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Dr. Evan Harris (Oxford, West and Abingdon): First, I alert the hon. Member for Woodspring (Dr. Fox) to the fact that if he sneaks out, which he is about to do, he will miss the opportunity to reply to the points that I would like to put to him in debate. After all, we are in a debating Chamber. I understand that he may have more pressing engagements than doing his job here, and I see from his departure that he has.
I suspect that the Secretary of State will also leave, but I hope that he does not, because I want to echo his tribute to Lord Clement-Jones without whose assiduityand, indeed, that of his Liberal Democrat colleagues in the House of Lordswe would not have the Bill, which is, I grant, the same as that which the Government introduced. I am glad that the Secretary of State at least paid tribute to him. The right hon. Gentleman was a little churlishI would like to say that that is unlike him, but I cannotin remarking that merely a few people played their part. Otherwise, I agree with everything he said,
My final tribute goes to my constituent, Sir Richard Doll, who was the first to publish the clear evidence that tobacco kills and smoking kills. His landmark study set the background not only for this policy, but for many others that Governments have introduced. I hope that future Governments do the same. The fact that he is still going strong at his ripe old age, nearing 100, testifies to what people can achieve if they do not smoke.
It is always a pleasure to be able to support the Government on a manifesto commitment, but it is more than a little unfortunate that we are supporting one from 1997. I concur with almost everything that the right hon. Member for Holborn and St. Pancras (Mr. Dobson) said about the Bill saving 3,000 lives, but it has come too late to save some that could have been saved had it been early legislation. Nevertheless, it is welcome.
Smoking is a public health disaster. The damage that it causes has been described by previous speakers and I shall not repeat what they said, but it is important to recognise that if the Government's only aim is to reduce the prevalence of smoking, they must recognise that their job is to help with that change, not just comment on it if it happens incidentally.
The danger is that the Government may think that they brought about incidental changes in the prevalence of smoking. For example, a large number of people who took up smoking before the dangers were known are dying off, which will inevitably lead to a reduction in prevalence if not in the incidence of people taking up smoking. That is not sufficient, however, and it would be complacent to say, "There has been a fall." We must recognise that the product kills, that it is addictive and that the people who manufacture it seek to recruit more smokers.
The Government must recognise that a comprehensive tobacco strategy has to do more than just ban tobacco advertising. There is a role for increased tobacco duty, but a one-club approach must not be used, because tobacco duty increases create the climate for increased smuggling. Unless commensurate action is taken to curb smoking and to impound smuggled tobacco, simply increasing duty, which may or may not produce more revenue for the Exchequer, will not solve the problem of access to tobacco.
Indeed, if the price of tobacco sold legally and carrying health warnings were increased significantly without tobacco smuggling being curbed, one would lose all the benefits of the price increase as well as those of the point-of-sale health warnings. There are no point-of-sale health warnings in pub car parks and increased tobacco duty is no price barrier for smuggled goods.
Again, the Government appear complacent, because the Secretary of State boasted that the number of cigarettes impounded by Customs and Excise has risen from 2 billion in 19992000 to 3 billion in 200001. As we heard from the hon. Member for Woodspring, the number of cigarettes estimated to have been smuggled increased in the same period from 14 billion to 17 billion. Despite more cigarettes being impounded, which is no surprise considering the increased flow, 2 billion more cigarettes net are being sold illegally to young people in this
John Robertson: Does the hon. Gentleman agree that the Proceeds of Crime Bill, which has been through the House and is being considered by the other place, will go a long way to attack the white van people who bring those cigarettes in? What he says about the Government doing nothing is not exactly true.
Dr. Harris: I hope that that Bill will do something, but my point is not that the Government are doing nothing, although they are not doing enough, but that they should not tell people that the situation is improving because of the increased capture of smuggled cigarettes when the figures suggest that it is getting worse. Nor should the Government see tobacco duty increases as the only answer, because there are problems with using that as the only measure.
I am speaking against a previous policy of my party, but it is appropriate to recognise faults in previous policies when they exist. Increased tobacco duty may have either a public health effect or a revenue-raising effect. It is difficult for it to have both. Therefore, to say that hoped-for increased cigarette duty revenues should go to the health service is self-defeating, because there will be increased revenue for the health service only if people continue to buy cigarettes carrying increased duty. I used to support that policy, but it is flawed. It might be more rational to use increased cigarette duty revenues, if they exist, within Customs and Excise to block the natural consequence of increased cigarette duties. We must recognise that there is a major problem with smuggled cigarettes, especially among young people.
The Secretary of State and the Government are always careful not to antagonise anyone who might later appear in a focus group, so they talk about the right to smoke being protected and the Government being keen to make that clear. But we are really talking about the right of 70 per cent. of smokers to be addicted to cigarettes, because those people want to give up: only 30 per cent. of smokersa small number of the populationwant to continue to smoke come what may.
I realise that there are civil liberties arguments relating to smoking what is currently a legal product, but they must be balanced against arguments about the risk of harm. When the Government talk of their smoking- cessation policies, they must acknowledge that they are dealing with addiction, and with a habit that is probably the single most dangerous in terms of risk. I support their cessation programme as far as it goes, but, as the Secretary of State recognised, it must go further. The Government's attempt to restrict access to Zyban and nicotine replacement therapies, especially in terms of the length of treatment, spoilt what would otherwise have been a good policy.
Notwithstanding evidence now confirmed by the National Institute for Clinical Excellence, Government funds for cessation products in the NHS were initially restricted to health action zones. When it was extended beyond those zones, the time for which Zyban could be prescribed was, at first, much less than what experts deemed to be the optimum. That may save money for hard-pressed drug budgets in the short term, but, as I
I see the Minister responsible for public health frantically scribbling a rebuttal. To rebut what I have said, she will have to claim that her policy on nicotine replacement therapy and Zyban when she took office was the same as that recommended by NICE now. It was not, although at the time the evidence was strong.
General practitioners in my area have told me that because they do not have specific funds for smoking- cessation clinics, they must take practice nurses away from other clinics. If the Government could provide money for the grass roots without having to cut other services, we would be even more impressed by their efforts.
The right hon. Member for Holborn and St. Pancras made an important point about the use of cigarettes in films and on stage, and in the fashion industry. I want to hear what steps the Minister is taking in terms of persuasionit is difficult to do this by means of legislationto educate the fashion industry, women's magazines, the film industry in Britain at least, and television. All the work done to secure a tobacco ban through direct advertising can be undone by the visible portrayal of cigarette smoking as in some way cool in the media to which young people pay attention.
The Government had some good things to say about the health of young women, particularly girls, and their body image, but they now seem to have gone quiet. The two issues are linked: many young women and girls smoke because they think that it will help them to lose weight. It is sad that the Government have gone quiet about the dieting fad, and I hope that they will not be deterred by the scurrilous coverage of their initiative.
The right hon. Member for Holborn and St. Pancras made many points that I had intended to make. That is one of the problems of the Chamber and the status of my party here: we always have to follow learned and useful contributions such as his. He made an interesting point about the question of a tax on production. He knows that that is a rational policy, but he also knows that it would cost jobs in the United Kingdom. Perhaps that is the price we must pay for a moral policy on tobacco products. We have export licence controls on arms, and we are, or should be, seeking diversification of the arms industry. The tobacco industry has had plenty of warning, and I hope and believe that a similar approach is not far away.
The Conservative arguments were shocking. Smoking policy is a litmus test of public health policy, and the Conservatives' justification for their opposition was wholly unconvincing. That is not surprising, because I suspect that the Opposition spokesman's heart is not really in his objection to the Bill. It may be said that that is good for the hon. Member for Woodspring, but I think it is worse politically to say something one knows to be wrong than to stand firmwhether in the shadow Cabinet or elsewhereand say that this policy is right and the policy of one's party and its leader stinks.