying to protect the sales of their widely unloved nicotine replacement therapies. What we have before the House is still a piece of legislation that is not fit for purpose. When even the Department of Health says that it risks increasing smoking, we know that we are facing a moral responsibility as legislators to review this in great detail. It most certainly should not just be nodded through.
It is no defence to say that some regulation is required. No sensible person would argue against us knowing what is going into e-liquids and what comes out in vapour. Potential toxins should be tested, as happens with food, cosmetics and other consumer products. But as the department admitted in an Answer to a Written Question, far more adverse incidents are reported by doctors about pharmaceutical nicotine replacement therapies than e-cigarettes. At most, a bit of tidying up of the testing process was needed.
Let me put three more questions to the Minister. The Royal College of Physicians describes the big warning labels that will deter smokers from using vaping devices as “illogical”. Does the Minister agree with the royal college on this?
Secondly, the ban on stronger vaping devices—the ones most likely to wean heavy smokers into vaping—was criticised two years ago by a dozen scientists writing to the Commission, which ignored their advice. Economists now predict that 105,000 extra deaths every year across Europe will result from the ban on stronger devices. Does the Minister agree with this estimate? If not, what is his estimate?
Thirdly, the directive proposes that, to cut down the risks of children starting smoking, it is necessary to create a minimum cigarette packet size of 20, yet it imposes a maximum size for vaping devices. This miniaturisation will raise prices and generate more packaging waste. Where is the logic in making the most successful substitute to tobacco more difficult to use?
The Minister has a choice. He can blame Brussels and say this is now a good reason to quit the EU in order to help people quit smoking—a lot of the country’s vapers, who are natural libertarians, are beginning to take that view and to dream of the day after Brexit when Britain abolishes the tobacco products directive and goes back to pioneering the virtual elimination of smoking and its replacement by something much less harmful. Or, if the Minister does not wish to turn this into a referendum issue, he can have a quick rethink and try to alter the implementation of the directive. We have a statutory instrument before us, about a third of which is devoted to stifling an exciting innovation that is saving lives. I beg to move.
Lord Brabazon of Tara (Con)
My Lords, I thank my noble friend Lord Ridley for raising this issue today. Like him, I intend to concentrate solely upon e-cigarettes and vaping. I have no views whatever on the rest of the directive.
Unlike my noble friend, I must declare a major interest in this subject, in that I smoked 20 cigarettes, a packet, a day for the best part of 50 years. I tried a number of different ways of giving up—patches, chewing gum and will-power, none of which worked—until two years ago when I took up using an e-cigarette. I have not had a cigarette since. I am pleased to hear of the health benefits my noble friend has described, which I hope I am now enjoying. I am also pleased that I now have the endorsement of the Royal College of Physicians and Public Health England in my course of action. It is, I believe, recognised by the Department of Health as the number No. 1 tool for helping smokers give up.
I do not know whether my noble friend has the figures—I do not—but I would estimate that 99% of people who smoke e-cigarettes are those who are trying to give up, or have given up, smoking real cigarettes. I cannot believe that anyone would start using an e-cigarette if they had not smoked an ordinary cigarette beforehand. Maybe some people have, but I do not know.
I can also tell the Committee that it is extremely good for the pocket, as well as the health, in that 20 cigarettes now cost something like £9 a packet, a large amount of which goes to the Treasury of course. I was spending £9 a day on cigarettes, whereas now I use a nicotine liquid, which comes in a 10 millilitre bottle, costs £5 and lasts me a whole week. So it is very good for my pocket.
I understand that nowadays a large proportion of cigarette smokers come from the lower-income categories of people and therefore it would be of great benefit to them if they were able to give up smoking cigarettes. I hope my noble friend can confirm that the type of nicotine liquid I use—which is 1.1% in 10 millilitre plastic bottles—will not be banned by this new regulation.
This directive was dreamt up in 2012, quite a long time ago before I—and, I suspect, most people—had heard of e-cigarettes. Like a lot of things that come from Brussels, it has not been adapted to the facts, including the fact that e-cigarettes are now recognised as a good thing. I hope my noble friend can assure me that he will do all he can to limit the damage that this directive might have on people who are trying to give up smoking.
4.45 pm
Lord Callanan (Con)
My Lords, I, too, pay tribute to my noble friend for introducing this debate. I have a great sense of déjà vu because I was one of the people in the European Parliament that he referred to, who helped achieve the original decision against this directive’s restrictions on e-cigarettes. I was also the shadow rapporteur for my group and part of the European Parliament negotiating team that sat until about 11.30 pm in the Berlaymont, with the Commission chairing the meeting and the Council on the other side of the table, thrashing out the messy compromise that we see before us now in the tobacco products directive. Again, I have no difficulties with the vast majority of the directive; my concern was with the articles on e-cigarettes.
Before I started working on this, I had no particular knowledge of the subject. But when any dossier is placed before you, the first thing you do is read the various publications available and listen to all the lobbying and advice and you are also contacted by constituents. I was first alerted to the issue when my email inbox started filling up with literally hundreds of emails from people all over the country—and, indeed, Europe—concerned that these magical devices they had used to give up smoking were going to be banned or severely restricted. Together with a number of MEPs from all sides—including members of both the Liberal Democrats and the Labour Party in the UK—we started a campaign to improve the directive.
I have to say that we were not particularly helped by Department of Health officials. I tried to speak to Ministers many times to find out who was behind the restrictions and why there was such a campaign against something which so self-evidently provides great public health benefits and harm-reduction measures, but I never got a clear answer. I was pointed to a recording of a former public health Minister appearing in front of the European Scrutiny Committee of the House of Commons. When she was asked why she voted for this directive on behalf of the Government, she turned to her officials and said “I think the e-cigarette provisions were removed from it, weren’t they?”—which showed a worrying lack of understanding of what she was voting for on behalf of the Government.
Nevertheless, we ended up with this directive. It was a messy compromise and it is very badly worded, but it is a lot better than it could have been had we not campaigned on it. My noble friend Lord Ridley is quite right to point out the somewhat murky role of various pharmaceutical interests in the production of the directive. When I asked questions in the Commission and the Council—it seemed to me self-evident that these devices were brilliant for reducing tobacco smoking, which I thought was what we all wanted—I asked why they were even in the directive in the first place, given that it is called a tobacco products directive and e-cigarettes are not tobacco products in any sense of the word. The answer I received many times was that this was argued for by the pharmaceutical industry, which would have an awful lot to lose if e-cigarettes supplanted or replaced nicotine patches and gum. I do not know the truth of that, but it seems that it was very successful in getting what it wanted.
I completely agree with all the points made by my noble friends, but I have two additional points to make. First, on advertising, the Royal College of Physicians has a proud history at the heart of tobacco control. Since its first report, Smoking and Health, in 1962, it has been an intellectual leader in the field and is worth listening to. When the headline on the press release on its latest report states in bold,
“Promote e-cigarettes widely as substitute for smoking”,
one would hope that the Government would get the message that its 21 world-renowned authors are trying to put across. But we would be wrong if we thought that, for the regulations that the department wants us to approve are not about the promotion of e-cigarettes but about the suppression of information about them.
Paragraph 176 of the department’s impact assessment forecasts that the EU rules will reduce e-cigarette advertising by 90%. How are smokers supposed to hear about e-cigarettes? In paragraph 167, the department nonchalantly claims that cutting advertising will in fact not reduce the number of smokers switching to e-cigarettes. We have heard this old argument many times before—not from health officials but from tobacco company executives trying to pretend that advertising smoking would somehow not increase the amount of smoking.
The messages that we give really matter. In the complex decisions that smokers make every day about whether to smoke or consume nicotine through much cleaner forms, their perceptions of the relative risks of these products are crucial. The Royal College of Physicians, Public Health England and Action on Smoking and Health have all raised deep concerns about how smokers perceive e-cigarettes to be much more risky than they actually are. It is very interesting that Action on Smoking and Health should now say that, because I recall that that was not the message that it was giving when we dealt with the directive.
We are certainly not going to give that message by banning 90% of advertising, nor by insisting on e-cigarette packaging carrying big health warnings, which is what the Government are asking us to approve in these regulations. The Royal College of Physicians described the imposition of these warnings as “illogical”, bearing in mind that nicotine patch boxes do not have to warn of the dangers of nicotine.
Much of the problem stems from media reporting of junk science. The worst example was a headline in the Telegraph in December, which screamed:
“E-cigarettes are no safer than smoking tobacco”.
It was a nonsense report based on, as I said, junk science.
The second point that I want to raise concerns novel tobacco products. A number of new products have been introduced in this category, particularly products called “heat-not-burn”. These are very interesting developments, and a range of other alternative products is also in development. Some of the ones coming to market contain tobacco, but they work by heating it and not burning it. The absence of combustion is key. We all know that, as my noble friend Lord Ridley has said, harm from smoking comes primarily through the toxins produced by the burning of tobacco. In 1976, Professor Michael Russell wrote:
“People smoke for the nicotine but they die from the tar”.
That was reflected in the title of the recent study by the Royal College of Physicians on e-cigarettes, Nicotine without Smoke. With such technological developments, and a new regulatory basis with the introduction of the TPD, are the Government looking at the opportunities to be had from the available range of products, in addition to e-cigarettes, as part of a harm reduction agenda in the new tobacco control plan?
This is truly a terrible piece of legislation, and I plead guilty for the part I played in helping to produce it in the first place. However, it is not too late to undo some of that harm and to help encourage the taking up of e-cigarettes and, consequently, a reduction in tobacco consumption. Instead of trying to restrict e-cigarettes, the Government should in fact be trying positively to encourage them.
Earl Cathcart (Con)
My Lords, these regulations, or the directive, directly affect me, my health and indeed my well-being. I started smoking before I was a teenager, building up to about 50 cigarettes a day. I tried every trick in the book to kick the habit, but nothing seemed to work. I knew that it would kill me—that I would be gathered by the grim reaper before my time—but I just could not stop. I could not kick the habit.
Then, two summers ago, I was in a taxi in a traffic jam. I was chatting to the driver and at one point I said, “I do wish we could hurry up because I’m dying for a fag”. He turned round with an e-cigarette in his hand and said, “Have you tried one of these?”. I said, “No. What is it?”. He explained that he had tried them and had not smoked a cigarette since. He kindly wrote down the details for me to google, but he insisted that if I tried e-cigarettes I must try the strongest ones I could get because, if I did not, I would not get the necessary nicotine hit and would be back on fags in no time at all. I took his advice about using the strongest nicotine—2.4%—and I have not looked back. I have not had one puff of tobacco since two summers ago, rather like my noble friend Lord Brabazon. So they do work and they do help people to stop smoking.
As we have been told, there are 2.6 million people vaping in the UK. Of those, 40% are, like me, ex-smokers and 59% are dual users who both vape and smoke. The Committee will agree that a single vape is better than a single drag on a fag. Interestingly, only 0.2% of under-18 year-old non-smokers have tried vaping, although continued use is negligible. Research conducted by Cancer Research UK found that smokers who vape are 60% more likely to quit than those who use will-power or over-the-counter nicotine products. These statistics demonstrate that vaping is used almost entirely—99%—by current and ex-smokers. Sixty-one per cent of them say that the sole reason for vaping is to stop using traditional tobacco products.
So why have we got this directive and these regulations? Our masters in Brussels believe that vaping could provide a gateway to smoking and that these tough new laws are necessary to protect non-smokers, particularly children, from using e-cigarettes. However, as I have tried to explain, there is no evidence of this. Ninety-nine per cent of those vaping are current or ex-smokers like me. As to children, as I said earlier, only 0.2% of under-18 year-old non-smokers have tried vaping. There is no evidence that vaping is a gateway to tobacco and no evidence that vaping products influence children.
As vaping is estimated to be 95% safer than smoking, you would think Brussels would want to encourage it. Where does Brussels get its evidence that vaping is harmful? I do not know. Has it been got at by the tobacco lobbyists, who have seen their sales of traditional tobacco fall, or by the pharmaceutical industry, as my noble friends Lord Callanan and Lord Ridley have already suggested?
Brussels is banning advertising; e-cigarettes must carry health warnings; and nicotine strengths are to be restricted. To my mind, restricting nicotine strength to 2% will be particularly damaging, but I would say that, as I still use the 2.4%—as do about a quarter of e-cigarette users. By taking up vaping, I hope to keep the grim reaper at bay for a little longer. I hope that when I run out of my 2.4% nicotine supply and I am forced to use the weaker nicotine, I do not switch back to smoking. That is the danger for many e-cigarette users. Perhaps by the time I run out of my 2.4% nicotine supply, stronger nicotine may be available on the black market, with all the dangers that that will entail.
I would like to use one or two quotes to back up my previous assertions. The Office for National Statistics has said:
“E-cigarettes are almost exclusively used by smokers and ex-smokers … and almost none of those who had never smoked cigarettes”,
were e-cigarette users. Public Health England has said:
“There is a need to publicise the current best estimate that using EC is … 95% safer than smoking”.
It went on to say that:
“Encouraging smokers who cannot or do not want to stop smoking to switch to EC could help reduce smoking related disease, death and health inequalities”.
This was backed by the Royal College of Physicians, which said:
“On the basis of the available evidence, the RCP believes that e-cigarettes could lead to significant falls in the prevalence of smoking in the UK, prevent many deaths and episodes of serious illness”.
Even the Prime Minister, last December, said:
“We need to be guided by the experts, and we should look at the report from Public Health England, but it is promising that over 1 million people are estimated to have used e-cigarettes to help them quit or have replaced smoking with e-cigarettes completely. We should be making it clear that this a very legitimate path for many people to improve their health and therefore the health of the nation”.—[Official Report, Commons, 16/12/15; col. 1548.]
Quite so.
I do not know what my noble friend the Minister is going to say when he responds, but I expect him to support the regulations and the EU directive. There is very little else he can do. Our masters in Brussels have told us to jump and, sadly, the only thing that the British Government can do is jump—until 24 June, of course.
5.00 pm
Lord Stoddart of Swindon (Ind Lab)
My Lords, I first declare an interest, because this is a tobacco and related products order and I am an associate member of the Houses of Parliament Pipe and Cigar Smokers’ Club. I am an associate member because I am a non-smoker, so they tolerate me. I am pleased to be a member of that club because I believe that the attitude towards smoking has been quite absurd in many respects. Measures have been taken against the smoking population—I am talking about the adult smoking population—that are not appropriate in a democratic society, which should allow adults to make choices about their lifestyle and not be dictated to by government.
However, we are not talking about tobacco today. I only just saw the Prayer from the noble Viscount, Lord Ridley—if it is a Prayer—for the debate that he has instituted today, and I think that he and other noble Lords have really put the case. As far as I am concerned, there is probably nothing else to say, except to give them support in resisting the Government’s, and of course the EU’s, decisions to restrict a product that is going to assist others in giving up tobacco smoking. That is almost impossible to believe: that a Government who have been so anti-smoking, and who have themselves brought in so many anti-smoking measures over the years—I have been involved with them for at least 25 years—should now, when we are on the brink of assisting people to give up tobacco smoking, put these very stringent restrictions upon them. Why on earth are they banning the advertising of them if they are a health benefit to people who smoke and the Government think that people ought to give up smoking? To me, that seems to be an absolutely absurd position.
Have there been consultations with the producers of what are called e-cigarettes, but perhaps that was a mistake because they are not cigarettes? Anyone who mentions cigarettes is immediately jumped on by the Government and the department, so it may have been a mistake to label them as cigarettes since they clearly are not and should not be treated as such. Have Ministers had discussions with these producers? I ask that question because the department and Ministers refuse even to meet and have discussions with the tobacco companies. Perhaps that is understandable because the World Health Organization recommends that they should not be given a voice. However, in this case it is something that will help people to give up tobacco. Again, have they had discussions with the people who produce e-cigarettes? I should like to know the answer to that.
The only other thing I have to say is this. I hope that the Government will listen to this debate, although in fact there is not much hope of that because in the past trying to get the Government to listen to reason is like banging your head against a brick wall. It does not matter what you say. They have their policies, but when they get into Government, they often change them. I can remember sitting on the other side of the Moses Room and listening to a former health Minister speaking—not voting—against some of the measures that were being introduced by the Labour Party. An example of those was the hiding of cigarettes behind blinds. He was against that, and indeed I well remember him meeting with retailers and saying how a Conservative Government would see that that was repealed. But of course they are in Government now and so they are in favour of it, and they have brought forward this legislation. It is not about banning a dangerous product like cigarettes; it is about a product which helps people to stop smoking.
So I hope that the Minister will listen carefully to the experiences of those who have spoken in this debate. I should add that I have met many people, including a relative of mine, who had been heavy smokers but were weaned off smoking by using e-cigarettes. I am obliged to the noble Viscount, Lord Ridley, for seeing to it that we have had a proper debate and I hope that the Government will listen to it.
Lord Snape (Lab)
My Lords, I should start by apologising to the noble Viscount, Lord Ridley, for missing the first few minutes of his speech. I appear to be a dupe to the railway industry at the moment. Today’s excuse for the cancellation of my train was a broken windscreen, which I thought was pretty unique. It was a 125 mile-an-hour Pendolino, so I suppose that the windscreen ought to be intact for the whole of the journey.
I agree very much with what has been said from both sides. I do not have any financial or personal interests to declare, although at the age of 74 I know that my generation are habitual smokers. I was surrounded by smokers. Both my parents smoked and, when I went to work for the railway industry, virtually everybody I worked with smoked. However, unlike the noble Lord, Lord Brabazon, or the noble Earl, Lord Cathcart, I managed to find the will-power to give up about 30 years ago. I did it purely by terrifying myself. It became apparent that smoking was synonymous with lung cancer. I convinced myself that every cigarette I lit was the one that was going to give me lung cancer, so eventually I terrified myself into stopping.
However, I do not understand the purpose of this SI or the fact that we are going to ban products that will help people to give up smoking. Like other speakers, I do not believe that someone who is currently a non-smoker will move from vaping to tobacco. Surely it has been proved, or is obvious enough, that people move the other way—from tobacco to vaping—and I cannot understand why the Government are so ready to accept this SI. That is not to say that I am getting involved in what is going to happen on 23 June.
There is a group of people whom the Government ought to be concerned about regarding smoking in the future. As I go round the country, I am concerned about the number of young people who smoke, particularly the number of young women, many of whom believe that smoking helps them to stay fairly slim—I was going to say “fit”, although obviously it does not do that. Anything that would help them to come off tobacco would be good. I have no doubt that the two medical doctors who will reply for both sides will tell us that there is no scientific evidence that smoking keeps you trim. However, I again quote my own experience. I put on a stone and a half quite quickly when I gave up smoking. There was no medical reason for that. It is a fact that smokers are anxious to put down their knives and forks and head for the door to have a cigarette immediately after the main course. Once I gave up smoking, I stayed for the ice cream and puddings and so on. So I want to know from the medical profession, from both sides of the Room, which will kill me first—smoking or my spare tyre. Understandably, I have been warned about both.
Mention was made by the noble Lord, Lord Callanan, of the reduced-risk tobacco products, such as the “heat-not-burn” products, which I understand the industry is currently looking at. I understand that the Chancellor mentioned these products in his recent Budget. I would be interested to know from the Minister what the Government’s intentions are. I fear that if the Treasury acts in the way that it usually acts under any Government, it will be another excuse to tax something as heavily as possible. However, if we are serious—which we are—about weaning people off the demon that is tobacco, then banning alternative products which are proven to be less dangerous is a far from sensible way forward, and I would be interested to hear from both Front Benches why they are apparently supporting this SI.
The Earl of Erroll (CB)
My Lords, I want to say just a couple of words about this. First, I do not really have an interest to declare. I have a wife who is a very heavy chain-smoker, but I do not smoke—I let her go on smoking because it keeps her slightly calmer and liveable-with, and it is probably better than her going on to Valium. Personally, I am a chocoholic, which is a different problem altogether.
I think that we should separate out in our minds the difference between the harm done by the burning of substances which we inhale and the harm, or not, from a particular drug within it—nicotine. If you separate those as two different issues, you realise that this is not the right directive, because this is about tobacco, which at the end of the day is a herbaceous substance which we dry and burn. That is what it is meant to be about; it is not about whether or not nicotine is a beneficial drug.
I do not know much about this because I am not a doctor. I read things in the press which say, for instance, that it can help with Alzheimer’s and dementia, and I read other things which say that that is rubbish. I agree with the noble Lord, Lord Snape, that nicotine definitely used to be an appetite suppressant. One thing that I predicted when tobacco was cracked down on was that we would have an obesity crisis. It is one of the few things that I have been right about and it happened very quickly. If we wanted to prevent all the problems with people being overweight, we could perhaps recommend smoking—it is a question of which way you go.
The calming effect is well known for people who are quite nervous and tense; again, I think that is from the nicotine rather than the burning part of it. We also now have signs over the motorways saying, “Tiredness kills—take a break”. In the old days, you had a cigarette when you were driving and felt tired. I know that you should take a break but sometimes it is 30 miles to the next place where you can stop or you have a deadline, so a nicotine hit was a perfectly acceptable way of keeping yourself awake. Maybe vaping would do that, but the point I really want to make is that we should not be confusing the two things.
5.15 pm
The point made by the noble Lord, Lord Stoddart of Swindon, was also apt and very good: “What’s in a name?”. They should never have been called e-cigarettes because they are not cigarettes. This goes back to the point of the noble Viscount, Lord Ridley, about having to separate the two issues. He was absolutely right there.
I have two things to finish on. One is that this is a directive which we are trying to implement into UK law, not a regulation, which would mean that it was directly applicable in the UK. You should be able to modify the purpose of a directive slightly, in light of the local circumstances, while still trying to comply with its spirit. I have not read the directive at all, so I do not know whether there should be some room for manoeuvre. If we feel that it would be better for the UK population to write it into our local laws in a different way, I hope that such an amount of latitude exists within the directive—and within the EU—to allow us to do that.
The final thing is that wonderful conspiracy theory: that the Treasury gets huge amounts of tax from the smokers but not from the vapers, so the Treasury may rather see us smoking than see vaping take off, and that the Government have a vested interest in making sure that this directive goes through unchanged to prevent vaping. Maybe they should declare that every time they try to promote the directive.
Lord Hunt of Kings Heath (Lab) (Shadow Health Minister)
My Lords, this has been a great debate and I am grateful to the noble Viscount, Lord Ridley, for once again bringing our attention to this matter. It is a pity that we are in Grand Committee and not in the Chamber, but I can understand the reason for that. I should declare my presidency of the Royal Society for Public Health, which has of course produced documentary evidence on electronic cigarettes.
It is tempting to debate Europe—and I look forward to the view of the noble Lord, Lord Prior, on that, as it clearly seems to be part of our debate—and it looks as if we have quite a long time to wait this evening. I am in favour of remaining in the EU, but I would remark that this directive does not seem to show much evidence of the Prime Minister’s claim to have negotiated a new concordat and relationship with the EU.
I am very doubtful about the argument that, if we were outside the EU, we would not be doing this. The fact is—I speak as president of the RSPH—that some elements in the public health world were prejudiced from the start against e-cigarettes. That clearly influenced the Department of Health and is the reason why it has taken such a mealy-mouthed approach to e-cigarettes, which is simply not based on evidence at all. It is interesting that, if you look at some of the papers produced by public health bodies, there are some weaselly words around this issue: “We still don’t know and we need to be very careful”. They are really trying to find a legitimisation for the initial very negative reaction, which I am afraid has laid the foundations for where we are today, because this is bonkers. It is simply madness. Here we have a product which is clearly of benefit to smokers and there is no evidence whatever that it will be used by non-smokers, which is where all this nonsense has come from. Why would a non-smoker take up these e-cigarettes?
The noble Lord, Lord Stoddart, and I have debated tobacco issues for many years, and he will know that I have been strongly in favour of very strong legislation. I moved the amendment to ban the smoking of tobacco in cars with children only a year or two ago, so I am not at all worried about being very tough on smoking, but e-cigarettes are completely different. I do not understand why they are part of the directive at all or classified in the same way.
The evidence is abundantly clear that e-cigarettes are almost wholly beneficial. My concern is that it is also clear that the public are, at the moment, confused. RSPH research revealed that 90% of the public still regard nicotine itself as harmful. Going back to September 2015, Public Health England issued a joint statement with other UK health organisations, saying:
“And yet, millions of smokers have the impression that e-cigarettes are at least as harmful as tobacco”.
It seems to me that one of the real adverse consequences of this is that, as it becomes known that there are going to be major restrictions on the promotion of e-cigarettes, all that will do is emphasise the belief that they are harmful. I have seen the RIA, but I could not see there any analysis of the impact that that could have on reducing the uptake of e-cigarettes among smokers. However, it is a very important point.
I want to put three points to the Minister. First, the noble Viscount, Lord Ridley, asked him what would happen to the investment in smoking cessation services. My understanding is that, as a result of the Government’s cut to the grant to local authorities for public health, smoking cessation services investment is going down. Will the Minister confirm that and say what he is doing to reverse the pattern?
The second point is that, clearly, this directive will go through, because there is no Motion to stop it. What monitoring will take place, and how soon will the Government undertake an assessment of the impact? Assuming that we are still in the EU, is the Minister prepared to go back to the EU if evidence becomes clear that this is having an adverse impact on smokers giving up smoking? I hope he can give some reassurance on that.
The third issue relates to enforcement. In the statutory instrument, regulation 53 makes it clear that:
“It is the duty of each weights and measures authority in Great Britain and each district council in Northern Ireland to enforce these Regulations within their area”.
What guidance is going to be given to the weights and measures authorities about taking a light-handed approach to enforcement?
It is quite clear that these provisions are not supported. It is pretty obvious that the Government themselves do not support them because of the amelioration that they have attempted in transposing the directive. At the very least, one could expect a message to be given to weights and measures authorities that the Government expect enforcement to be proportionate, minimalist and certainly light touch.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con) (Government Health Minister)
My Lords, I do not know whether to thank my noble friend Lord Ridley for bringing this debate here today or not. The arguments that have been put have been very powerful and it would be obtuse of me to say otherwise.
Perhaps I can start by going back to the opening words of my noble friend Lord Ridley, who said that there are three ways of trying to influence the behaviour of people doing things that do harm: you can punish them; you can hector them; or you can try to offer safer alternatives. In the article he wrote in the Times some time ago, he used the example of methadone as something that is not desirable in itself but is used as a means of treating people with heroin addiction.
In the case of tobacco we have tried all three things. We have penalised people through taxation, we have hectored them incessantly for years, and having tried nicotine replacement therapies, in a sense vaping is a way of encouraging people to use something that is considerably less harmful than smoking. Actually, most people would agree that we have been hugely successful in reducing the consumption of tobacco in England. I was asked for a statement of the Government’s view on vaping; I think I can say unequivocally that we are in favour of it as a means for people to come off smoking cigarettes. There is absolutely no question about that. The reports produced by Public Health England and most recently and very powerfully by the Royal College of Physicians entirely endorse that view. The president of the Royal College of Physicians, Professor Jane Dacre, said in response to the report:
“With careful management and proportionate regulation, harm reduction provides an opportunity to improve the lives of millions of people”.
I pick that out because she used the words “proportionate regulation”, and that is really what we are discussing today. It is not about whether we are in favour of vaping or not, it is about what kind of regulation should be around it.
On the European element, given that the noble Lord, Lord Hunt, could not resist throwing that in as one of his questions, I am not sure whether if we had been left to our own devices we might not have come out with something far worse several years ago. The noble Lord was kind enough to mention the original views of PHE and the MHRA, so we may well have brought in a licensing system or even have banned them altogether. I am not sure that one can lay this at the door of Brussels or indeed our own Government. We have been far too quick to resort to regulation in many areas and as a rule I am wholly in sympathy with less regulation. That is the best place to start. What we are discussing today is whether this regulation is proportionate, what damage it could do or what the directive’s unintended consequences might be.
I should just mention while I have it to hand, to put the concerns of my noble friend Lord Brabazon of Tara to rest, that the concentration which he is taking it at will not be affected. It will not have to be licensed by the MHRA, but sadly I cannot say the same to my noble friend Lord Cathcart, who at 2.4% is higher than 2%, which is the cut-off point for licensing. But I shall come to that in more detail in a minute, if I can.
Perhaps I may pick up on a few of the fears that noble Lords have expressed about the directive and see whether I can allay their minds today. It has been said that the directive will ban flavourings in e-liquids. I should make it clear that it will not do so. What it does say is that flavourings which pose a risk to human health should not be used; we could probably all agree that that is a sensible rule. There is an additive called diacetyl, which I think is also used in the making of popcorn, and there are other flavourings where there is some evidence that airways can be inflamed. The noble Lord appears to be questioning that, but I think the RCP report cites evidence that some flavourings can cause damage.
It has also been said that the directive will ban all advertising and prevent shop owners communicating with their customers. It does not do that. The new rules do not prevent information being provided to customers either online or in physical retail outlets, nor does it ban online forums, independently compiled reviews or blogs. Some advertising will also be allowed, such as point-of-sale, billboards and leaflets, subject to the rules set out in existing advertising codes to ensure that these do not appeal to people aged under 18 or non-users. There will therefore remain a wide range of information on the products available to smokers who wish to buy these products.
Lord Stoddart of Swindon
I take it that they will not be allowed to advertise on television—am I right about that? I see television adverts from the pharmaceutical companies for Nicorette and that sort of thing, so why on earth should these products be treated differently?
5.30 pm
Lord Prior of Brampton
What the directive is trying to do, though it may not be doing it well, is to differentiate between smokers and non-smokers, particularly non-smokers under the age of 18. It wants to encourage information being given to smokers but does not want to risk the unintended consequence of normalizing vaping so that people who do not smoke start doing so. That is the purpose behind it.
The noble Viscount, Lord Ridley, asked how much money would be spent on public information. If there is evidence that the impact on advertising is such that smokers are not getting the right information about switching to e-cigarettes or vaping then there will be a strong case for a public information campaign to correct that, but we will have to wait and see what impact the directive has. It has also been said that the directive will ban certain types of products and make those that are available less effective. No current type of e-cigarette will be banned. In addition, it is worth noting that this is a fast-growing, highly disruptive and innovative market—I read somewhere that Goldman Sachs has put vaping down as one of the eight most disruptive products being marketed worldwide at the moment. Although we do not know how many products there are in this new and dynamic market, there may be as many as 25,000. Officials are persuaded that after this directive comes through there will still be many products on the market.
Concerns have been raised about the cost of notification for products that are below 20 milligrams per millilitre. The MHRA has announced that the fee for notification will be £150 per product and has been leading work with our partners in other member states and UK industry to develop and publish pragmatic guidance on the reporting requirements to minimise the burden on business. So, we will have to wait and see but I do not think it is right to assume that there will be a significant diminution of the number of products in the market.
Lastly, concerns have been expressed that the limit of 20 milligrams per millilitre will not meet the needs of smokers who are most addicted and that they will be unable to benefit from the harm reduction potential of these products. Again, this is not the case. Higher strength products can still access the market after 20 May, but they will need a medicines licence. Indeed, the Government would welcome a wider range of applications for licensed products. The noble Viscount, Lord Ridley, said that there is only one at the moment—which is true—and that it has not been properly marketed. But the Government would welcome more products in this space so that they can be made available to those such as the noble Earl, Lord Cathcart, who need and would benefit from them.
We know that the most commonly purchased products are below 20 milligrams per millilitre, though we do not know the exact number above that limit. We also know that at this strength or below, it meets the demands of the majority of current users and balances the risk of exposure of nicotine to children with the needs of users. Last week the European court agreed with this assessment, ruling that the provisions set out in the tobacco products directive, including those limiting strengths, were proportionate and valid.
It would be a massive unintended consequence if, as a result of this directive, fewer people gave up smoking.
Lord Lawson of Blaby (Con)
It may well be unintended. I would not know the intentions of the curious people who devised this measure, but it is certainly an inevitable consequence, and it is the consequence that matters, not the intention.
Lord Prior of Brampton
The intention of the regulations is to make vaping safer and less variable than it currently is. The intention of the directive is to make it a better product and to cause more people to use it. If it does indeed result in smokers not giving up smoking, then it will have achieved the reverse of what the Government wish to do. The Government’s view is clear: we wish people to quit altogether but if, as a way of quitting, they can give up smoking and take up vaping, that is something that we wish to encourage. Of course, I understand that nothing I can say today will satisfy my noble friends and other noble Lords, but I have done my best to put our case forward.
Lord Hunt of Kings Heath
The Minister is very gracious to keep giving way. It is interesting that he used those terms. There is a reluctance to promote vaping. Even in the words that he used there was a qualification. The Government would prefer everyone to give up smoking but it sounds as though they are half-hearted about this. I understand why they are in that position but the issue that I raised with the Minister is that the evidence is that the public are confused. My concern is that if weights and measures authorities enforce this in a heavy-handed way, it will confirm the public’s view that there is something wrong with vaping. For goodness’ sake, if we could persuade all smokers to vape, it would be a fantastic public health movement. Why is there this hesitation? I do not understand it.
Lord Prior of Brampton
I think that the hesitation comes because for a number of years the evidence around vaping was not clear. Many distinguished scientists felt that it was potentially harmful; it was not just the tobacco lobby. It is now absolutely clear, as I said earlier—I am unequivocal about this—that vaping is far more preferable to smoking. That does not alter the fact that quitting altogether, either smoking or vaping, is probably the best outcome.
Lord Snape
The noble Lord, Lord Callanan, and I mentioned the “heat-not-burn” products. I know that strictly speaking they are not covered by the SI but, as I understand it, they are covered by the legislation emanating from Brussels as a whole. As the Chancellor mentioned in his Budget that he was looking at an alternative to cigarettes, I wonder whether the Minister can comment on the Government’s future intentions.
Lord Prior of Brampton
If that is on the taxation point, I am not aware of any intentions to tax these products. I will find out more about that question and write to the noble Lord but, as things stand, I am not aware of any intention to do so.
Earl Cathcart
My Lords, the noble Lord, Lord Hunt, has twice mentioned weights and measures authorities enforcing this in a heavy-handed or a light-touch way. Can the Minister comment on which he thinks they will do?
Lord Prior of Brampton
I certainly hope that enforcement will be more Italian than traditionally British, if I may put it that way.
Lord Stoddart of Swindon
I am obliged to the Minister for giving way yet again. I understand that he has no power over taxation but, as a member of the department, he has the opportunity to make recommendations to the Treasury. Would he be prepared to ask his department to recommend to the Treasury that it should not put any tax, other than VAT, on this product?
Lord Prior of Brampton
My Lords, I am not responsible for public health in the Department of Health but I will talk to my honourable friend Jane Ellison, who is the Minister for Public Health and will put that view to her very strongly.
Viscount Ridley
My Lords, I will be brief because I know that other noble Lords are waiting to start the next debate. I am most grateful to all those who have spoken in the debate: my noble friends Lord Brabazon, Lord Callanan and Lord Cathcart; the noble Lords, Lord Stoddart, Lord Hunt and Lord Snape; the noble Earl, Lord Erroll; and my noble friend Lord Prior. I say to the noble Lord, Lord Snape, that he looks in extremely good shape. He did not get the advice he was looking for about his health and I am not medically qualified, but he looks fine to me.
Lord Snape
I apologise for interrupting, but what are his medical qualifications in reassuring me?
Viscount Ridley
I withdraw the advice.
I agree with the noble Lord, Lord Stoddart, and the noble Earl, Lord Erroll, that we need to change the vocabulary in this area. Indeed, I myself now use the phrase vaping device rather than e-cigarette whenever possible because it makes more sense and it is a shorter term. I was also fascinated to recall when listening to the noble Earl, Lord Erroll, how one kept awake on motorways before Red Bull was invented. I did not realise that cigarettes had that effect. The noble Lord, Lord Hunt, has put his finger on it. There is still a real issue of public confusion, which we have seen reflected in recent opinion polls. Over the past couple of years, people’s suspicions about these products have increased because of the misinformation in the studies that were cited by others. The issue of harm is a tricky one to get across to the public because you cannot say that vaping is absolutely safe or that it is good for you. Vaping devices are certainly good for smokers, but in absolute terms they are not good. However, that is not the point. The point is relative harm and harm reduction.
I had originally wanted to put down a regret Motion to express stronger dissatisfaction with the directive and the way it is being brought into law, but the best chance of getting a debate before the end of the Session was through a take note Motion. I am sure that the Grand Committee wants to take note. Perhaps I may make a couple of other brief points. My noble friend Lord Brabazon mentioned that smoking is very regressive at the moment: it bears down much more heavily in terms of cost and suffering on poorer people than richer people. It is no longer an equal opportunity killer, if I can put it that way.
I am most grateful to my noble friend the Minister for the very different tone in his response from that of his predecessor, when we first debated this matter some two years ago in this Room, and for his unequivocal statement that it is a good thing for smokers to take up vaping. I was also encouraged to hear him make the point, and I will press him on it as we go forward, that although the directive prevents advertising, it does not prevent public information campaigns to get the point across to smokers. With that, and the promise of Italian light-style implementation, I beg to move.
Motion agreed.
Author:About James Dunworth
Main blogger at the Ashtray Blog, co-author of a University of Alberta study of "Electronic cigarettes as potential harm reduction products", co-author of the book: "Electronic Cigarettes: What the Experts Say." Works at ecigarettedirect.co.uk.
source: http://www.ecigarettedirect.co.uk/ashtray-blog/2016/05/huge-parliamentary-support-for-e-cigs.html
