---

Tobacco Control Strategy

It is a pleasure to serve under your chairmanship, Mr Betts. What an excellent and extremely

well informed debate we have had. I thank the right hon. Member for Rother Valley (Kevin Barron) for raising this important issue for debate. In a way, the timing is more helpful for me than for right hon. and hon. Members, inasmuch as this is a piece of work to which we in the Department of Health are turning our minds, so it has been enormously helpful to hear the views of colleagues from across the House on how we go forward. There are some areas of the topic on which I can respond, but some on which Members might have to wait until a little way into the new year.

The Government have a very clear position on tobacco control, recognising that smoking is and remains one of the most significant challenges for public health, with all the devastating social and personal consequences that Members have outlined. The Government have been proactive and, I think, ambitious in their approach to tobacco control. That was reflected in the comments made by both Government and Opposition Members, for which I thank them. It is also reflected by the fact that many other countries approach us for advice on tobacco control matters. Over the time I have been in this post, it has been a pleasure to attend a number of international events at which we were asked to provide a leadership role. I will say a little more about international matters before I finish.

Our efforts are paying off, and have paid off. As the shadow Minister said, they build on the good work done by previous Governments in previous Parliaments, and we continue to see year on year reductions in smoking. Since 2010, its prevalence has decreased by almost 3%, saving thousands of lives and, of course, countless families from the pain and harm caused by smoking. At various events in the past I have been open about discussing my experience of that harm in my own family. I know that I speak for other Members who have seen that as well.

Before I talk about the new strategy, it is worth reflecting on progress against the current tobacco control plan. We have met, or are on track to meet, the three national ambitions. Adult smoking prevalence is now at 18%, which is the lowest rate since records began; only 8% of 15-year-olds smoke, which is also an all-time low; and rates of smoking in pregnancy are falling, with the most recent figures showing a rate of 10.5%, so we have a high degree of confidence that we will meet that national target as well. On 1 October, it became an offence to smoke in a car carrying children and for adults to buy tobacco for those aged under 18. Making the latter—also known as proxy purchasing—an offence has been called for a great deal in the past. As has been noted, we have also passed legislation to introduce standardised packaging and consulted on how we intend to transpose the revised EU tobacco products directive into UK law.

Despite those achievements, smoking is still the leading cause of premature death and health inequality, and Members have rightly focused on that throughout the debate. About 8 million people still smoke, and the resulting number of premature deaths has been recorded. There continues to be enormous regional variation, which weighs heavily on me—I know that the right hon. Member for Rother Valley is very conscious of that as well. In some areas the prevalence rate is as high as 29%. With that backdrop, we can by no means think that the battle is won.

There is similar variation in ill health and death rates associated with smoking, as the hon. Member for Central Ayrshire (Dr Whitford) eloquently outlined. That variation means that there can be 472 deaths per 100,000 people in one area and fewer than 200 deaths in the same population in others. Throughout the country, we see variation in rates of smoking by pregnant women from more than 25% to about 2%. I know that some areas are working really hard to address that variation. I pay tribute to the people working in places that, despite the high rates that they battle, have seen encouraging results, such as the public health and NHS teams in Blackpool. They are bearing down on their high rates with some success and have done very well.

While we are discussing the ill health caused by smoking, perhaps this is a useful moment to give the shadow Minister a little reassurance in two regards. He made a good point about oral cancer, and I can confirm that one of the pictures in the new library of photographs being introduced with the tobacco products directive will feature throat cancer, so that will draw attention to it. Also, we received welcome information today from the British Dental Association setting out how dentists can help with smoking reduction and the identification of oral cancer. We will consider that further as we develop the strategy. That is welcome and timely news.

As we are talking about the work that people have done in different areas, such as the efforts to bear down on smoking in pregnancy, which have seen some welcome drops, I want to mention the role of health professionals. Their role has run as a thread through the debate, and I suppose it will be ever more relevant as some services look to integrate more with health professionals in the NHS and elsewhere. The movement of health visiting into local government in October—it is now commissioned through local government, as are public health services—offers a welcome opportunity to get some really close working between those two functions in local government right across the board.

As we look at the new tobacco strategy, we are working with Health Education England to identify how NHS health professionals can be further supported to act on smoking. Nevertheless, progress has been made, and I congratulate the midwives and health visitors who have done such good work to identify women who smoke during pregnancy. We have seen their work reflected in the ongoing reductions in the level of smoking during pregnancy, but there is more to do, so we are looking to build on that success.

As I have said, the Government remain committed to tobacco control, and our goal is to drive down the prevalence of smoking in England. At this point, I should say that we are working very closely and constructively with colleagues in the devolved Administrations on that shared objective. Our officials speak to each other regularly, and we are always interested to look at what measures are introduced. As always, it was good to hear the contribution from the hon. Member for Central Ayrshire. Tobacco-related deaths are avoidable, so we want to do more to avoid them.

Although I have said this in an event in the Palace of Westminster, I have not yet confirmed it in the Chamber, but I can confirm that the Government will publish a new tobacco control strategy for England next summer, which I think is a sensible timetable. I hope Members agree that, given the significant measures coming into

force in the spring and the fact that we want a little time to reflect on the current strategy, that strikes the right balance. The work is under way already, which is why this debate is a timely opportunity to hear Members’ thoughts. I will ensure, throughout the timetable for developing and producing a new strategy, that there are ample opportunities for Members on both sides of the House to contribute to the strategy development. Important stakeholders, such as those who contributed through Members’ speeches today and supplied useful briefing materials ahead of the debate, will have important and regular opportunities to influence the strategy and have input into it.

In developing the strategy, we will review the current national ambitions, and we will further empower local areas and support action within them, particularly where tobacco control strategies can be tailored to the unique needs of local populations. We cannot ignore the stark differences in the results of different areas across our country, so the new strategy has to focus on those discrepancies. Robust activity at that level is vital if we are to tackle the impact of health inequalities in England and ensure that smoking prevalence continues to decline in all communities. We will, of course, need to support local authorities in pursuing collaborative partnerships and securing a high return on investment as they prioritise and streamline their budgets.

A number of questions were asked about funding, and we will give careful attention to it. I am not in a position to comment in detail on the funding of the strategy itself, about which hon. Members made a number of points and expressed concerns. It was made clear in the spending review that the public health budgets are to be ring-fenced for the next couple of years and protected, with conditions stipulating that the whole budget must be spent on public health duties.

If any right hon. or hon. Members are concerned about what is happening in a particular area, I ask them to please speak to me. The chief executive of Public Health England remains the accounting officer for how the ring-fenced public health grant is spent, and I am always extremely happy to ask him to speak to Members about their concerns about what is happening in their own areas. Manchester was mentioned specifically. I can confirm that we are aware of Manchester City Council’s decision, and Public Health England is currently working with it to identify how it can provide cost-effective support to local people who want to stop smoking. The new control strategy has not been finalised, so we cannot commit to the level of funding that will be needed, but Members have made their views on that extremely clear.

I gently say to my hon. Friend the Member for Harrow East (Bob Blackman) in particular that we have championed the way in which, over the past five years, local government has done extremely well in providing excellent services for less cost. It has focused far more on outcomes than on the money spent. It is relevant to bear that in mind, given that Members have expressed reasonable concerns about the local government spending landscape.