Anti-Smoking Therapy and Treatment (Hansard, 14 March 2001)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, our measures to help smokers give up include a comprehensive education strategy and the NHS Smoking Helpline. In addition, we have announced today that we intend to amend the relevant regulations so as to allow doctors to prescribe any available nicotine replacement therapy as part of NHS treatment.

§ Baroness Gale
My Lords, I thank my noble friend for that very encouraging reply, especially on National 843 No Smoking Day. Studies show that more girls than boys now take up smoking. Does the Minister agree that there is grave danger to the future health of girls who take up smoking, especially when they may wish to have children? Smoking can cause problems in conceiving, during pregnancy and for the health of the child. Can my noble friend say what health support and advice can be given to girls to discourage them from smoking?

§ Lord Hunt of Kings Heath
My Lords, I hope that they follow the example of the noble Countess, Lady Mar, who I understand celebrates the first anniversary of giving up smoking. I agree with my noble friend. It is worrying that statistics show that in the age range 11 to 15 and 16 to 19 more girls than boys smoke. Earlier this year we announced a £3 million campaign and initiative to co-ordinate all services for pregnant women who wish to give up smoking. Many local health authorities through their various smoking cessation plans have targeted programmes. I also agree that we have to think about young girls. The education tobacco strategy campaign is targeting young women. It is considering whether a specific programme should be developed in relation to young girls.

§ Lord Clement-Jones
My Lords, I welcome the Minister's statement today and the actions being taken which have been urged upon him from these Benches for some considerable time. However, does not the fact that the Government have not yet introduced in this House the Tobacco Advertising and Promotion Bill display a rather lesser commitment to the cause?

§ Lord Hunt of Kings Heath
Not at all, my Lords. So far as concerns the introduction of NRT through GP prescribing, we have always said that we wanted to see how the use of NRT through smoking cessation programmes would develop. I am very glad that we have made the announcement. So far as concerns the advertising Bill, that, as ever, is a matter for the usual channels. I remain ready and eager to take the Bill through the House when the occasion arises.

§ The Countess of Mar
My Lords, perhaps I may first thank the Minister for his remarks. Will doctors be able to prescribe what helped me enormously after I had tried to give up smoking 5,000 times; namely, using double nicotine therapy? I used the patches and I also used the lozenges. The lozenges fitted in with the peaks of the desire for nicotine and ironed those out, and the nicotine patches gave a steady level of nicotine. There is, I believe, some Finnish research which shows that in many cases this method is very helpful.

§ Lord Hunt of Kings Heath
My Lords, the list of products to be removed from Schedule 10, which can now be prescribed, is extensive. It essentially involves Nicorette and a series of patches as well as nasal spray and nicotinal gum. An amendment is being made to 844 the general sale list order which will allow the sale of nicotine lozenges with a maximum strength of 1 milligram.

§ Lord Hogg of Cumbernauld
My Lords, can the Minister tell the House what the Government are saying to employers to encourage young people not to start smoking? Those of us who live up in the City during the working week see groups of young people standing outside the offices of great banks and so forth smoking—having a smoking break. They are all very young. It is most unfortunate that the role models that young people follow smoke. But what are we doing to persuade employers to tell their employees that it is bad for them?

§ Lord Hunt of Kings Heath
My Lords, my noble friend makes a valid point. As part of any local smoking cessation programme, it is very much up to the local health authority to engage in discussions with employers and other relevant bodies, whether voluntary or statutory organisations, and to have a proactive campaign to encourage staff to desist from smoking. The NHS faces a considerable challenge in that area, particularly among the nursing profession. That is something that very much exercises us.

Baroness Young
My Lords, perhaps the Minister will elaborate further on the answer He gave to the noble Baroness, Lady Gale, on the subject of young girls and smoking. Does He not agree that it is a very serious matter? It is observable anywhere and it is schoolgirls particularly who are smoking. What steps are the Government taking to attempt to deal with this very difficult problem?

§ Lord Hunt of Kings Heath
My Lords, I expressed my concern at the level of young girls smoking. It is particularly of concern that more girls than boys are smoking at young ages.
The programme can be separated into two parts. First, there is the tobacco education strategy. Over three years £50 million will be spent on a whole series of media campaigns aimed at the general population and young women to discourage them from smoking. Secondly, at the same time, there are the local smoking cessation programmes. They will be run by every health authority charged with developing local programmes, some of which will be aimed at young girls. Schools very much have a role to play. I hope that they will co-operate with the health service to play their part.

§ Lord Faulkner of Worcester
My Lords, is the Minister satisfied with the progress that the hospitality industry is making in the adoption of its voluntary code of practice on smoking? The latest figures I have seen are that only 1 per cent of its establishments have adopted the code. There are still enormous numbers of places where there is no segregation between smokers 845 and non-smokers. The industry is supposed to reach a target of 50 per cent by next year. Are the Government doing anything to make sure that that target is met?

§ Lord Hunt of Kings Heath
My Lords, my noble friend is right to draw attention to the Public Places Charter which is a voluntary agreement in the hospitality sector. That commits signatories to increase the provision of facilities for non-smokers, to improve ventilation and to give customers better information about the level of smoke-free facilities in a given establishment. The targets that have been set are that, by March 2000, 40 per cent of all pubs, bars and restaurants which are members of the Restaurant Association should be aware of the charter and that 1 per cent should be compliant, but by December 2002, 90 per cent of its members should be aware and 50 per cent compliant.
My noble friend is right to say that the impact on the ground has so far been too slow. We are very much committed to working with the industry to encourage it to ensure that its members, as far as possible, take note. For many of them it makes good business sense to offer smoke-free facilities.

§ Earl Russell
My Lords, while smokers remain about 30 per cent of the population—there is no argument about discouraging people from starting—it would not be wise to make smokers either unemployable or unable to have a meal when away from home.

§ Lord Hunt of Kings Heath
My Lords, as someone who is now on his 30th attempt to give up smoking, I have some sympathy with what the noble Earl says. We roust do everything we can to discourage people from smoking. We should also ensure that, wherever possible, there are smoke-free environments for nonsmokers. But we should not treat smokers as people to moralise against, nor should we make them feel that their civil liberties and rights of existence are under threat. We want a balance. That is what the Government are trying to achieve.

§ Baroness Trumpington
My Lords, is the Minister aware how much I regret not being in the Chamber for the first part of the Question because I was attending the very well attended all-party pipe smokers and cigar smokers luncheon?

§ Lord Hunt of Kings Heath
My Lords, it certainly sounds like it!

§ Earl Howe
My Lords, can the Minister confirm that NRT works only if the person who is taking it does not continue to smoke cigarettes at the same time? Bearing in mind that the cost of NRT is some £10 to £20 a week, what steps will be taken to ensure that GPs do not prescribe it to those who are not going to take it seriously?

§ Lord Hunt of Kings Heath
My Lords, the noble Earl is right to raise the question. In the health action zones 846 where NRT has been made available it has been for a period of up to six weeks, which has enabled an effective control to be placed on the use of NRT. That has proved to be successful. The noble Earl asked about GP prescribing. Prescribing is a matter for the clinical judgment of the GP concerned. I am sure that GPs will wish to take account of the point raised by the noble Earl.