Neil O’Brien – 2022 Speech on Smokefree 2030
The speech made by Neil O’Brien, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 3 November 2022.
I thank my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this important debate. I add my voice to the voices of those who have wished the hon. Member for City of Durham a speedy recovery. A lot of the people who contributed to this debate, including the hon. Members for Stockton North (Alex Cunningham), and for Blaydon (Liz Twist), and my hon. Friend the Member for Erewash (Maggie Throup), who all spoke eloquently, have personal experience on this subject, and a real passion for and dedication to achieving a smoke-free England by 2030—a goal to which the Government are completely committed.
I am pleased to update the House on the Government’s work on the Khan review—the independent review of Smokefree 2030 published in June. Tragically, smoking remains the single biggest cause of preventable illness and death across the country. There are still six million smokers in England, and up to two out of three of them will die from smoking unless they quit. Smoking causes seven out of 10 cases of lung cancer, and most people diagnosed with lung cancer die within a year. One in five deaths from all cancers in the UK was connected to smoking in 2019. Smoking substantially increases the risk of heart disease, heart attack and stroke. Smoking is responsible for around 3.7% of all hospital admissions, and so costs the NHS a staggering £2.4 billion each year.
People who start smoking as a young adult lose an average of 10 years of life expectancy, or around one year for every four years of smoking after the age of 30. As many hon. Members have said, action is vital if we are to meet the Government’s manifesto commitment of extending healthy life expectancy by five years by 2035. The Government are committed to levelling up society and extending the same chances in life to all people across the country. As various Members have said, smoking is one of the largest drivers of health inequalities, and rates vary substantially across the country; we heard about that from the hon. Member for Stockton North. As Dr Khan stated in his independent review, smoking prevalence is four and a half times higher in Burnley than in Exeter, so there is huge variation around the country.
Smoking is a huge drain on the household finances of the most disadvantaged families. In Halton in Cheshire, smokers spend an estimated £3,551 a year on tobacco—nearly 15% of their income. That is a shocking statistic. Reducing smoking presents a huge economic opportunity to increase productivity and people’s incomes. Smoking is very high in certain populations, and as my hon. Friend the Member for Erewash said, a third of all cigarettes smoked in England are smoked by people with a mental health condition—an incredible fact.
Behind all these statistics are individuals, families and communities who are suffering from the harms of tobacco. That is why we are so committed to our goal to be smoke free by 2030. We have committed to doing more to help smokers quit and to stop people taking up this deadly addiction in the first place, because we know that most smokers want to quit and many wish they had never started.
The UK is considered a global leader on tobacco control, and investment in evidence-based stop smoking interventions, a strong regulatory framework, local authority stop smoking services and the NHS has ensured that we now have the lowest smoking rate on record: 13.5% in England, down from 21% in 2010 and 45% in 1974. That is a huge change in our society.
In the 2017 tobacco control plan, we set a bold ambition to reduce smoking prevalence among 15-year-olds from 8% to 3% or less by the end of 2022. I am pleased to say we are well on track to meet that target. The Government have also committed to an escalator that increases duties by more than two percentage points above inflation until the end of the current Parliament. In 2010, the average price of a packet of cigarettes was £5.70; and in 2022 the average price is £12.72. Since 2010, duty on cigarettes has more than doubled, and a minimum excise tax has been introduced to increase the price of the very cheapest cigarettes, because we know that one of the most effective ways of stopping people smoking is making it more expensive.
On top of that, we continue to fund a range of comprehensive tobacco control interventions. We have provided £72.7 million to local authority stop smoking services through the public health grant, and more than 100,000 people have quit with the support of a stop smoking service in 2020-21. This year alone, we have provided £35 million to the long-term NHS commitment on smoking, which means that by the end of 2023-24 all smokers admitted to hospital, whether an acute hospital or a mental health hospital, will be offered NHS-funded tobacco treatment services. We will be using those regular touch points, as my hon. Friend the Member for Erewash suggested, to drive down smoking.
My hon. Friend the Member for Harrow East asked about maternal smoking, and the same model is being provided for expectant mothers through the new smokefree pregnancy pathway, including focused sessions and treatments. A new universal tobacco treatment offer is being piloted as part of specialist community mental health services for long-term users of specialist mental health and learning disability services, to help the most vulnerable populations.
The change in treatment for women who smoke in pregnancy is remarkable. Women now routinely get a carbon monoxide test. People will be offered support. In some cases, there are exciting experiments with vouchers and financial incentives that can help, particularly in some poorer communities, people to stop smoking. There is a lot of work on maternal smoking.
Since leaving the EU, we have implemented a new UK-wide system of track and trace for cigarettes and hand-rolled tobacco to deter illicit sales. I have talked about how we have increased duties to drive up prices and to deter smoking, which would of course be undermined if illicit products were circulating.
We have limited the number of cigarettes that people can bring into the country via duty free to 200, making it much harder for those who want to illegally evade excise duties on tobacco. That will help to prevent the sale of cheap cigarettes, further reducing the illicit market.
Although smoking rates have fallen, we recognise that they are not falling fast enough. That is why we asked Dr Khan to undertake the independent review to help the Government to reduce the devastation that smoking causes. The review makes a number of bold recommendations.
Stop smoking services run by local authorities and funded through the public health grant continue to offer smokers the best chance of quitting, and people who get help from local stop smoking services are three times more likely to quit successfully than those who try to quit unaided. I pay tribute to the work of those services, and I assure them that they remain a key part of the Government’s smokefree 2030 ambition.
Alex Cunningham
The Minister knows as well as I do that local authorities have been under tremendous financial constraints in recent times. How can we ensure that local authority public health continues to be funded so that these services can continue? At the moment the services are quite inadequate.
Neil O’Brien
The hon. Gentleman is right that these services are hugely important. All authorities saw an increase last year and there is a 2.8% increase this year, with funding heavily weighted towards more deprived areas, but there is much more we need to do, and we keep it under active review.
We are also building investment in anti-smoking marketing campaigns. It was heartening to see the number of people who joined the annual Stoptober campaign last month. This well-known initiative encourages smokers to abstain for 28 days each October, as we know that smokers who manage to quit for 28 days are five times more likely to quit permanently. In England, the Stoptober campaign has now helped more than 2.1 million people quit since its inception in 2012.
Dr Khan also called for the NHS to prioritise further action to stop people smoking. The long-term NHS plan commitments are a huge step towards preventing smoking-related illness, and they are making significant progress towards reducing preventable ill health and reducing the burden of smoking on the NHS. I have talked about using touch points in hospitals to offer people help to stop smoking.
We have discussed vaping as a substitute for smoking. We recognise that vaping is far less harmful than smoking and can be an effective quitting device. We also recognise that there is more the Government can do to tackle the myths and misconceptions that surround vaping. Our recently published “Nicotine vaping in England” report set out the most up-to-date evidence on vaping, providing an even more compelling case for supporting smokers to switch. However, in recognition of the recent increase in vaping rates among children, which my hon. Friend the Member for Erewash mentioned, we are doing more to prevent children from vaping. We have updated our online materials, and we are working closely with the Department for Education to communicate with schools on how best to set policies around vaping.
My hon. Friend asked a specific question about the MHRA and medical licensing. We are working closely with the MHRA to support a future medically licensed vaping product, which would carry many benefits, including tackling scepticism of e-cigarettes among healthcare professionals. We understand that several products are applying for medical licences early next year. I pay tribute to my hon. Friend for all the work she has done on public health.
As a world leader in tobacco control, the Government continue to support lower and middle-income countries to implement effective tobacco control strategies, and through official development assistance funding to the World Health Organisation-led framework convention on tobacco control 2030, we are supporting a further nine countries to protect their populations from the harms of tobacco.
Both my hon. Friend the Member for Harrow East and the hon. Member for Denton and Reddish (Andrew Gwynne) mentioned article 5.3 of the tobacco control treaty, to which I can confirm the Government are absolutely committed. I consider myself forewarned about the report mentioned by my hon. Friend the Member for Harrow East.
The Government are determined to address the challenges raised by the independent review and to meet our bold smokefree 2030 target. I understand the compelling arguments made by the Khan review and the very strong evidence in the recent “Nicotine vaping in England” report. Over the coming weeks, we will be quickly taking stock on whether a refreshed tobacco control plan is the best way to respond, and on how and when to take forward all the suggestions made by that review.
The Government recognise that more action needs to be taken to protect our people from this dangerous addiction. We know that the action we take must be comprehensive, bold and ambitious. The prize of reaching a smokefree 2030 will be huge for this country, particularly for our most disadvantaged citizens. I thank all hon. Members who have taken part in this debate.
