November 5, 2024

expert reaction to the tobacco and vapes bill

Scientists comment on the Tobacco and Vapes Bill, including plans to ban smoking outside schools and hospitals. 

Prof Ann McNeill, Professor of Tobacco Addiction at the Institute of Psychiatry Psychology & Neuroscience, King’s College London, said:

“The last time we saw a White Paper announcing a comprehensive tobacco control strategy to combat smoking was over 25 years ago, so a refresh and enhancement of that strategy is desperately needed.  This Bill should reenergise the campaign to make tobacco smoking obsolete, and bring an end to England’s biggest killer. But to do so, the government will need to stand firm against powerful industries. Caving in to the hospitality industry at this early stage is a worry. They have missed an opportunity to reduce the visibility, and acceptability, of smoking even further.”

Prof Sean Semple, Professor of Exposure Science, University of Stirling, said:

“The measures proposed in the tobacco and vapes bill are very welcome. Taking steps to create a tobacco-free generation are hugely positive and will help reduce the ill-health burden caused by smoking. Banning smoking outside schools and hospitals also sends an important message about the harms caused by second-hand tobacco smoke, but we should remember that the highest concentrations and longest exposures experienced by most non-smokers still occur in the home: we need to change social norms and make it as unacceptable to smoke inside homes, particularly where children are present, as it is in workplaces, bars and in outdoor playparks. 

“It is disappointing that the government has rolled back on restrictions on smoking in outside spaces of bars. A recent large study across Europe measured levels of nicotine in the air in outdoor terraces of over 200 bars and cafes, including 20 venues in the UK. Nicotine was present in the air in over 90% of terraces sampled. Higher concentrations were found in outdoor settings during evening and night-time, where two or more smokers were observed at the time of measurement and where the terraces had some walls or roof coverings. While these outdoor concentrations are much lower than the levels that would have been present inside bars prior to the smoke-free legislation of 2006/7, the World Health Organization state that there is no safe level of exposure to second-hand tobacco smoke and that the risks of heart and lung diseases increase with increasing exposure.”

Prof Caitlin Notley, Professor of Addiction Sciences, Lifespan Health Research Centre, University of East Anglia, said:

“It is very important that smokefree legislation does not include vaping. Vaping is a harm reduction approach for adult smokers trying to quit smoking. Policies that deal with smoking and vaping in the same way send a very confusing message. In our smoking cessation trial in hospital emergency departments, patients found it easier to switch to vaping in contexts where they were supported to do so, such as smoke-free but ‘vape friendly’ NHS sites.

“The ban on single use vapes that was previously announced sends a clear message to young people, as these vapes have to date been a low cost, easily accessible option to take up vaping, with marketing fairly obviously targeted at young people. However bans can have unintended consequences, and the history of prohibition tells us that outright bans often do not work. Already manufacturers are producing low-cost re-usable devices, so a ban specifically on disposables may have very limited impact. Through our work we know that young people can easily get hold of illicit black-market products – a ban may fuel black-market sales, which is a real concern as we have no control over unregulated products. Banning products may also confuse people about relative harms. We have to focus on the immense harms to health caused by tobacco smoking and avoid putting people off switching to less harmful alternatives, such as vaping. Policies to regulate products and limit the marketing so as not to appeal to children are important, but in tightening regulations we must not make reduced harm products harder for adult smokers to access, as this could unintentionally prolong or even increase levels of tobacco smoking.

Prof Jamie Brown, Professor of Behavioural Science and Director of the UCL Tobacco and Alcohol Research Group, said:

“Labour will today introduce a world-leading Tobacco and Vapes Bill that has the potential to be the most important public health intervention for a generation. The critical piece of the legislation will be a new law to make it illegal to sell tobacco products to anyone born on or after 1 January 2009. It is likely that this will phase out smoking for the next generation.

“While cigarettes and smoking remain the number one public health priority, the bill also includes powers intended to reduce vaping among people who have never smoked, such as restrictions on marketing and display. Given the evidence on how such measures affected smoking prevalence, it is likely that these changes will reduce vaping uptake in people who have never smoked. However, it is important that these measures are introduced alongside other messaging and policies that continue to encourage and support smokers to use e-cigarettes to help them quit smoking, such as mass media campaigns and the Swap to Stop scheme.”

Prof Lion Shahab, Professor of Health Psychology and Co-Director of the UCL Tobacco and Alcohol Research Group, University College London, said:

“Today, the government has taken a monumental step to correct a 100 year-old wrong by introducing a new Tobacco and Vapes Bill, amended from the previous government bill that did not make it through the wash-up period when the summer election was called. This bill includes a number of world-leading measures; key among them the powers to create a smokefree generation by making it an offense to sell tobacco to anyone born after January 1^st, 2009. When cigarettes first became popular at the beginning of the last century, few could have predicted that smoking would kill 100 million people by the end of the it, and that it would continue to kill more than 8 million people each year, including over 80,000 people in the UK. By creating a product that is both highly addictive and deadly, cigarette smoking has caused untold misery far and wide. If parliament passes this new bill, it would put the UK at the very forefront of the fight to eradicate one of the most harmful inventions of modern times and protect the future of the next generation to allow them to live a full life, unencumbered by entirely preventable cancer, cardiovascular and pulmonary disease. Other measures include further restrictions on where cigarettes can be smoked outdoors, which will not only protect non-smokers from second-hand smoke but also hasten the denormalization of smoking by making it less visible, further driving down smoking rates.

“Given the rapid rise in youth vaping over the last few years, this bill introduces sensible measures to curb their use, including restrictions on advertising and sponsorship, packaging, point-of-sale displays and tackling the illegal sale of vapes. However, in order to improve population health as a whole, it is also important to acknowledge the role that e-cigarettes have played in reducing smoking prevalence in the UK, which stands at a record low. To that end, legislation to protect youth has to be balanced with the need to support smokers to quit, including with e-cigarettes. In this context, it will be important to monitor unintended consequences of some of the measures in this bill (on flavour restrictions) and in a separate bill (banning the sale of disposable vapes) as these may make e-cigarettes a less attractive smoking cessation tool for young and adult smokers. Therefore it is crucial that the government is committed to ensuring the delivery of a comprehensive tobacco control strategy that also includes funding for smoking cessation services, provision of behavioural and pharmacological support to smokers as well as public health campaigns, as these will have a crucial role to play in reducing smoking prevalence to achieve the government smokefree target of 5% by 2030, which it is likely to miss on current projections.”

https://www.gov.uk/government/news/smoking-ban-introduced-to-protect-children-and-most-vulnerable

Declared interests

Lion Shahab: “no relevant COI”

Ann McNeill: “no conflicts”

Caitlin Notley: “No COIs to declare”

Jamie Brown “has received unrestricted funding to study smoking cessation treatments from Pfizer and J&J, who manufacture medically licensed smoking cessation medications, most recently in 2018.”

Sean Semple: “No conflicts of interest.”