Contribution
My Lords, Amendment 193 in my name and those of the noble Baronesses, Lady Northover and Lady Grey-Thompson, covers much of the same territory as Amendment 199. It would require the Secretary of State to publish a road map to a smoke-free country every five years. It lacks the ambition of my noble friend Lord Bethell, who provides not just a road map but a destination and a date. If we were to agree with my noble friend, that would be worthwhile progress.
This group of amendments is important because, although the Bill is a step forward in promoting public health and reducing the numbers who start to smoke, as it stands it does very little to help the 6 million smokers who are already endangering their health. The amendment reflects the latest APPG on Smoking and Health report, which calls on the Government to publish a road map to a smoke-free country. The Labour Party promised to publish such a strategy in its health mission document, Build an NHS Fit for the Future, saying it was important that no one should be left behind. It said:
“We will build on the success of the last Labour government with a roadmap to a smoke-free Britain”.
I hope this amendment will find favour with the Minister. Can the Government confirm that they have the same target as the last one, to achieve a virtually smoke-free England by 2030?
As I said, the rising age of sale will not affect current smokers but, as the legislation is progressed with, we should not forget them. Smoking is not evenly distributed across our society. There are higher rates of smoking in nearly all groups experiencing disadvantage and high rates among people with mental health conditions, those on low incomes and those living in social housing—the people most at risk of being left behind, whom the Government have rightly said they will look after. In turn, these differences fuel the gaps in healthy life expectancy between different groups in our society and undermine progress on addressing inequality.
To end this inequality, the Government need a clear plan or road map on how we can achieve a smoke-free future for all parts of society. That road map should include clear targets. For example, the APPG on Smoking and Health has called for a national target of 2 million fewer smokers by the end of this Parliament. Is that something that the Minister could sign up to? If such a reduction were achieved, the country would be on track to have less than 5% smoking two years later and could continue progress to make smoking obsolete within 20 years, within shooting range of my noble friend Lord Bethell’s target.
There should also be specific targets for vulnerable groups with high rates of smoking. Under the last Conservative Government, the target to reduce smoking among 15 year-olds was achieved. The previous Government also set a target to reduce the prevalence of smoking in pregnancy to 6% or less by the end of 2022. That target was not met, but it helped mobilise significant support for pregnant women, which has led to a reduction—it fell at the fastest ever rate last year.
The last Government also committed to other targets—for example, using the pioneering Swap to Stop scheme. It is welcome that the Government have maintained their commitment to some of these initiatives, but they should be part of an overall strategy so that we have a clear vision of where we want to go and how the various components help us reach that target. There is also a risk that, once this legislation has passed, the Government, both locally and nationally, are lulled into believing the job has been done, so we need a clear plan now and every five years until we have created a smoke-free country.
I understand the pressure on the NHS, but the astonishing decline in smoking among pregnant women was achieved by embedding support in hospitals alongside financial incentives. However, these services are now threatened with cost pressures in the NHS, seeing some ICBs reduce or decommission those vital services. Within a road map to a smoke-free country, the role of ICBs could be clearly laid out and the importance of these services in helping to reduce the incidence of smoking could be clarified.
So the Bill is ambitious. It is world leading when it comes to stopping the start, but we need the Government to have a similar ambition for supporting the current 6 million smokers in the UK to quit for good.