§ 11.7 a.m.
§ Mr. Robert Kilroy-Silk (Ormskirk)
I beg to move,That this House calls upon the Government to lay before Parliament a draft Order under section 105(1)(b) of the Medicines Act 1968 containing the following provisions:'For the purpose of section 105(1)(b) of the Act, tobacco and smoking substances are specified as substances which are not themselves medicinal products, but if used without proper safeguards are capable of causing damage to the health of the community, and it is hereby ordered that the following provisions of the Act shall have effect in relation to such substances as those provisions have effect in relation to medicinal products, that is Parts I, II, III, V, VI, and VIII'.Although I am a relatively heavy smoker, I accept that there are very serious hazards and risks to health in smoking and that it is a cause of serious illness and death. In such circumstances I believe that the House, and the Government in particular, have a clear duty to do everything possible by educational and scientific means to safeguard and advance the health of the community by taking special measures in regard to tobacco and tobacco substances.
Specifically, I submit that it is the Government's responsibility to take the lead by using all possible means to help smokers to give up the habit, which is life-destroying, and to take steps to persuade others not to get hooked on the habit in the first place. Smoking is particularly prevalent among an increasing number of juveniles and young persons, especially schoolchildren.
Recent studies have shown that there is an alarming increase in the incidence of smoking among schoolchildren many of whom are seduced by the sedulous advertising of the industry into the impression that if they smoke they will fulfil ambitions. The advertising presents an image of a virile, dynamic, energetic life—at an age when the children are immature and cannot pass a proper judgment about the risk to their health and the general hazards involved in smoking. I believe that the Government would be failing in their duty if they did not take all possible steps and actions open to them to take far more control of smoking and tobacco substances.
The health hazards of smoking are not disputed, and I do not think that any hon.
787 Member would claim that the overwhelming evidence from many authorities in a decade or more could be contradicted or invalidated. The case has been demonstrated by two reports, particularly by a report in 1971 by the Royal College of Physicians.
All the studies in this country and abroad have clearly demonstrated the dangers and risk to health and have emphasised the need for preventive measures. Indeed, the Government—and my hon. Friend the Minister of State, Department of Health and Social Security emphasised this on 6th August—have estimated that there are about 50,000 premature deaths a year as a result of smoking, about 15,000 deaths annually of unborn babies, deaths attributed to the smoking habits of their mothers. Smoking is linked to a range of horrific illnesses and diseases among which the most important are the well-known illnesses of lung cancer, heart disease and bronchitis.
It is not just the deaths we must consider, but the considerable suffering and ill health caused to a large proportion of our adult population. It is difficult to be precise about the effect in terms of working days lost. The Government's estimate is that about 26 million working days a year are lost as a result of illnesses directly attributable to smoking.
The World Health Organisation said in 1970:Smoking-related diseases are such important causes of disability and premature death in developed countries that the control of cigarette smoking could do more to improve health and to prolong life in these countries than any other single action in the whole field of preventive medicine.In itself that is a gross indictment of measures taken so far, both by successive Governments and the industry, to draw attention to the risks and hazards to health of smoking. It is an indication of the failure to take more positive and imaginative measures to reduce those risks and hazards. There is overwhelming evidence of the damage and the risks. The Government would be remiss in their duty if they did not act positively and quickly.
It is my submission that the Government and hon. Members have a clear duty to take steps effectively to minimise the risks to smokers. That is no doubt an objective that will be shared on both 788 sides of the Chamber. The Government also have a clear duty to ensure that they do everything possible to persuade nonsmokers not to begin the habit. The Government—and a responsible Opposition—have a role to play in ensuring that there is the fullest provision of information dealing with the dangers to health and the illnesses that can be derived from smoking. The way to do this is to ensure that tobacco and tobacco products are subject to the same kind of vigorous assessment and control as other non-medicinal products regarded as being dangerous to health.
We are not talking about defining tobacco as a medicinal product—as the industry brief sent to hon. Members suggests. The Medicines Act specifically states that it can also deal with non-medicinal products dangerous to health. It is now 15 years since the first report of the Royal College of Physicians was published—it was entitled "Smoking and Health". Yet, unfortunately, very little has been done in the intervening period to take effective action to bring home in any dramatic way the dangers inherent in smoking, or to negotiate much more positive agreements with the industry. Although there has been progress on a limited scale, it has been mainly confined to what the industry will accept. What the industry has accepted has been what it believes will not be substantially detrimental to its interests.
The industry has made certain voluntary agreements, but they have been pinpricks in terms of the scale of the problem and in any event they have not substantially reduced the scale of advertising, sponsorship, or promotion. From recent figures it can be seen that they have certainly not reduced the consumption of cigarettes, or even of those that are most highly dangerous. Successive Governments have attempted to obtain voluntary agreements with the industry. They have proved difficult to obtain and, when obtained, have been given grudgingly and unwillingly by the industry and frequently subsequently flouted and broken.
This applies particularly to advertising. It is here that agreements are most often flouted by the industry. The industry has found loopholes in agreements and ways of evading their spirit. Because of this, all the dangers to health —which are not contested substantially, 789 but which are generally accepted and have been well documented and demonstrated here and abroad—have not been brought home. A long time has elapsed since the first dramatic scientific warnings on the dangers of smoking. Within that period very little has been done to take positive action to reduce the risks and to control the way in which tobacco and tobacco substances are marketed and promoted.
We now need, as the Government accept, machinery analogous to that of the Medicines Act, machinery that would enable action to be taken and based upon advice from an independent, expert committee. Such advice would be given after consultation with the industry. What is proposed in my motion is that tobacco and tobacco substances should come under the umbrella of the Medicines Act. I suggest that there should be a committee similar to the Hunter Committee, analogous to the committee that considers the safety of medicines. This new committee would be composed of independent, impartial, scientific and medical experts.
The committee would have the power to investigate the sale and manufacture of tobacco and tobacco substances. It would be able to look into means of reducing the tar yields and the nicotine and carbon monoxide contents. It would be able to assess, investigate and give advice about health warnings, information on packs, leaflets and advertising. It would also be able to try to arrive at codes of practice for promotion, advertising and sponsorship of sporting events by cigarette and tobacco manufacturers. This committee would look into the whole question of substitutes and additives.
I ought to stress at this point that bringing tobacco and tobacco substances under the umbrella of the Medicines Act and referring them to a committee, which could be the Hunter Committee made legal, as it were, does not of itself mean that there would be today, tomorrow, next month, or next year, the automatic imposition of controls on advertising, sponsorship, sale and manufacture. There would be no question—as some of the more hysterical opponents of my motion have suggested—of people being able to obtain cigarettes only on prescription, or through authorised outlets. I emphasise that this is an advisory concept. Further 790 action on the advice would have to be determined in the light of legislation brought to and considered by both Houses of Parliament.
The committee would not have the power to make the kind of regulations and controls that many people who oppose this imaginative and positive approach to the problems of smoking and health seem to think exist and wish to pretend exist. There could not be and would not be any further controls without legislation. The method of using the Medicines Act, or something analogous to it, would have great advantages.
By agreeing to this motion and, I hope, introducing an order we should be demonstrating that cigarettes, tobacco and tobacco substances are clearly recognised as being dangerous to health. The Government would be giving a public demonstration of the risks and dangers. All the aspects that may be a bone of contention between the industry and the Government would be under continual assessment and investigation. The industry would be fully involved and consulted at all stages.
This is not an attempt to set up a committee that would arrogate to itself powers to intervene, to determine and to impose. The committee would be independent and impartial and would consider problems dispassionately and objectively, taking the industry into its confidence and its consultations at every stage in an attempt to formulate not restrictionist measures, but measures conducive to the health of the community. There would therefore be great flexibility in this procedure in that controls could not be introduced without the Government acting upon considered advice—and then only if voluntary agreements had not been made—and acting only through controls, if it is to work through controls, that have been debated in Parliament and determined democratically.
The procedure would also provide a framework of law, which is, I understand, the Government's policy, and reserve powers to back up the voluntary agreements. I should hope that, as a result of bringing tobacco and tobacco substances within the Medicines Act, there would be far more impetus from the industry towards arriving at voluntary agreements so that the legal reserve 791 powers would not be used very often. However, because they existed the industry might be far more forthcoming about making voluntary agreements that nevertheless had the potential back-up of legal powers for the occasional rogue manufacturer, or for the foreign manufacturer who might not be a party to and did not wish to abide by agreements voluntarily made by the industry, the committee and the Government.
Another important facet of the suggested procedure is that it would de-politicise the issue. One of the problems of any attempt to inject a saner element into the way in which we control the use of tobacco and tobacco substances is the fact that inevitably the industry sees itself as being in a situation of conflict with the Government. It is continually dramatised in the Press as being a confrontation between a laissez-faire type of industry that wants to be left alone and an interfering, interventionist Government.
The suggested procedure would take the whole question of smoking and its relationship to health out of the area of conflict and confrontation, and politics, and put it into the arena of dispassionate, considered assessment by an independent, scientific and medical committee, where it should always have been. As I have said, it would have the further advantage of de-politicising the issue, because, when my hon. Friend the Minister of State goes to higher places, we should not be confronted by a Minister perhaps more apathetic to the subject and not as enthusiastic about and committed to the health of the community as he is.
There would be a much more consistent approach to the issue and a more on-going attitude towards the health hazards and dangers inherent in smoking and a more consistent and on-going strategy for their removal. There would be a continuing dialogue, almost on a daily basis, between the industry and the committee in, one would hope, the shared expectation of arriving at common objectives beneficial to the industry, to the committee and, most important of all, to smokers, such as myself.
What is needed is a revolution in our attitudes to smoking and its relationship to health and a sustained strategy for the future. For far too long we have adopted what can only be described as a restric- 792 tionist, negative attitude. What we want is a much more constructive approach to the issue, involving consultation among all the effective interests, with agreed solutions to an agreed problem.
The Government have already set out their view that they wish to continue through a system of voluntary agreement. However, my hon. Friend the Minister of State said on 6th August that the Government wanted to see in existence a system of voluntary agreement based upon an independent medical and scientific advisory committee. The Government have said that they believe that the stage has been reached when this can be best achieved through a framework of law. I hope that there will be no going back on that clear and specific commitment.
Legislation, to which my hon. Friend the Minister of State has committed himself and the Government, is favoured not only by the Government but by organisations such as ASH, the Royal College of Physicians, the British Medical Association and the World Health Organisation. The procedures have worked well in relation to the pharmaceutical industry. There has been a continuing dialogue with the industry with no ill effects to it and no serious conflict has arisen. As a result of legislation, a number of voluntary agreements have been arranged between the industry and the Government.
The procedure suggested in the motion would provide for a wide range of consultations and the injection of an independent element within a legal framework, but subject always to the oversight of Parliament. The legal powers could be held in reserve to give legal backing to arrangements that have already been operating successfully and that have been supported by all the major companies, or to ensure that they are not flouted by companies or foreign manufacturers.
A committee of the type suggested would have particular value in four main areas. First, it could help in making agreements with the industry on the gradual phasing-out or modification of products recognised as being particularly dangerous to health after careful assessment of those products and consultations with the industry. That could be one of the committee's first remits.
793 Secondly, the committee could help to ensure that the danger from the tar, nicotine, or carbon monoxide content of certain brands was clearly, fairly and concisely presented on packets and leaflets and in advertising. That would not be a gross interference with the liberty of the subject or the freedom which the industry regards so highly. It is certainly an infringement of the liberty of the subject not to warn him of the inherent dangers of particular brands, and I should have thought that, if the industry was concerned, as it says it is, about the safety of its products, it would take all possible measures to remove the dangers or to make sure that the people who bought its products were fully aware of the dangers and risks that they were taking.
Thirdly, the committee could give advice on the role of advertising and promotion, particularly in relation to children. A campaign started this week to discourage schoolchildren, some of them very young—11 years of age and upwards—from smoking. We know that about one-third of young boys are habitual smokers. Studies have shown that after the second cigarette, they are virtually hooked for life on smoking. Though the evidence is not as conclusive as one would like, there is at least a suspicion that the smoking habit of the young is largely a result of the kind of advertising to which they are subjected.
There could at least be an agreement about which brands are the most dangerous and which are the least dangerous —because, of course, they are all dangerous—and an attempt to estimate how advertising could lead to a switch in consumer demand away from the most dangerous. That would not be too great an obligation or imposition on the industry. It could and should be prepared to collaborate with the Government in such a matter.
The most important and immediate need is to control substitutes and additives. Much work is going on here and abroad in an attempt to find substitutes for tobacco, and this is a recognition by the industry that it has a product by which to some extent it is embarrassed. There are also attempts to find additives to make smoking safer.
It is not my aim to prohibit smoking. As a smoker myself, I should resent that
794 most deeply. I am not attempting to ban, prohibit, or impose curbs on the freedom of the individual to live his own life in his own way. I would be the first to challenge any attempt to restrict my self-acknowledged addiction, but it is important to try to make smoking safer for those who do smoke and to persuade other people not to start. Many millions of our fellow citizens would continue to smoke however much we embarked on education and propagada drives to ram home the dangers of smoking. These are the people with whom we should be concerned.
I am worried about the plans of manufacturers to introduce substitutes, additives, or a combination of both. There are risks of new hazards being introduced into smoking. There are many unknown factors. We are embarking on an unchartered area and there is a need for maps. These maps could be provided by the order that I am suggesting and by the committee that I hope would look into the whole question of substitutes and additives.
There is a clear distinction between tobacco and tobacco substances now on the market—we have to try to make these safer, help smokers to give up the habit and others not to start—and the whole new question raised by products containing substitutes or additives. Here there must be firm control from the beginning so that they cannot be the cause of death and ill-health in future as cigarettes and tobacco substances have been in the past.
It is no exaggeration to say that cigarette manufacturers are merchants of death and retailers of disease. They must not be allowed to do either of these things with the new substitutes and additives. There must be strict control over their future wares and they should not be allowed to peddle new products on an unsuspecting public unless they have been properly tested and approved in advance.
The Hunter Committee, an independent scientific committee on smoking and health, reported last year and set out guidelines for the testing of tobacco substitutes and additives. It is crucial that I emphasise to the Minister of State that no cigarettes containing substitutes or additives should be marketed in this country unless they have been seen to conform to the guidelines set out by the 795 Hunter Committee and that the Committee has confirmed to the Government that the substances or additives have satisfied the guidelines.
The Hunter Committee considered that the use of additives and substitutes carried substantial dangers. I propose that in the interests of health the House should call on the Government to lay an order specifically in the first instance to control substitutes and additives. We are talking not about what is already on the market, but about new, unknown, untested, untried and potentially dangerous products about to flood the market. Under the order the Government would have the power—and I hope that they would take it—to license products containing substitutes or additives on the advice of the independent committee.
§ Mr. Kenneth Clarke (Rushcliffe)
If it emerged that the industry would give a voluntary undertaking not to market any substitutes or additives unless it had clearance from the Hunter Committee, would the hon. Member still think it necessary to legislate by laying an order, as the motion recommends?
§ Mr. Kilroy-Silk
If the industry said that it would not introduce any substitute or additive unless it had been cleared by the Hunter Committee and had satisfied the guidelines laid down by the Committee last year, that would be a welcome step, but I think that legislation would still be necessary. We are dealing not just with manufacturers in this country, but with those elsewhere. If manufacturers are prepared to agree voluntarily not to market products containing substitutes or additives without clearance from the committee, they have no reason to oppose legislation.
Perhaps I should emphasise again that no new products containing substitutes or additives should be allowed to be marketed unless they have been licensed and cleared by an independent committee. This is the least we should do and we have a duty to accomplish it.
However, although this would be a logical, useful and welcome step, in itself it is not enough and in many ways it would be a red herring. If the industry is willing to accept voluntary controls over substitutes and additives, which are 796 marginal to the main issue, from its record one must suspect that it does not have much to worry about. While one would welcome such a step, the Government should not claim it to be a major coup, but should use it as a step on the ladder to further minimising risks to health.
This debate would not have been necessary if the industry had shown a proper sense of responsibility to the community in the past. It would not have been necessary if, instead of reacting negatively to events, the industry had taken the initiative itself and had been more open and welcoming to initiatives taken by other organisations and by the Government. The industry has constantly had to be prodded like a recalcitrant and obstinate mule and it has given concessions unwillingly and grudgingly. Most of those concessions have not materially affected its welfare or its sales and have certainly not affected its profits. The industry as a whole bears a heavy responsibility for the effects of the product that it markets.
§ Mr. Kenneth Lewis (Rutland and Stamford)
The hon. Member is criticising the people who quite legitimately manufacture a product for sale to the public. Does he not appreciate that whenever Ministers of either Government have requested discussions with the industry, it has complied, has argued its case and then has gone along with what the Ministers have suggested? The Chancellor of the Exchequer takes a large amount of money out of this industry—I believe that the figure is £1,700 million a year. How can the hon. Gentleman complain about the line adopted by the industry when the Chancellor takes an even more positive line in refreshing the revenue?
§ Mr. Kilroy-Silk
I am not here to defend my right hon. Friend the Chancellor; nor would I do so. The hon. Gentleman said that the industry was willing to discuss matters with Ministers. Of course it is, and it will keep those discussions going for as long as possible because of its own vested interests. The industry has not been willing to take positive initiatives itself. One would have thought that an industry of this size and wealth, recognising the health hazards and problems which are caused, through no 797 fault of its own, would feel some sense of responsibility to the community and would take positive steps, if for no other reason, for the benefit of its own public relations, on which I believe it has been badly advised.
The industry should have recognised these problems and shown itself as not needing to be called unwillingly into the arena for discussions on making smoking safer, but responsible and willing to take action on its own account. It has not done that. Instead it has responded and reacted and shown itself negative in defence of its own vested interests. It has gone to absurd lengths to do so. The industry's brief for this debate is fanciful, inaccurate, misleading and spurious
§ Mr. Kilroy-Silk
—in many of the most important aspects with which we are dealing.
The industry bears a heavy responsibility for advertising, particularly as it affects children. What initiative has it taken in the light of the overwhelming evidence of the number of children who are now smoking addicts and who are laying themselves open to a future of potential premature death, illness and discomfort? The industry has ploughed very little of its resources back into the community except in ways which are a direct benefit to itself. It has done little in a positive sense, and I believe it could be helpful in its responsibilities for the future health of children only if it supported our intentions today to try to remove, through this moderate, responsible and sensible measure, the risks to health.
There is no attempt today on my part, and I would resist any such attempt, to ban smoking. We cannot do that in a democratic society, and we cannot tell adults what to do. This motion is in no way motivated by spite or a killjoy attitude which tries to curb or control other people's pleasures. It is motivated only by concern for the health and welfare of the community. It is not a measure of intervention or interference in the industry. There can be no controls without them having first been debated and approved by Parliament. It is a measure which would commend itself to any sensible, objective, reasonable
798 person, and because I believe it to be reasonable and moderate, I commend it to the House.
§ 11.45 a.m.
§ Mr. T. H. H. Skeet (Bedford)
I pay tribute to the hon. Member for Ormskirk (Mr. Kilroy-Silk) in having the initiative to select the subject for today's debate. I believe, however, that he spoilt his speech towards the end when he made all sorts of allegations against the companies involved. Of course there are dangers in smoking. The hon. Member and I share the great sin of smoking. Perhaps the rest of the country might follow my example in not smoking in the morning but smoking in the afternoon, a method by which I have cut down my own tobacco consumption.
One can die from an over-indulgence in food or drink, and gambling and all sorts of other activities can affect one's health. Many of my hon. Friends and I sincerely feel, however, that we can over-legislate, that we can provide laws that are too complicated. If the companies are prepared to enter into voluntary arrangements that will work, that will be the most sensible and effective way of seeing that the Government's ideas are implemented.
The hon. Member referred to the Hunter Report. Perhaps I may quote from paragraph 12, which says:Companies which have expressed an interest in marketing in the United Kingdom cigarettes containing a tobacco substitute have seen earlier drafts of these guidelines and have agreed in principle to abide by them.Surely that amounts to co-operation. How can the hon. Member possibly say that the companies were disposed to ignore the Hunter Committee? The very opposite has been the case. When a former Government found it necessary to put a health warning on cigarette packets, the companies agreed.
§ Mr. Skeet
My judgment is that advertising does not lead to increased consumption. People will always resort to an acceptable social habit whether or not there are controls on advertising. The purpose of declaring the tar content was to try to persuade people to buy those 799 brands which contain less tar, and there may be some sense in that.
The hon. Member for Ormskirk referred to the Medicines Act 1968 and to Section 105(1)(b) in particular. I do not believe that that provision provides an adequate solution. It says:if used without proper safeguards, is capable of causing danger to the health of the community, or of causing danger to the health of animals generally or of one or more species of animals".If there is any danger from tobacco, it is to the individual and not to the community. I believe, therefore, that this provision does not apply. It was intended to deal with insecticides and herbicides which have an effect on the community.
If the hon. Member is to utilise that method, might it not be better to approach the industry for discussions to see whether it will voluntarily undertake to accept certain proposals without resorting to statute? After all, why is the statutory form required? There is already sufficient control. The industry is prepared to investigate matters which affect the smoker. It is prepared to try to determine what it is safe to advertise even against its own interests and to undertake other matters which are of considerable importance.
Reference has been made to tobacco additives. Is it considered that water when added to tobacco is an additive which can be injurious to health? Mentanol, oil of lemon, glycerine and sugar are all used as additives. Arc they considered to be capable of causing injury to health? Perhaps the Minister will consider that point. Will he also consider the implications of using the Medicines Act 1968? Under that Act the Minister would have power to prohibit the sale of cigarettes. He would be able to make them available only on prescription from a pharmacist.
Advertising could be banned completely or controls could be placed upon the contents of advertisements. The requirement could be made that information leaflets should accompany each packet of cigarettes. In an extreme case a skull and crossbones sign could be placed on each cigarette to indicate that there was an inherent danger to health. I am certain that the hon. Member for Ormskirk recognises the power that is given 800 to the Minister by certain sections of the 1968 Act.
I am sure that the hon. Gentleman does not intend that what I have described should come about. I do not believe that he wants the Government to have complete control over the industry. The Government could tell the industry virtually to close its doors and to stop producing the product which a few people in the House consider injurious to health. A short while ago the hon. Gentleman said that approximately 50,000 young children had been deprived of their lives because their mothers smoked. If he is calling upon the House eventually to pass an Order limiting the use of smoking, he may have cause to recollect the legislation which we passed several years ago on abortion, which will cost the nation a million children by 1980.
§ Mr. Kilroy-Silk
The hon. Gentleman is spoiling his case. He will recognise that none of the things he has suggested can be done without the approval of Parliament. He is right in saying that the Government can do this, that and the other—of course they can, given the approval of Parliament. The hon. Gentleman is putting forward a specious argument.
§ Mr. Skeet
The hon. Gentleman has misunderstood my argument. We can do anything we like with the agreement of the industry. It is always my principle to move by consent. If the industry consents to do something, it means that we have its immediate co-operation. In that situation the industry is not looking for loopholes. If we proceed by consent, the industry will want to help the Government and its customers. It will want to move towards trying to get a tobacco which is safe and secure. Let us remember that the Government, as my hon. Friend the Member for Rutland and Stamford (Mr. Lewis) has said, collects £1,700 million from smoking.
The tobacco industry, like all private enterprise, is not irresponsible. It does not want to poison the nation. The hon. Member for Ormskirk smokes, and he is quite capable of stopping the habit if he wishes to do so. The industry has been diversified and I understand that it has spent £10 million to £15 million in trying to find an adequate substitute which will be safe. I do not accept some reports. In 801 Germany a report found in one direction whereas in another part of the world another report found in a completely different direction. I am prepare to accept for the purpose of the argument that there is an element of danger involved in smoking.
It is my contention that the advertising of cigarettes does not increase consumption but prompts people to move to another brand. It is rather interesting that the Minister has advanced evidence on this topic. He has mentioned the McGuinness and Cowling Report from Warwick University which was published in the European Economic Review in June 1975 but he has made no reference to the James Hamilton Report from the Department of Economics of Wayne State University of the United States. That Report also appeared in 1975. It investigated the sales and advertising expenditure that takes place in 11 different countries. It concluded that cigarette advertising has had little influence on cigarette consumption.
One or two of the figures that appeared are rather interesting. Where there is a complete advertising ban—namely, in Italy, Poland, Hungary and Czechoslovakia—the increase in cigarette consumption between 1969 and 1974 was 27.6 per cent. in Italy, 18.6 per cent. in Poland, 7 per cent. in Hungary and 18.9 per cent. in Czechoslovakia. In France, where there has been monopoly restriction—I understand that that is what the hon. Gentleman is seeking—the increase has been 25 per cent. In countries where there is free competition with voluntary restrictions with which the companies have voluntarily complied—namely, the United States, Germany and the United Kingdom—the increases have been very much lower. The figures for the three countries are 14–6 per cent., 14–2 per cent. and 9.7 per cent. I believe that those figures will be conclusive in proving that advertising does not increase consumption but persuades an individual who thinks it is a good social practice to move from one brand to another.
The argument can be put forward that advertising might even be essential to persuade the young that if they are to smoke at all it is perhaps better to smoke cigars or safe cigarettes. If there were a complete ban on advertising, it would mean 802 that the young would receive no guidance whatsoever.
Let us also bear in mind our export trade. If our overseas markets, and particularly the Middle East, gained the impression that the British tobacco companies are selling virtual poison on the home market, our export trade would be extinguished overnight. I hope that the Minister will take that point into account. The export trade is of considerable importance.
I also ask the Minister to weight most carefully the dealings that have taken place between the Government and the companies and the number of steps that have been taken. In 1971 there was the adoption by the industry of health warnings. In 1975 indications of tar groupings appeared on packets. That information had previously been published in relevant journals. In 1965 restrictions were placed on television advertising with the cooperation of the industry. In 1975 we had the Hunter Committee, and now we are dealing with the latest proposals. I ask the Minister to consider whether we are not going too far in pursuing this course. Might it not be better to go back to the drawing board and to say to the companies involved "Let us agree on proposals for the way ahead"? That is surely the most effective way of securing the public's health.
§ 11.59 a.m.
§ The Minister of State, Department of Health and Social Security (Dr. David Owen)
It may be for the convenience of the House if I intervene at an early stage. This is an extremely complex issue and we have heard my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) and the hon. Member for Bedford (Mr. Skeet) put forward differing views about how the problem should be tackled.
I think that the House will be grateful to my hon. Friend for giving it an opportunity to discuss smoking and for drawing attention to the Medicines Act. I think it will also be grateful to him for the manner in which he has deployed his case. I think it is already clear that the debate shows promise of dealing with this subject with a degree of seriousness that has not always been approached.
As I have said, we are dealing with a complex problem and a major public health hazard. Approximately 19 million 803 people in this country—that is, nearly half the adult population—smoke cigarettes. It is estimated that cigarette smoking is responsible for at least 50,000 premature deaths annually and a great deal of consequential ill health and suffering.
The smoking-related diseases—lung cancer, bronchitis and heart diseases—unlike the diseases resulting from the nineteenth century public health problems, are not experienced immediately on exposure to the inhalation of cigarette smoke but take years to take their toll, but with young people smoking cigarettes consequential effects such as lung cancer are now presenting themselves in the late thirties and early forties. Therefore, it is not only a problem of killing people near the end of their lives.
It was in 1950 that the suggestion came from Doll and Hill that there was a connection between cigarette smoking and lung cancer, and in the past 25 years the evidence of the dangers of smoking has steadily accumulated.
Important to the increasing awareness of the dangers of smoking were the two reports of the Royal College of Physicians in 1962 and 1971 on smoking and health, a review by the United States Surgeon General on the health consequences of smoking in 1964 and in subsequent years and a World Health Organisation report in 1971.
In its 1971 report the Royal College of Physicians said that there was no doubt of the close association between exposure to cigarette smoke and lung cancer and that cigarette smoking was an important factor in causing coronary heart disease and was the most important predisposing cause of chronic bronchitis and emphysema.
In 1971 the World Health Organisation in a report concluded that, in relation to lung cancer, chronic bronchitis and coronary heart disease, the hypothesis that smoking increased the incidence or severity of the disease was proven by the evidence in each case.
The United States Surgeon General's review in 1973 reported that recently-conducted epidemiological and clinical studies from several countries continued to confirm that cigarette smoking was one of the major risk factors contributing 804 to the development of coronary heart disease, that there was an association between cigarette smoking and increased prevalence of respiratory symptoms and decreased coronary function, and that cigarette smoking was the major cause of lung cancer.
In response to the mounting evidence, successive Governments have shown increasing concern. In 1965, as the hon. Member for Bedford mentioned, the direct advertising of cigarettes on television was banned by the Government and in 1971 a voluntary agreement was reached with the industry on such matters as the printing of a health warning on cigarette packets with a reference to it on advertisements and the testing of cigarette brands for their tar and nicotine yields.
In 1973 the Government set up, with the agreement of the industry, a committee of independent scientists and doctors under the chairmanship of Dr. R. B. Hunter, Vice-Chancellor of the University of Birmingham, to advise on the scientific aspects of matters concerning smoking and health. This committee has rightly concentrated particularly on the testing of tobacco substitutes and additives to tobacco and its guidelines on these matters, already quoted in the debate, were included in the committee's first report published last year. I am sure that all hon. Members are very grateful to the committee for its important pioneering work in preparing these guidelines. Nothing similar has been produced in any other country. I am convinced that the systematic application of scientific and medical advice to the problem is the real way forward.
A study in 1967 suggested that only 2 per cent. of cigarette smokers were able to limit themselves to intermittent or occasional smoking. The majority were regular and dependent smokers who seldom went more than an hour or two without smoking. Of those teenagers who smoked more than a single cigarette, only 15 per cent. avoided becoming regular smokers. It was in the light of such findings as these that I explained to the House on 27th October last that the Government had decided to ask the Hunter Committee, in addition to its work on substitutes and additives, to review all the evidence now available on
805 the dangers to health from the various substances in cigarette smoke, in particular from nicotine and carbon monoxide. This should help to show, among other things, how the dependence of such a large proportion of the population on nicotine might be reduced and, by the formulation of a long-term strategy, help to try to reduce the hazard of smoking.
As part of the all-important immediate strategy aimed at trying to persuade people not to start smoking or to give it up, the Government have supported and will continue to support the Health Education Council and the Action on Smoking and Health team in their vital efforts to ensure that everyone in the community is aware of the risks to health from smoking. Here I very much agree with the words of my hon. Friend the Member for Ormskirk. He laid great stress on the need to get greater education and greater information to young people. This is a very high priority.
In July 1974 I put a number of specific suggestions to the industry. They covered the provision of money by industry for health education on smoking; the abolition of cinema advertising; tar group descriptions on packets and advertisements; a stronger and more prominent health warning; the abolition of gift coupons, or their limitation to brands in the two lowest of the five tar groups; and discussion of the use of sports sponsorship to promote cigarettes.
I explained to the House on 10th April 1975 the limited responses from the industry at that time to my suggestions. These were an offer by the industry to withdraw cinema advertisements from programmes showing "U" films and the placing of tar group descriptions of cigarette brands on Press and poster advertisements. The industry also proposed to take action on two other matters. It agreed that the advertising of free samples should end and that control over the code of practice for the advertising of cigarettes, which had been clarified, should be taken out of its hands and exercised by the Advertising Standards Authority. One company, Imperial Tobacco, undertook to remove unilaterally its cigarette brand names and insignia from racing cars.
806 The Government felt that that was an inadequate response and we announced on 6th August our intention to discuss with the industry machinery analogous to that provided for in the Medicines Act 1968. Some parts of this are referred to in the motion.
In fairness to the industry, I should tell the House that since my announcement of 6th August further voluntary steps have been agreed by the industry. Tar group descriptions will in future, as I asked, appear on packets. The industry has agreed that cinema advertising would be limited to "X" programmes. It has decided that cigarillos will no longer he advertised on television. The industry has also said that it was prepared to discuss a voluntary limitation on sports sponsorship with my right hon. Friend the Minister responsible for sport, and these negotiations will start soon. Many of my original suggestions made in July 1974 have now been agreed and it would be churlish of me not to acknowledge this and thank the industry for its response.
There are, I know, many people who believe that all cigarette advertising should be abolished. They believe, and there is some evidence for this, that advertising and promotions increase sales, although I know that this is contradicted by some of the reports mentioned by the hon. Member for Bedford. But this is a very serious study that I have quoted, and I have put a copy in the Library. On the other hand, it would be absurd to pretend that abolishing advertising would mean that 19 million people would stop smoking cigarettes, and it would mean that brand switching to safer cigarettes would be more difficult to achieve.
Some people advocate stronger use of the price mechanism, and there is clear evidence that price is a major factor. The present Government have increased substantially the cost of cigarettes, but pricing cigarettes off the market would have quite unacceptable social consequences in that the poor would suffer while the rich would continue to smoke. What is needed, therefore, and needed desperately, is a strategy for helping the 19 million people who smoke, and who are heavily physically and psychologically dependent on cigarettes.
§ Mr. Kenneth Lewis
The Minister has just made a very strong case against smoking as a health hazard, but he goes on to say that the raising of the price of cigarettes affects the poor rather than the rich. Surely, if he wants people to stop smoking it would be good if they could not smoke.
§ Dr. Owen
The question is one of balance, like most of these things. It is probably the common view on both sides of the House, and certainly my strong view, which I have emphasised on a number of occasions, that we cannot ban people from smoking. Some people take a different view about whether we should ban advertising. If one raised the price of a cigarette to £5 one would, by the back door, be banning cigarettes for the large bulk of the population. There comes a time when by using the price mechanism one can, in effect, ban cigarettes for some people because their financial resources are so limited. Like so many of these problems, it is a question of balance.
§ Dr. Owen
No. I have made it clear on previous occasions that I think that advertising has some effect on the total consumption of cigarettes. It is difficult to be precise about the exact amount, but I believe that it has an effect. There are contrary views.
I have stressed the need for a strategy for helping the 19 million people who smoke and who are heavily physically and psychologically dependent on cigarettes. The industry has made it clear that it will not support any measures which are designed even in the long term to abolish cigarette smoking whether by health education or other means. This is an area which will have to remain the Government's responsibility. The question is whether the industry can be involved in the long-term strategy of safer smoking. Some believe that even to talk about safer smoking is to compromise one's stand against all smoking. I do not believe that this is realistic.
It must be faced realistically that no matter how effective health education programmes prove to be, it is regrettable but true that millions of adults will go
808 on smoking for a very long time to come, and the Government must in all their proposals and activities recognise this as a fact. It is on the reduction of the hazards to health among smokers that the industry and Government can and should co-operate, and it is very significant that my hon. Friend who has brought this motion to the Floor of the House is himself a fairly heavy smoker. I have always rejected a strategy which fails to understand the problems and difficulties of the confirmed smoker, and a strategy that is composed only of restrictions, warnings and education will not be sufficient.
Yet there is no easy path to safer smoking. The mere addition of substitutes cannot be expected quickly to produce a materially safer cigarette, and the mere fact of changing the mix will not necessarily lead to safer cigarettes. No one should think that the production of a safe cigarette is just around the corner. Nevertheless, I want a long-term strategy which aims to reduce the hazards of smoking, and I have looked for a system which would, within a statutory framework—which I believe is a necessary counterweight to the commercial interests of the industry—provide for co-operation between Government and industry and flexibility to meet changing needs.
The co-operation of the industry in any such strategy is important, because if it does not continue to put a heavy investment into experiments and research for safer cigarettes we shall not make rapid progress. If it does not collaborate in such a strategy, we shall simply continue with a series of ad hoc measures on advertising restrictions reluctantly agreed by the industry or imposed by the Government. Smoking will continue, the present most dangerous cigarettes will continue to be manufactured and people will go on dying unnecessarily.
As has been mentioned in the debate, we already have in the field of health a system primarily used for the control of medicinal products and other substances which are capable, in the words of the Medicines Act, of causing danger to the health of the community if used without proper safeguards.
Since 1968 the Government have had considerable experience of the way the 809 Act works in relation to the pharmaceutical industry, and they believe that it provides an appropriate and flexible framework within which the joint responsibilities of industry and Government to safeguard health can be exercised. In particular, the very full consultation process and the use of expert medical and scientific committees help to avoid confrontation between Government and industry in areas where the public interest and commercial interest are bound to differ. Experience has shown that for the most part agreement can be reached voluntarily. The Government, while recognising the special problems on cigarettes, believe that it is possible to secure the same results in relation to tobacco products.
I therefore announced to the House on 6th August that the Government would open negotiations with the tobacco industry and others on the use of the type of system provided under the Medicines Act. The industry has made it clear to me, understandably from its viewpoint, that it would prefer to continue working entirely through voluntary agreements. I have told the industry that a statutory framework is essential.
I am glad to say that the suppliers of a large proportion of the British market have now agreed that we should set out to undertake our shared responsibilities on a partly voluntary and partly statutory basis. I say "a large proportion" because I have to tell the House, with regret, that part of the home market which is linked with companies abroad has not found it possible to give its agreement.
The Government none the less consider that, on the basis of agreement by companies responsible for the production of over 70 per cent. of the cigarettes consumed in this country, including the largest British producer, it would be unreasonable for them not to go ahead and lay proposals before Parliament. To do otherwise would be to allow the interests of firms outside this country to frustrate what the Government and what I may term the home industries are prepared to carry forward in the interests of the health of the people of this country. I should make it clear, however, that I still hope that all parts of the tobacco industry will join with those firms which have indicated in advance that they have chosen to work with the Government, after having 810 weighed not only their commercial interests but also the wider aspects of health and safety.
§ Mr. Kenneth Clarke
Will the Minister confirm my understanding that the whole of the industry has agreed to enter into voluntary undertakings not to market additives or substitutes without using the Hunter Committee's procedure and that the remaining argument is simply whether the Minister needs to legislate? If the Minister has a voluntary undertaking to achieve all that he claims to want at the moment, why is it necessary to legislate? Is it because he wants to open a door to the future use of the further powers which the Medicines Act might give him, extending his control over tobacco products and their advertising and marketing to a much greater extent than he acknowledges today?
§ Dr. Owen
It would be helpful to the House if the hon. Gentleman were to listen to the rest of my speech. The point he has made is incorrect. Substitutes and additives are already covered by legislation, and the House has already thought that it needs some form of legislation. I shall describe shortly why it is the common belief of most people in this field, not least the Hunter Committee, that the existing legislative cover is not sufficient. It is a question of Customs and Excise powers under the Finance Act.
I was explaining the partly voluntary and partly statutory basis of the agreement. The statutory part of the agreement will apply to the use of substitutes and additives to tobacco in smoking products which could play an increasing role if used under careful scientific and medical control in the manufacture of a safer cigarette. The Government intend to lay a draft Order under the Medicines Act, which would be subject to an affirmative resolution, after further consultation with the industry, the Medicines Commission and the independent scientific Committee on Smoking and Health.
The Order, which will be made under Section 105(1)(b) of the Medicines Act, will ensure that those tobacco products consisting of or containing a substitute for tobacco or an additive to the tobacco would need a product licence from the Government. Such a licence would be
811 granted on advice received from a statutory committee on the safety of the product. This committee would be established under Section 4 of the Medicines Act and would be based on the existing independent scientific committee under the chairmanship of Dr. R. B. Hunter—the Hunter Committee.
These arrangements for licensing products with substitutes and additives would replace the existing outdated statutory controls, originally established for fiscal reasons and now contained in the Finance Act. It is in this field of substitutes and additives where there is the greatest need to ensure that existing health problems are not exacerbated by the introduction of substances in smoking products many of which are new to this country and some of which are completely new. It was this power particularly which was stressed by my hon. Friend the Member for Ormskirk when he made a distinction between it and some other powers that could be applied under the Medicines Act.
Under these arrangements, existing smoking products containing additives, on sale in this country as of today and as at present made up, would continue to be available under arrangements to be discussed with the industry. These particular additives have been used for many years in this country without being thought to introduce any additional hazard to health. New products containing additives or a substitute would. however, have to go through the full procedure for licensing.
Under the voluntary part of the system, which has, I believe, the full agreement 812 of the whole tobacco industry—
§ Mr. Kilroy-Silk
Is the Minister able to say when the Order will be made? Secondly, can he indicate whether additives and substitutes will be allowed to be marketed prior to the Order being made?
§ Dr. Owen
I have read the section with quite considerable care and prefer not to elaborate, because it has considerable legal consequences for the firms concerned. I prefer to stick to what I have said. The fact is that it is limited to substitutes and additives, as my hon. Friend stressed.
Under the voluntary part of the system, which, I believe, has the full agreement of the whole tobacco industry, Government and industry have agreed to work together on measures to reduce the risks to health from smoking. These measures will be based on completely independent medical and scientific advice. It is envisaged that this advice will be provided by the same people as those forming the committee established under Section 4 of the Medicines Act to deal with smoking products including substitutes or additives. But the provision of such advice will not form any part of their statutory responsibilities. Thus they would provide advice to industry and Government over the whole field of smoking, but the statutory advice would trigger off statutory action in the field of licensing, on grounds of safety, of products containing substitutes and additives. On other aspects the committee's advice would be implemented through voluntary agreements.
It may be helpful to the House if I set out briefly some of the areas on which I hope that further progress can be made by voluntary agreement within the new framework. A main aim under the voluntary agreement would be to achieve a steady reduction over the next few years in the tar yield and other smoke constituents such as carbon monoxide and nicotine which are judged on independent medical and scientific advice to be excessive. I have made it clear to the industry that I believe that the promotion and advertising activity of the industry should in future be compatible with this independent scientific and medical advice. I have also said that the Government will expect to see an end to the advertising and promotion of products judged, in the light of the advice received by Government and industry, to have tar yields or other smoke constituents which are excessive. All the cigarette manufacturers in the United Kingdom have assured the Government that they are ready to start negotiations on further voluntary agreements within this new framework, and I believe that the whole industry will cooperate in this strategy.
The Government realise that progress on the lines I have set out will entail considerable changes for the tobacco industry in its system of manufacture, promotion and sale. I accept that the progress which I think can be achieved will need to be achieved by stages. For example, coupons might go first for cigarettes with a large tar content, then 813 all advertising cease, followed later by withdrawal of the product. It would be unreasonable, and contrary to the spirit of the new system, to expect changes involving the whole manufacturing process to take place overnight. On the other hand I am determined to move as fast as we reasonably can because of the serious health aspects of this problem.
I also accept that the industry needs, for its own investment planning and commercial interest, to have a clear strategy, within which it can work for a period of years without being asked to undertake unreasonable changes. This is what I believe the proposed system of part statutory and part voluntary arrangements can achieve. If this proves to be so, it will mark a completely new strategy for dealing with the health hazard of smoking.
Some will no doubt attack the proposals for not introducing full statutory cover immediately and for relying in the first instance on reaching voluntary agreement. I do not deny that I would have preferred to have had more reserve powers from the outset, but to have forced this through would have been to forgo the co-operation of the industry which is a vital ingredient for effective progress, and it must be admitted that effective voluntary agreement is a more flexible method than relying on regulations.
I undertake that Health Ministers will report annually to the House on progress on this new system. The independent scientific and medical committee will also make to Health Ministers an annual report which will be published both for its statutory and for its non-statutory responsibilities. Voluntary agreements will not be static but will remain flexible so that new scientific and medical evidence can be taken into account after it has been assessed by the independent committee.
Although the voluntary agreement will cover the use to be made of advertising and promotion, it does not cover its content. On the latter, the Government have decided to wait until there has been a full year's experience of the effectiveness of the new code for advertising of cigarettes about to be introduced by the Advertising Standards Authority. Although the Government considered that in some 814 respects this code did not go far enough, it marks an important step forward and should be judged on its results.
In conclusion, I believe that the arrangements now proposed are a wholly new departure which deserves serious study and time to prove itself. I have made it quite clear to the industry that if progress through voluntary agreement, when judged in the light of the reports I have promised from the Government and from the independent medical and scientific committee, is thought to be insufficient to protect the public from the risks to health from smoking, the further statutory provisions of the Medicines Act which are open to us will be applied to the whole range of tobacco products. Most of these are specified in my hon. Friend's motion. I hope that this will not be necessary. The industry has made it quite clear that it would oppose this wider applicaion of the Medicine Act.
I hope that its confidence in the efficacy of voluntary agreements will be borne out in practice. I want the industry's cooperation. I want to move away from a sterile confrontation, but I hope that the industry will not underestimate the Government's determination to enforce this strategy by statutory means if the voluntary system fails.
§ 12.25 p.m.
§ Dr. Gerard Vaughan (Reading, South)
I am sure that the whole House will agree that it has been very helpful to have the Minister intervene so early in the debate, because it is clear that he has made considerable progress in his discussions with the industry, and I congratulate him on the very moderate and wide-ranging approach that he has adopted. We all know how dedicated he is to the need to do something about smoking in our community today.
Although the industry is divided in its views about the need for legislation, it is clear that in the main it is willing to collaborate with the Minister wherever possible. However, although we all know that there is a need for a long-term strategy, I suggest that even today the Minister has failed to explain satisfactorily why legislation is necessary. He is dealing with an industry that is wholly willing to co-operate with him and that has shown this since 1971 in a whole 815 series of agreements. I cannot understand why the hon. Gentleman will not give the industry a little longer to work out with him the strategy that he agrees we need.
I want also to congratulate the hon. Member for Ormskirk (Mr. Kilroy-Silk) on bringing this important subject before us today and on the moderate and well-reasoned way in which he moved his motion. I found him very persuasive. If I did not know a little more about the medical problems than he does and I have read the Medicines Act very carefully—I should have found myself in agreement with much of what he said. I share with him his desire to adopt a constructive approach and joint, agreed progress between the industries concerned and the Government, and this view is clearly shared by the Minister. I also share with the hon. Gentleman the desire to remove party politics from this area. Health matters are not an area for party conflict, and certainly the smoking problem is not. I welcome very much the recognition in the hon. Gentleman's speech of the progress that has been made already by voluntary agreements of one kind or another with the industry.
However, as my hon. Friend the Member for Bedford (Mr. Skeet) says, there is a serious danger here of either over-legislating or threatening to over-legislate, and in this case of using the wrong legislation. I shall return to that in a moment.
In my view the Medicines Act was never intended for this purpose—even some small part of it—and I noticed that the hon. Member for Ormskirk used the word "analogous" several times, which suggests to me that he does not really think that the Medicines Act is a suitable vehicle for this. He would prefer to see completely new legislation to do the job, and I agree with him. In fact, it is the means and not the end about which we have doubts.
It is one thing to say that the Minister would not use extensive powers if the House gave them to him and quite another to be sure that at some time in the future some other Minister would not go ahead with the powers that we are discussing.
§ Dr. Vaughan
I think that that is the case, and I shall come to it in a moment. This House has a clear responsibility to legislate in a way that will not lead to future abuses.
I hope that opposition to this motion will not be seen as supporting or advocating smoking, because that is not the case. I was one of the sponsors of the Bill introduced in 1971 by the late Sir Gerald Nabarro following the report of the Royal College of Physicians. I should not like to see any opportunity missed which was likely to be helpful in reducing the risks of smoking. It is significant that by voluntary agreement alone we have now reached a point where, according to a recent survey, 96 per cent. of those interviewed knew that smoking was dangerous and likely to cause serious ill-health and disease in later life. So, whatever may be said about the inadequacies of educational programmes, this message is getting through.
In 1971, only five years ago, there were still serious doubts about whether smoking really was dangerous. Today, there is no doubt at all and we know the main diseases caused by smoking—cancer of the lung and chronic bronchitis. We know that the 50,000 people a year who die prematurely because they smoke could be spared. There is no doubt, either, that from a medical point of view and from a community health point of view there is an increase in safety, in proportion to any reduction in the amount of the smoking, so that, even when people have smoked for many years, it will still be helpful for them to stop, or even to cut down the number of cigarettes they smoke each day. Therefore, these educational programmes to let people know the risks that they run are well worth while. Most of us must surely support any action that will stop or reduce smoking.
I hope that a safe tobacco can be developed soon. As we all know, the tobacco industry believes that it may be getting near to achieving this. The average tar content per cigarette is now 35 per cent. less than it was 10 years ago. That can only be of benefit.
817 In the event that we cannot develop a safe tobacco, I hope that with an expanded education programme especially for children, over a period, it will be possible to phase out smoking for the majority of people. That is the Swedish approach. Clearly, it cannot be done immediately. It will probably take at least one generation. The Minister recognised that in his speech today and on 6th August when he said that there could be no question of banning the sale of a product used by half the adult population.
Many people are greatly dependent on or even addicted to tobacco. Banning sales would lead immediately to a black market, and that is the last thing we should want. We must also recognise that the tobacco industry comprises a major part of our economy. It employs large numbers of people. It produces substantial revenues—£1,600 million a year to the Exchequer. Therefore, I cannot envisage the Secretaries of State for Employment or Industry, or the Chancellor of the Exchequer, welcoming any reduction in the size of the tobacco industry. Any suggestion of that nature is unrealistic.
The tobacco industry is a major supporter of sport. Our sports activities were supplemented by over £5 million last year. Half industry's contribution to the arts£250,000—came from the tobacco industry. Therefore, for many very strong reasons, although we must try to make smoking safe, from the point of view of our general community economy and our employment position we must consider carefully what we do. Motions such as this today must be looked at seriously.
On 16th March 1971 the then Secretary of State, my right hon. Friend the Member for Leeds. North-East (Sir K. Joseph), said:I would like to pay a tribute to the responsible and helpful way in which they"—the tobacco industry—have approached these discussions".—[Official Report, 16th March 1971; Vol. 813, c. 1190.]Since then, apart from the issues of contributing to the education programme and of removing the words "Her Majesty's Government", I do not think that there has been any issue in which the tobacco industry has not participated or assisted. It is for those reasons that I suggest again 818 and again that there is no need to legislate in this area.
The Medicines Act was never intended for application to tobacco. Indeed, I wonder why the hon. Member for Ormskirk tabled his motion. We know his flair for bringing to our notice matters that have public attraction and that are news-worthy. However, I respect his point of view and I am sure that he was motivated by more than that.
During his speech in August the Minister also used the word "analogous". On that occasion—he has done the same today—he failed to explain why legislation was needed. I believe that he went further in August than he intended. He found himself on a hook where he was not supported by his other ministerial colleagues. Today's motion has been useful to the Minister. He has been able to bring this matter to the House and also to push the tobacco industry a little further than perhaps it was ready to go.
§ Dr. Owen
I deny completely what the hon. Gentleman has just said. Moreover, he asserted that during the Standing Committee stage of the Bill there was no discussion about whether tobacco products could be covered by the Medicines Act. That is not quite true. My hon. Friend the Member for Nottingham, West (Mr. English) raised this specific point either during the discussion on whether there should be an affirmative order under this particular part of the Act or during an intervention in the overall debate, when it was decided that there should be an affirmative order. This specific point was raised by my hon. Friend during the debate.
§ Dr. Vaughan
I thank the Minister for his intervention. Plainly, I had not made myself clear. My point was exactly the reverse of what the Minister said. During the original discussions of the Medicines Act in 1968, considerable attention was given to the possibility of including substances not used for direct medicinal or veterinary purposes. The Minister is correct in saying that the hon. Member for Nottingham, West (Mr. English) spoke considerably about this subject. There were fears on both sides of the House that at some time the Medicines Act would be used in this way. There were specific assurances by the Minister at that time that that would not be so.
§ Dr. Vaughan
Yes. On Second Reading on 15th February 1968, referring to Clause 93, the Minister of Health said that the Act would be used only in relation to products sold for medicinal use.
My hon. Friend the Member for Derbyshire, West (Mr. Scott-Hopkins) persisted. Referring to Clause 93, he said:the Parliamentary Secretary should look much more closely at this point because all kinds of products which are not medicinal can be brought in".The hon. Member for Nottingham, West, who is also noted for his persistence on important points, said:For example, there seems little doubt that under Clause 94(1)(b) cigarettes should be included, and my right hon. Friend could control the entire advertising campaign."—[Official Report. Standing Committee D, 21st May 1968; c. 773–80.]The point I make about the Medicines Act is that it was quite clear on that occasion that hon. Members were afraid that it might be abused.
Reading the debate in full and the assurances given by the Minister at that time we appreciate that it was never intended that the scope should be widened. There were many assurances from the Government at that time. Indeed, as my hon. Friend the Member for Bedford has suggested, a case could be made that the Government might well be acting ultra vires if it were.
If the Section 105 order is invoked, as we have heard already, a whole series of bizarre and ridiculous actions could be introduced. I do not intend to weary the House by going through them all. I cannot believe that the hon. Member for Ormskirk read the Act thoroughly, because the results of bringing in the Medicines Act in full would be both irresponsible and ludicrous. Of course the Minister has a far more limited application in mind. I should be interested to know the reactions of the tobacco industry to what he has just said.
I ask the hon. Member for Ormskirk to withdraw his motion. That would be a reasonable and constructive move to make in view of the Minister's statement. I ask the Minister not even to consider going ahead with these proposals. I sug- 820 gest that he goes back to the industry and allows further voluntary agreements to develop. He has already had the industry's firm undertaking to abide by the guidelines laid down by the Hunter Committee. Moreover, the industry has said that it will not introduce any new substances without the full agreement of the Committee.
§ Dr. Owen
Is the hon. Gentleman aware that in 1973 the Government of which he was then a supporter introduced the Medicines (Extension to Antimicrobial Substances) Order which, under Section 105 extended the use of the Medicines Act to substances with antimicrobial properties whichmeans the capacity to inhibit the growth of, or to destroy bacteria and other micro organisms whether in vitro or in vivo"?Will the hon. Gentleman explain how that can be compatible with some of his interpretations of the use of the Medicines Act?
§ Dr. Vaughan
I am well aware of the point that the Minister has just made. However, it does not alter the main theme of the argument. He is trying to use for the tobacco industry a totally inappropriate Act. I ask the Minister not to shelter behind the dubious use of this Act, but to set out with the industry now a planned programme for continued research, a programme for the introduction of substitute smoking materials and for extending the education campaign against smoking.
If the Minister reads our discussions in 1971, he will see that all kinds of exciting suggestions were made about collaboration with local authorities regarding smoking in public buildings and on public transport. I suggest that moves of that kind, very few of which have been implemented, could be taken up by him and become an object for his energies.
Finally, if the Minister still feels that legislation is needed, I direct his attention away from the Medicines Act and instead to Section 4 of the Finance Act. I believe that under that section he could extend the requirements of the Customs and Excise to refer to the Department of Health and Social Security. Through that Act he might find a more appropriate and far less complicated and dangerous way of achieving the results that he seeks.
§ 12.41 p.m.
§ Mr. John Cronin (Loughborough)
The hon. Member for Reading, South (Dr. Vaughan) in his interesting speech said that he thought the Medicines Act was never intended to be used for the purpose suggested by my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk). I think we can all accept that. The important thing is that the Medicines Act is a convenient framework to give the Minister of State the statutory powers which he requires. It is fairly common experience that Acts which have not been intended for a certain purpose have been converted for that purpose without any detrimental effect.
The hon. Member for Reading, South and to some extent the Minister of State put a lot of emphasis on the co-operation of the tobacco industry. I appreciate that in this complex and delicate matter co-operation is necessary and helpful. But we are being over-optimistic in thinking that such co-operation will get us very far. We have had co-operation from the tobacco industry since at least 1965, but smoking steadily increased up to 1973. Therefore, whatever cooperation we have had from the tobacco industry has certainly not reduced smoking.
The common sense of the situation is that the directors of tobacco companies have a duty to increase profits for their shareholders. Therefore, to assume that these gentlemen will co-operate with the Government in anything which will reduce their sales indicates an idealism which bears no relation to reality.
I congratulate my hon. Friend the Member for Ormskirk on introducing this motion. Speaking as a practising consultant surgeon, I can say that he has the gratitude of most of the medical profession for having done so.
As the Minister pointed out, there is no doubt now about the harmful effects of cigarette smoking. The hon. Member for Reading, South was the first to agree about the serious effects of smoking on the health of the population. I think that I can perhaps underline that by quoting from the annual report "On the State of Public Health" for 1969 by the Chief Medical Officer, Sir George Godber. In one of the most authoritative statements that we have had, he said: 822On reasonable assumptions about the main groups of such deaths from lung cancer, chronic bronchitis and ischaemic heart disease, some 80,000 premature deaths probably occur in England and Wales each year and for the whole of the United Kingdom the number must approach 100,000.It is a gigantic problem when we think in terms of the deaths of 100,000 people annually caused directly by tobacco smoking.
Some hon. Members have referred to the ill effects on the economy of any restrictions on the tobacco industry. But Sir George Godber in his report states:We cannot estimate the amount of working time lost from illness due to cigarette smoking, but it must be responsible at least for the greater part of 38–6 million days of sickness absence certified as due to bronchitis in 1969.Therefore, it obviously has a severe effect on the economy as well.
The problem is to try to induce the 19 million people who smoke to stop smoking, to smoke less or to modify their smoking habits so that they should be less injurious. The Minister of State rather emphasised the desirability of doing that, but again he was being overoptimistic. We all know that smoking is a severely addictive form of drug-taking. It is very difficult for smokers to give up smoking. In fact, anyone who wishes to give up smoking may anticipate being mentally and physically unwell for at least two months.
It is probably optimistic to hope that much can be done for the present generation of smokers. The most important thing is to stop people taking up smoking, particularly young boys and girls. The key to this must be some reduction in advertising. There is no doubt that advertisements tend to indicate—sometimes subtly, but other times directly—that tough and romantically successful people smoke frequently and steadily. That is the whole idea conveyed by advertisements. These pressures on young people must be of a severe nature. Therefore, it is important to control advertising to a much greater extent. There is a strong argument for stopping cigarette advertising altogether, but certainly there should be more effective control over it.
Perhaps I may review the measures which have already been taken. The Children and Young Persons Act 1933 prohibits the sale of cigarettes to young 823 persons under the age of 16. But a survey conducted recently by ASH indicated that about 86 per cent. of tobacconists were still selling cigarettes to children under that age and that the majority of tobacconists were very ill informed or ignorant of the law. I suggest that the Government should take effective action to tighten up the law in this respect. It is scandalous that such a large proportion of tobacconists, either consciously or unconsciously, should flout the law which prevents the sale of cigarettes to children under the age of 16.
In recent years cigarettes have been marketed subject to the 1964 Television Act and to various voluntary codes which have been policed by the manufacturers, but these have been largely ineffective. I say "largely ineffective" because of the steady increase in the consumption of tobacco. The Advertising Standards Authority took control of some cigarette advertising but even that has not proved very effective. There are no effective controls on sports sponsorship, on coupon schemes, on incentives to retailers or on circumventions of the regulations on matters such as the advertising on television of "same name" cigar brands. Whenever legislation has been threatened, the manufacturers have given some mild concessions but they have never been more than that. The Minister is being unduly optimistic in thinking that voluntary agreements will induce them to go much further than they have done so far. There is no escape from the fact that tobacco manufacturers are spending £80 million a year on inducing people to become addicts of this lethal drug.
I suggest that the time has come for more effective statutory controls, and I have no doubt that the motion would have the effect of producing useful statutory measures. I am certain that there is no hope of getting any effective action without a large measure of statutory control. It is absurd and unreasonable to expect the directors of tobacco companies to take steps to reduce sales and reduce the profits of their companies. They would rapidly be removed from office by the shareholders if they took any effective steps in that direction.
I suggest that in addition to what is proposed in the motion the Minister should have statutory powers not only 824 to reduce advertising but to have more effective counter-smoking advertising to show the general public the ill effects of smoking. It would be helpful if more effective education were given to children in schools to help them realise the awful dangers and unpleasantness that will occur to them in time to come if they start to smoke.
There may be a case for pursuing the idea of substitutes and additives. The hon. Member for Reading, South hopes that a safe cigarette will be produced. I have doubts about that, but it is something on which one can experiment and hope for such a result.
There is an even stronger case for a budgetary attack on smoking. There is no doubt that smoking has been reduced by about 10 per cent. in 1974 and 1975, and that must be due to the enormous increase in the price of cigarettes. I suggest that that is one of the most effective ways of attacking the cigarette problem.
One point that has impresed me in the debate is that so many hon. Members have spoken about the need to show consideration to the tobacco manufacturers and make voluntary agreements rather than interfere with them to an unreasonable extent. The hon. Member for Hornsey (Mr. Rossi) was vociferous on that account in his intervention, and the hon. Member for Bedford (Mr. Skeet) is anxious that there should be no interference with tobacco manufacturers. Do tobacco manufacturers really deserve all this consideration? The simple fact is that nobody would smoke if cigarettes were not produced and if they were not induced to smoke them either by the example of others or by advertising.
By their activities the tobacco manufacturers are directly responsible for the deaths of about 100,000 people a year. That is proved beyond all doubt not only by the Royal College of Physicians, by the World Health Organisation and by the Surgeon General's Report in the United States, but by the Chief Medical Officer to the Department.
§ Mr. Kenneth Lewis
I am the hon. Member for Rutland and Stamford, not the hon. Member for Hornsey. Does the hon. Gentleman think that motor car manufacturers are responsible for the 825 deaths of hundreds of thousands of people on the roads every year?
§ Mr. Cronin
I am talking about a different situation. Car manufacturers produce vehicles in which people who behave recklessly can cause accidents. Tobacco manufacturers produce an addictive—[Interruption.] I hope that the hon. Gentleman will allow me to answer his comment. Tobacco manufacturers produce an addictive drug and do everything in their power in the form of advertisements to induce people to become addicted to it. If a comparison is to be made, I suggest that the analogy is to be found with those who push cannabis. The most severe legal sanctions are available for use against those who peddle cannabis, yet that is a mild drug. The hon. Member for Reading, South is an authority on this subject and I am sure he will agree with that statement, yet people who peddle cannabis are subjected to quite savage legal penalties. I suggest that tobacco manufacturers are more akin to drug pushers than to motor car manufacturers as suggested by the hon. Member for Rutland and Stamford (Mr. Lewis).
§ Mr. English
Had I not done so, I should not have been able to intervene. Would my hon. Friend say the same of brewers and distillers?
§ Mr. Cronin
I would not, because the ill effects of alcohol are negligible compared with the ill effects of tobacco. It is convenient to have a consultant physician on the Opposition Front Bench. I am sure the hon. Gentleman will agree that alcohol does not kill more than a few thousand people a year in this country, compared with the gigantic figure of 100,000 who are killed by cigarette smoking. That is an important factor to bear in mind.
There are no grounds for soft pedalling in the attack on tobacco manufacturers. They are, in effect, mass killers. They are committing genocide by their products. I know that they are members of the establishment. They are people whom some would regard with respect. One of their chairmen was knighted in a recent 826 New Year's Honours List. One has grown accustomed to the activities of the tobacco manufacturers, but in simple scientific terms they are killing 100,000 people in this country every year and they are causing massive ill health. I suggest that there are no grounds for treating them with any special consideration.
There is a heavy duty on us this afternoon. We are confronted with an appalling situation of mortality and ill health caused by the tobacco industry, and we have a heavy responsibility in deciding how we vote. I suggest that the motion, which was admirably moved by my hon. Friend, will give the Minister powers which he requires, and which he says he requires, to cope with the tobacco manufacturers. It is often suggested that the powers of Members of Parliament are limited and that sometimes the House of Commons does not take its duties as seriously as it should. Here is a unique occasion when we can show beyond all doubt that as a House we are concerned about the savage loss of life that is occurring as a result of the activities of the tobacco industry. By voting for the motion we can take some effective measures to put a stop to them.
§ 1.0 p.m.
§ Mr. Kenneth Lewis (Rutland and Stamford)
The more I listen to this debate, the more I have a sense of unreality. I can understand the speech by the hon. Member for Loughborough (Mr. Cronin). He is a doctor and wants to see people live as long as possible. That is the kind of doctor I like. The unreality of the situation is that a large number of people in this country want to smoke and do smoke. It is only those who smoke too much who eventually die younger than they otherwise would. Moderate smoking does not lead to early deaths.
I was amazed to hear the hon. Member for Ormskirk (Mr. Kilroy-Silk) say that he spoke from a smoking position. I am glad that he has raised this matter today. There is nothing wrong with ventilating the subject; the more publicity it gets, the better, and the more of us who know that heavy smoking is not good for us, the better. But the hon. Member for Ormskirk complained about cigarette manufacturers being in business. He suggested that they were the greatest blackguards because they took no notice of the Government and had made no concessions.
827 But the fact is that when the Government told the industry that they wanted to cut down on advertising and put warning notices on cigarette packets, the manufacturers co-operated in that exercise. Surely the hon. Gentleman is not in a position to complain that cigarette manufacturers produce and sell cigarettes when the hon. Gentleman smokes their products. We can hardly expect tobacco manufacturers not to want to sell their goods. That is why they are in business, and there is nothing criminal about wanting to do that.
§ Mr. Cronin
Surely the fact that my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) still smokes, although he knows and has made clear the severe dangers of doing so, is an indication of the dangerous addiction that arises from cigarette smoking and is a strong argument in favour of the motion.
§ Mr. Lewis
I said that the hon. Gentleman was not in a strong position to complain about the manufacture of these products when the hon. Gentleman himself smoked them. I did not think that that argument was very strong. As a matter of fact, the people involved in the manufacture of cigarettes are not only directors. There are many thousands of workers employed in the tobacco industry and many small retailers who sell the product in the shops.
§ Mr. Kilroy-Silk
The hon. Gentleman should try to quote me correctly. He knows that I did not complain about the manufacturers, who were producing cigarettes long before the health hazards were known. I complained that they had not taken enough positive steps to avoid health hazards and risks.
§ Mr. Lewis
I appreciate the point. I remind the hon. Gentleman that every cigarette packet contains a warning about the health dangers that arise from smoking. We see advertisements about these dangers in railway stations and on placards everywhere.
I believe that the danger in politics is that Governments and Oppositions get together in a cosy kind of way and decide
828 that they should do something for the public that the public does not want. I am not saying that the dangers should not be made clear to everybody. But when the Government have undertaken that exercise, what more can they do? If they go any further, they might be in danger of trespassing on the ground covered by the second motion today, which deals with personal liberties.
The danger is that when both sides of the House become involved in a limited exercise of seeking to control what people may do, that exercise grows and grows. Indeed, a committee is now being appointed at a time when we are seeking to cut Government expenditure. Who is to pay for it and how many staff will it require? I am sorry that we are not to have a ministerial reply to this debate, because we might have been given an answer to those questions.
Furthermore, who will represent the smoker on that committee? If the committee is to consist only of members such as the hon. Member for Loughborough who is against smoking, and if it is to contain no other views, how can that committee arrive at a fair assessment? Are the cigarette manufacturers to have as a representative on the committee?
I believe that the Government are becoming schizophrenic about the whole subject. They are going through the motions of taking action, but I do not believe they want people to stop smoking. I noticed that the Minister of State was not very keen on the idea of preventing people smoking by taxing the commodity so highly that they would not be able to afford it. The Minister was not prepared to go as far as that. I emphasise the Government's schizophrenia on this subject because we all know the amount of tobacco revenue exacted by the Chancellor of the Exchequer.
The Government are also in difficulty over the question of sponsorship. The Minister of State did not appear to want to give up sponsorship, but that sponsorship is now being eroded because the tobacco manufacturers, in face of the obligations imposed on them, have to cut back on expenditure. It has been suggested that the advertising should be cut. I believe that the manufacturers waste too much money on advertising. I would rather see money spent on greater 829 sponsorship, but this is a matter of commercial judgment.
I believe that if cigarette advertising were to be done away with on television and newspapers, certainly the newspapers, which are already in a difficult situation, would lose advertising revenue. Advertising would still make a large impact on the public, because every little tobacco or sweet shop would advertise tobacco products. This would apply to the small shop as well as to the supermarket. Whatever restrictions one imposes, advertising will still occur. Outlets are bound to exist unless the sale of cigarettes is stopped completely.
I am in favour of educating people against too much smoking. We have an excess of legislation and I hope that the Government, having decided on steps to educate the people, will allow them to make up their own minds. My old father, who died only a few weeks ago in his ninety-first year, smoked a pipe all his life. There is a danger that we shall act as scaremongers. I smoke, I hope not too heavily. I do not believe that I or anyone else, young, middle-aged, or old, can have any doubt that smoking is injurious to health. Let people make up their minds.
The Government are not right to legislate on this subject. They can get voluntary agreements. The most important thing is that the manufacturers and the Government together should add to the money spent on research. The hon. Member for Ormskirk did not give any credit to the manufacturers for the millions of pounds being spent by them on research in attempts to improve the quality of the product. The Government and industry together can best serve the public not by trying to get it to do something it does not want to do, but by improving the quality of the product and eradicating the substances which create health dangers such as bronchitis, cancer, heart trouble and the like.
Improving the product quality is something that concerns manufacturers and must concern any Minister responsible for health matters. To go beyond that and to shadow box, to pretend that we want to cut back on sales and ineffectively to seek to do so, is not realistic.
Although I am glad that the hon. Member has raised this subject and I was interested to hear what the Minister had 830 to say, it seems that there are two dangers. The first is that we become too heavily involved in legislation and the second is that we try to force the public into attitudes it does not want to adopt.
When the Minister comes to consider this committee, I hope that he will recognise how essential it is that its membership should be balanced so that it has on it people who hold the views that I have put forward so that it is not composed solely of those who are against smoking. If we have such a balanced committee, it might ensure that any report produced is not as disastrous as it might be.
§ 1.13 p.m.
§ Mr. Arnold Shaw (Ilford, South)
Let me first congratulate my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) on bringing this motion before us. If it does nothing else, it will have the effect of urging the Minister to take further action, which I am sure he wishes to do. It will, perhaps, be highly effective if in replying to the debate my hon. Friend declares a conversion brought about by his own eloquence. That would have tremendous repercussions throughout the country.
So far we have been dealing with this subject on the basis of possible legislation and the attitude of the Government. Points of view have been put either for or against and hon. Members have talked about how far the tobacco industry is prepared to move voluntarily to meet the requirements of public health. The industry has been shown as a great paternalistic set-up which is there almost solely for the purpose of looking after the health of the country. I take a different view altogether. The tobacco industry is there because it provides large profits for those engaged in it. That is the foremost thought in the minds of the manufacturers when going about their business.
So far we have been concerned with the obvious effects of tobacco smoking on the health of the smoker. I have to declare an interest as a non-smoker. I wonder whether the Minister will spare a thought for non-smokers, who are at serious risk even though they are innocent bystanders. It has been said that through education of one kind or another the majority of people recognise that smoking is harmful. I wonder how many non-smokers realise how harmful the 831 smoking of others can be for them when they are involuntarily exposed to tobacco smoke.
I remember recently visiting a hospital deeply involved in research into lung cancer. I was blithely told by a doctor there "It does not matter whether you smoke or not. You will still be affected if you come into contact with smokers." That certainly gave me something to think about. I am a little worried about it. There is little doubt that the chief sufferers are those who smoke, but the concentration of smoke in confined places can have a serious effect on others. For instance, car drivers who, like myself, would not refuse the request of a passenger to smoke can be affected.
In other cases—I am not talking about myself now—the effect of the smoke in conjunction with that of alcohol could produce a highly dangerous situation. We know, too, that persons with heart disease can be seriously prejudiced if they are in a smoke-filled room. Harm can be done to asthma sufferers. Attacks can easily be induced in a smoky atmosphere. Measurable levels of nicotine have been found in the blood and urine of non-smokers who are exposed to tobacco smoke.
§ Mr. Eric Ogden (Liverpool, West Derby)
Would not my hon. Friend agree that reasonably modern cars, such as those produced by Ford, Triumph or Vauxhall, incorporate ventilation systems which change the air roughly every 30 seconds? Second, is my hon. Friend prepared to set an example and not take his tea or coffee and sausage and beans in that part of the Members' Tea Room reserved for smokers?
§ Mr. Shaw
My hon. Friend makes the point for me. The trouble is that so many cars are not up to the standard he describes. Perhaps we might have legislation to bring them up to standard. As for my drinking tea or eating sausages —to which I am not addicted, incidentally—in the Tea Room, I might go to that part set aside for non-smokers. Although I am not a smoker, I am a social person. I find that that part of the Tea Room provided for nonsmokers—I hope that I am not giving away any secrets—is occupied generally 832 by people who read newspapers and who are not addicted to the sort of conversation—intelligent conversation, if I may say so—for which one goes to the Tea Room. However, I shall consider the advice to sit in that part of the Tea Room set aside for non-smokers. I should be happier if the whole of the Tea Room were set aside for nonsmokers for the benefit of Members as a whole.
We know from research that smoking by mothers in pregnancy has a harmful effect on the successful birth or otherwise of a child and that there is evidence of slight physical and mental disadvantages in the growth of the child. Children of parents who smoke are also at greater risk, particularly in the first year of their lives when the incidence of bronchitis and pneumonia is much greater.
Efforts have been made to safeguard the health of non-smokers in public places. Smoking is prohibited in the auditorium in most theatres. In some cinemas, smokers are requested to sit in a certain section, though I cannot accept the validity of this rule, because smoke does not stop half way in the cinema, but tends to drift. The number of nonsmoking compartments on the London Underground has been increased over the years.
Those are all welcome trends, but the Minister should take on board the idea of extending the provision far more to protect people, including myself, who suffer as a result of the activities of those who, according to some hon. Members, should have the right to smoke to their heart's content.
It has been implied that the Government refuse to act because to do so would affect the Revenue. I am sure that that is a valid observation. But no one has referred to the tremendous loss to the country—a loss difficult to quantify—resulting from the effect on the health of a large number of people who are ill as a result of smoking or who are unable to go about their daily work, thereby affecting the economy of the country. There is also the balance of payments. I am sure that if we did not import tobacco, that would be of great value to the economy.
I hope that as a result of this debate some measures will be taken to deal with 833 this matter. I draw the attention of the Minister to the plaintive cry made on behalf of people who are innocents and who want his protection.
§ 1.25 p.m.
§ Mr. George Gardiner (Reigate)
I should like to join those hon. Members who have thanked the hon. Member for Ormskirk (Mr. Kilroy-Silk) for enabling us to debate this subject. I should also like to thank the hon. Gentleman for his speech. Although I do not have all the information necessary to lead me to join him in all his censures on tobacco manufacturers, I agree totally with the rest of his argument, which was substantial.
I was interested in the speech of the Minister of State, and I would not wish to quarrel with the rather cautious approach which he outlined. Some might feel that it was too cautious, but time will tell. It was useful and welcome that the Minister of State and the hon. Member for Ormskirk stressed that in tackling this social problem it is not desirable to heap restrictions upon restrictions. I join my hon. Friends in believing that there are too many assaults on our freedoms, and I do not seek to deny to people any freedoms which they hold dear.
However, we are concerned with striking a balance between what different people and groups of people believe to be their rights. There is the liberty of people to smoke, in full knowledge of the risks involved. Equally there is the liberty of others to breathe air which has not been polluted in this way. I was glad to hear the comments of the hon. Member for Ilford, South (Mr. Shaw) in that connection. The matter is well summed up by the maxim that whether one smokes is a personal matter but that where one smokes is a public matter.
We have made considerable progress in defining no-smoking areas in public places, but I agree with the hon. Member for Ilford, South that we should go much further. The time will soon be upon us when we should be thinking of defining no-smoking or smoke-free areas in places of work, because that is where many people suffer the worst pollution through their lungs from working colleagues who are addicted to smoking.
We have heard a good deal from the Minister and others about the value and 834 virtue of adopting voluntary approaches and seeking with manufacturers voluntary means of tackling this problem, but we can do a good deal through voluntary approaches among smokers themselves.
I am always impressed by the number of smokers who say that they would like to give up smoking, perhaps to save money or because they recognise that it does not do their health any good, but they confess that they do not give it up for various reasons. They think that if they do so it will make them more tense at work or socially. They feel that they may lose their self-assurance in company.
Some people feel that to give up smoking will increase their appetites and make them fatter. Most of all, however, people do not give up smoking, and do not make the effort to give it up, because they do not believe that they can. In the next stage of the campaign we should go out of our way to help this section of smokers. What is involved here is a psychological exercise. And we must try to build on the undoubted fact that it is much easier to give up smoking if one does so in company, whether with one's family or with colleagues at work.
I should like to draw the attention of the House and the Minister of State to an experiment which is to be conducted shortly in my constituency in an attempt to help smokers and which might provide some lessons which could be applied nationally. A "Don't Smoke Day" or "D-Day" is being held and we hope that large numbers of smokers will voluntarily commit themselves not to smoke on that day. The first "Don't Smoke Day" was held in the town of Monticello in Minnesota on 7th January 1974. A large proportion of that town's smokers gave up cigarettes for the day and a significant number found that this break was enough to enable them to give up smoking for a week, with a smaller number giving up the habit for good.
The experiment was so successful that nine months later a "Don't Smoke Day" was organised throughout the State of Minnesota. A day was fixed and was preceded by an intensive three-week campaign by various organisations, including clubs, schools, newspapers and local radio and television. Smokers were invited to sign pledge cards which read:I promise not to smoke on D-Day".835 These were made available in banks, schools and voluntary health agencies and it became a communal exercise with a certain light-hearted aspect to it.
The real purpose, of course, was to get smokers to look beyond that one day and say to themselves that if they could give up smoking for one day they could try it for a week or even longer. It is important in an exercise like this that advice and sufficient aids are made available to help those who wish to give up smoking. The indications from this State-wide experiment are that about 10 per cent. of those who signed the pledge found that it helped them to give up smoking altogether, and another "Don't Smoke Day" was held in the State in October last year.
With that history in mind, a pilot scheme is being prepared in my constituency. The organisers include ASH, the National Society of Non-Smokers, local doctors, civic leaders, including the mayor of the borough, who is a smoker, and, most important, the East Surrey Community Health Council, which recognises that this is an important experiment in preventive medicine. Our local "Don't Smoke Day" has been fixed, appropriately enough, for 3rd March, which is Ash Wednesday. Literature is being prepared for distribution on a large scale. Approaches are being made through youth clubs, the local Press and various other organisations, and various aids to help smokers will be on sale. Even in an area such as Reigate and Banstead, with an electorate of 70,000, it would be very worth while if just 1,000 people could be helped to break voluntarily a habit they wish to give up.
I should like the Minister of State to express his support for our "Don't Smoke Day". His support would be very important to help us obtain the co-operation of other bodies throughout the area. The experiment could yield valuable experience which might possibly be applied at a national area in subsequent years. I hope, therefore, that the Minister will express his support for this practical and entirely voluntary pioneering effort by a community in preventive medicine.
§ 1.35 p.m.
§ Mr. John Parker (Dagenham)
I compliment the Minister of State on his speech. I realise that Ministers have to 836 get their proposals through the Government, and that this is probably as far as we can get in this direction at the present time.
The tobacco industry is never likely to make any concessions that would cut its profits. It is a profit-making industry and shareholders expect their profits. Therefore, sooner or later the Government will have to take steps to impose legislation on the industry.
I agree with the hon. Member for Reigate (Mr. Gardiner) that whether a person smokes is an individual choice but that where he smokes is a social matter. The question of personal liberty has been raised and it is the subject of the debate scheduled to follow this one, but the question should be "Personal liberty for whom to do what?" We must be very clear where we draw the line on this matter. Non-smokers have rights as well as smokers and we must protect the community as a whole. There should be new legislation to deal with the subject. In particular we should control advertising because, although it may affect adults only in their choice of brand, it encourages young people to smoke. They believe that it is manly to smoke, and if there was no advertising there would not be this propaganda building up in their minds the desire to smoke. Advertising should be drastically controlled.
I introduced two Ten-Minute Bills on this subject in the 1970 Parliament which would have prohibited all advertising of cigarettes, whether on television, radio, the Press or billboards. All sponsorship by cigarette companies would also have been banned.
When the first Bill was voted on on 19th January 1972 it was given a First Reading by 132 votes to 73, with the supporters coming from all parts of the House, which was indicative of hon. Members' feelings on this subject. Opposition to the proposals came from the hon. Member for Canterbury (Mr. Crouch), who said that it would damage the advertising industry. Despite his plea, the First Reading was carried. When the Bill came up again the following year on 20th February there was considerable lobbying on both sides to get a vote, but when the opponents found that they were likely to be heavily defeated they let the First Reading through without a vote. They
837 were frightened that the majority would be even larger than on the previous occasion.
I am sure that in this Parliament there would be a strong vote for any effective steps to deal with tobacco advertising. Public opinion has built up considerably since 1973.
The current issue of Marketing deals with the advertising industry in an article on the possible effects of a ban on cigarette advertising on the advertising industry generally. It shows that all the major newspapers have been considering a possible ban on cigarette and tobacco advertising and have been adjusting their position to accommodate this possible change. In 1969 the Mirror Group drew 20 per cent. of its advertising revenue from cigarettes and tobacco. This has now been reduced to 4 per cent. The weeklies and the magazines have made a substantial reduction. The TV Times, which in 1972 drew 20 per cent. of its advertising revenue from cigarettes, has now reduced that figure to 10 per cent. or 12 per cent. The Sunday Times Group obtained £902,000 from tobacco advertising in 1972. Between July 1974 and June 1975 this sum fell to £650,000, and in view of the rate of inflation in the intervening period that represents a much bigger drop than the figures suggest. The article concludes that, although a sudden ban on cigarette advertising would be damaging for the advertising industry, the effect would not be so bad because of the adjustments that have already been made.
There is then the question of sports sponsorship. The hon. Member for Reading, South (Dr. Vaughan) said that it was to the credit of the tobacco industry that it sponsored certain sports and the arts. That is nothing more than Danegeld, an attempt to buy off opposition with gifts and build up good will. Even some advertising of Sotheby's in favour of tobacco carries the message that it is chic to smoke. I do not think that that argument was worthy of the hon. Member for Reading South. There are plenty of firms outside the tobacco industry which would be willing to take on the sort of sponsorship which is done by Benson and Hedges and other tobacco firms.
When there is television coverage of football matches, the camera turns to the 838 cigarette advertisements which surround the arena. Objection was taken to this practice and the advertisements were covered up during some matches. This created great indignation among the tobacco manufacturers, who attempted to get the covers removed because they were interfering with their business.
Any Bill on this subject should tighten up on the access of children to cigarettes, and that should apply particularly to vending machines. The theatres have banned smoking not so much because of pressure from the public but because the actors find that with smoke in the atmosphere their voices become strained. The same is true of opera singing generally. We are about the only country which allows smoking in cinemas, and we should rectify that omission. We should certainly tighten up the rules concerning smoking in public places.
London Transport has tightened up the position on the buses, but we lag behind the rest of Europe. Throughout the EEC there is practically a complete ban on smoking in public transport. There should be a similar general tightening up here. I have had many complaints about the situation in airport lounges, such as at Heathrow, where travellers complain that the atmosphere is made insufferable by smoking, especially when flights are delayed and people must spend a long time waiting around.
I was pleased to see the lead given by Prince of Wales recently when he said at a public function, when someone asked if the loyal toast could come early, that smoking should be postponed until after the eating had finished. We do not want to follow the American custom of smoking between courses and having all our food spattered with ash. If people must smoke, let them to do so at the end of the meal so that those who do not smoke can go.
I am interested in the changes in hospital practice. I had the misfortune to spend about seven weeks in St. Bartholomew's Hospital in 1970. At that time everyone in the ward smoked, and there was no discouragement. I went in again for an appendicitis operation in 1974 and was delighted to find that smoking was strongly discouraged by all the authorities there. Neverthless, a man in the bed next to me who had been operated on for cancer of the throat had a cigarette 839 in his mouth as soon as the nurse was out of the room. I cannot understand that behaviour. I am glad that the hospital authorities are taking a lead in persuading people about the evils of smoking.
I hope that the motion will be carried and I wish the Minister good luck in going ahead with his proposals. Nevertheless I should like much more drastic legislation, and I believe that sooner or later there will have to be comprehensive legislation to deal with the advertising of tobacco and the annoyance it causes to nonsmokers and in an attempt to safeguard smokers themselves.
It has been said that it would be very much to the disadvantage of the revenue if there were to be a big drop in smoking. But there would also be a big gain for the country, because people would spend less time off work suffering from the complaints caused by smoking and fewer hospital facilities would have to be set aside to deal with the casualties of lung cancer and other illnesses caused by tobacco. There might be a drop in the revenue, but the country would gain in other ways which would eliminate any net loss to the nation.
§ 1.48 p.m.
§ Sir George Young (Ealing, Acton)
I congratulate the hon. Member for Ormskirk (Mr. Kilroy-Silk) on choosing this subject and generating such an interesting debate. I listened with interest to certain Labour Members who gave themselves away. It was clear that the reason why they spend so much time in the Chamber is not through any commendable interest in the proceedings but is simply to get away from the other smoke-filled rooms in the Palace of Westminster.
The House will want to reflect at leisure on what the Minister of State said, mainly because he read sections of his speech at high speed. I welcome the advances he announced. I do not share his optimism about getting as far as he would wish with a voluntary agreement with the industry. There would seem to be a risk of arresting any trend towards safer cigarettes by subjecting new additives and substances to more stringent criteria than are applied to tobacco. All cigarettes should be subjected to the same criteria, regardless of whether they consist of tobacco or any other additives, and I 840 am concerned at the danger which might stem from the steps that the Minister announced.
I question the emphasis which the Minister has said is to be his method of proceeding. He said that he wishes to concentrate on the 19 million people who smoke, but I believe that he should concentrate on the 40 million who do not. It seems a strange paradox that when three beagles are caught smoking at the ICI laboratories no fewer than 204 Members sign an Early-Day Motion demanding that the Home Office bans the disasteful practice at once, yet when 52,000 people die each year as a result of the same activity most Members show little concern. Indeed, many are prepared to defend the current situation. That is yet another example of our dual standards. It seems that we are prepared to deal in a kinder way with animals than with each other.
This year approximately 100 of my constituents will die prematurely because they smoke. The figure is the same for the constituencies of the Members who are taking part in this debate. If present trends persist, one child in 10 at present in school will die as a result of smoking. That means that about 800 children currently at school in my constituency will die.
One of my constituents is a consultant physician and cardiologist at the Central Middlesex Hospital. Recently he wrote to me as follows:As one of your constituents and a physician to a hospital in which many of your constituents are treated, I should like to bring to your attention a matter which is of great concern to me as well as to many of my medical colleagues, that of smoking and health. My own wards at this hospital contain many men and women suffering from coronary heart disease, cancer and chronic bronchitis, often in a state where palliative treatment alone is possible. I am therefore continually made aware of the tragedy of so much preventable diseaseI am conscious that two doctors have already taken part in the debate. I cannot compete with their medical knowledge but I know that tobacco smoke has three highly poisonous ingredients and that each has complex effects on the body, the ingredients being tar, nicotine and carbon monoxide. Tobacco tar is an irritant causing chronic inflamation of the membranes. That is one of the most important factors leading to chronic 841 bronchitis. Carbon monoxide displaces oxygen from the blood and reduces the efficiency of the blood by about 10 per cent. Nicotine interferes with the autonomic nervous system, which is responsible for the reflex control of most organs. That interference causes faintness and nausea in the novice, but as the habit develops those symptoms are superseded by the stimulation of sympathetic nerves, causing over-activity of the heart, suppression of appetite and constriction of small blood vessels near the body's surface.
I hope no one will suggest that smoking is actually good for one's health or that it has anything but an adverse effect on the human body. I believe it to be a much greater health risk than many drugs which are currently controlled by the Medicines Act. For that reason alone I shall be interested in pursuing the solution which the hon. Member for Ormskirk has put forward.
The Department of Health and Social Security has estimated that 52,000 people die annually aged 74 and under. It has also estimated that if smoking were reduced by 40 per cent. there would 20 years later be more than 100,000 fewer widows and widowers and nearly 2,000 fewer people in hospital. How sad it is that we have not implemented very many of the recommendations of the World Health Organisation, in particular the recommendation that we should adopt a differential system of taxation to discourage the smoking of cigarettes with a relatively high tar content. Nor have we made it illegal to offer tobacco to children and adolescents. Further, we have not prohibited the use of vending machines for tobacco products where such machines can be used by children and adolescents.
The Minister of State is on record relatively recently at a conference organised by the Health Education Council and ASH as saying that he will support their activities enthusiastically and that he is totally convinced that cigarette smoking is the largest avoidable hazard to health in this country. Apparently he urges all Back Benchers to put every possible pressure on him so that he can move forward. I wonder whether what he said this afternoon is compatible with the commitment which he gave at that conference and whether he feel that he has reacted as sympathetically as he might 842 to the pressure being put on him this afternoon.
Mention has been made of the revenue that is gained from the sale of tobacco products. It has been said that the industry contributes a large sum to the Exchequer, but it is contributed not by the industry but by the consumer. If there were a total ban on cigarettes, which no one is contemplating, there would be a distressing shortage to the Exchequer, but the impact of that shortage has been exaggerated. If people could not spend their money on cigarettes they would spend it on something else, thereby generating revenue to the Exchequer. If they did not spend their money but saved it, the same economic impact would be achieved as if the money had been taken away from them in taxation.
The importance of the Customs and Excise duty to the Exchequer has decreased. Whereas in 1960 tobacco duty accounted for 10 per cent. of all revenue, the figure has now dropped to about 6 per cent. The cost to the economy in lost working days, sickness benefit and fires is estimated at about half the tobacco duty revenue. The economic implications are not quite as straightforward as might have been thought.
I now turn to the issue of advertising and sponsorship. I have been intrigued by the argument put forward by tobacco manufacturers that advertising has no effect on total cigarette consumption or on the proportion of the population smoking cigarettes. Some years ago I remember listening to those who advertised toothpaste. They argued that one of the beneficial spillovers of the campaign promoting their brand was to encourage some people to brush their teeth and to encourage people to take a broader interest in dental hygiene.
It strikes me that that contention, which I accept, is now being stood on its head by the tobacco interests. One can only reiterate the comment made by the Secretary of State for the Environment by saying "Codswallop" when confronted with the argument that the advertising of cigarettes has no effect on total consumption.
I would greatly welcome much tighter control on advertising and much faster action than the Minister seemed to 843 announce this afternoon. As regards sponsorship, I would view with equanimity the loss of £4 million to sport. I would accept that loss if there were to be a reduction in smoking.
Nor do I believe it healthy that sport should become so dependent on the tobacco industry. The industry is really interested not in promoting sport but in exploiting a loophole in the present advertising regulations. It has been argued in a penetrating article in the New Statesman that sponsorship has done much damage to sport. Part of the article read:The growth of sponsorship over the past 10 years since the ban on cigarette advertising on TV would appear not only not to have helped but actually to have harmed traditional, healthy sports in this country.Since then other articles have drawn attention to the fact that other sponsors would step in if the tobacco manufacturers withdrew. Sport has managed to survive for many hundreds of years without sponsorship. This is another example of our dual standards. It seems that we are prepared to accept the advertising of tobacco if we think it is in the interest of sport.
I regret that the Minister responsible for sport has been persuaded to accept the arguments put forward by the tobacco manufacturers about sponsorship. As regards the sponsorship of Members of Parliament, I note that the manufacturers have undertaken to prevent any association in their advertising with health, vigour and sexual attractiveness. Perhaps they should adopt the same criteria in choosing Members of Parliament whom they sponsor.
I turn finally to the moral problem that is involved. Many of my colleagues believe it to be no part of the Government's duty to prevent individuals from harming themselves provided that they know what they are doing and provided that they cause no harm to others while doing it. I do not share that view. I believe that Governments have a wider duty to prevent citizens from doing damage to themselves, and in particular to their children.
In practice I believe that that view is shared by both political parties. During the period of office of the previous Conservative Government a law was passed
844 compelling motor cyclists to wear crash helmets. On the face of it, that law infringed the liberty to which I have referred. The present Government are determined to compel motorists to wear seat belts. It would seem that this liberty, if liberty it be, has been infringed by both parties. It strikes me as a rather odd liberty to defend—namely, a liberty to damage one's health. We should remember that it is the most precious and irreplaceable asset that an individual is given.
The basic issue is whether the House should treat tobacco addiction as a major public health hazard and should commit substantial resources to combating it or whether it is to continue with the range of voluntary solutions that have characterised our approach over the past 20 years, which, I believe, have proved to be totally ineffective.
It is commonly admitted that we are well down the league of progressive antismoking countries and have not gone nearly as far as other countries, particularly Sweden, in campaigning against cigarettes. I believe that we should do what the Swedes are now doing, which is to organise a 25-year smoking control programme aimed principally at children and try to phase out smoking over that period. This is a campaign which involves keeping children out of sight of cigarettes at all stages of their lives, starting with parents, teachers and so on, up to university age.
I do not think that as a country we have yet decided whether we wish to adopt a positive approach along those lines. The Minister's response today when faced with the basic problem of whether we should continue by voluntary agreement or proceed by legislation was to say that we would proceed half by voluntary agreement and half by legislation. I believe that that represents the conflict which still faces us. We have not as yet decided how to approach the problem.
I do not know whether the Medicines Act is the right way to go about it. I am inclined to accept what the Minister said—that other legislation which may be more appropriate is needed. I regret that he gave no indication of the timetable he proposes to adopt in this other method of tackling the problem.
§ Dr. Owen
I did not imply any other legislation. I think that this legislation is suitable. It is a question of drafting the Order and consulting the various bodies, which under the terms of the Act one would wish to do. It is a matter of a few months and then of coming to the House for approval or otherwise.
§ Sir G. Young
I am grateful to the Minister for shedding some light on the time scale involved—" a few months". I take it that perhaps before the summer we shall have before us the Order to which he referred. That intervention by the Minister was particularly helpful.
§ 2.2 p.m.
§ Mr. John Cartwright (Woolwich, East)
Like almost every hon. Member who has taken part in the debate, I begin by thanking my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) for giving us this opportunity of debating the subject of smoking and health.
I am very encouraged by the measure of agreement that we seem to have in all parts of the House about the costs to the community of smoking. We have heard of the at least 50,000 premature deaths a year that are directly attributable to smoking and of the extent of other serious illnesses that are the direct result of smoking. Hon. Members have referred to the cost borne by the National Health Service of treating cases of lung cancer, other lung disease, bronchitis and so on, which come directly from smoking. We have heard references to the cost of social security payments to those off work as a result of illnesses caused directly by smoking. We have heard about the lost production due to illnesses caused by smoking, which has been estimated as at least 26 million working days annually.
We have also had what is in many ways the most dramatic estimate of the extent of this problem, which is so dramatic that it bears repeating. That is the estimate of the Department of Health and Social Security, which stated that in factual terms, if smoking were reduced by 40 per cent., 20 years later there would be 100,000 fewer widows and widowers and nearly 2,000 fewer people in hospital.
Against that sort of background, this sort of problem would justify the most rigorous action by any Government, particularly as it is a self-inflicted problem.
846 I should have thought that if there had been any other substance freely on sale to the public and causing this sort of major damage to health, there would have been rigorous Government action to remedy the problem. However, as we have heard, we have virtually no statutory controls. We have a very limited public campaign to draw attention to the evils of smoking, and we have relied almost wholly on a voluntary approach, with the quaint notion that the tobacco companies will be prepared to take effective action designed to reduce their own sales. I am not impressed by this voluntary approach, as are some hon. Members, particularly some Opposition Members.
We have heard references to the health warning on packets. I question how effective that warning really is. The Consumers Association published the results of a representative sample survey last year which showed that 82 per cent. of those surveyed were not influenced at all by the health warning on packets, and that it had no effect at all on their smoking. We have heard references to the health warning in advertisements—but not, sadly, on advertisements displayed at sponsored sports meetings or the advertisements which advertise those sponsored meetings.
We have heard already that the voluntary advertising code, which was enforced by the industry itself, turned out to be so ineffective and breached so often that the Advertising Standards Authority now has the responsibility for enforcing a somewhat more rigorous code. Some of us will watch with some interest how much more effective the new code is.
I am bound to say that the sum total of what has been achieved by this voluntary approach is not particularly impressive. We still have, for example, a very substantial measure of Press advertising, particularly the highly glossy advertising in colour supplements and women's magazines. We still have no limitation on sports sponsorship, which many of us regard as the most insidious form of advertising. We have no reduction of the coupon schemes, which positively encourage people to smoke more heavily. If there is not a case for a total ban on advertising tobacco, it seems to me that there is a very powerful case for the strengthened regulation of advertisements, covering the amount and extent of advertisements and their content and type 847 —a regulation along the lines of the World Health Organisation recommendation and of action taken by a number of other countries.
We know that spending by the tobacco industry on advertising and promotion of all types is now between £70 million and £80 million a year. That, I understand, is tax deductible, so the taxpayer makes a contribution towards that. On the other hand, we know that Government spending on anti-smoking campaigns of all types is now running at about £1 million a year. It seems that this is a typical David and Goliath situation, without, sadly, the happy ending in the Biblical story, because I doubt very much whether the power of the Davids of ASH and the Health Education Council could topple the very well-heeled Goliaths of the tobacco firms, with their sophisticated techniques and massive budgets.
One of the problems of approaching the subject on smoking and health is changing the climate of opinion in our society. Sadly, that climate at present reflects the view that smoking is acceptable. One rather odd example of this was given in the November 1975 edition of Which?, which referred to a British Rail special excursion offer to the Channel Islands. In addition to a special price ticket, British Rail were throwing in free 200 king-size cigarettes. The Consumers Association pointed out to British Rail that there was something a little illogical about the Government paying out taxpayers' money in anti-smoking campaigns and British Rail, heavily dependent on subsidies from the taxpayer, at the same time encouraging people to smoke. Sadly, British Rail did not accept that view. British Rail said that the offer was very successful and that it wanted to continue it.
That underlines the problems that we face in trying to change society's attitude towards the smoking habit. It seems to me that some legislative framework, some statutory controls, would be an essential first step to changing this sort of attitude.
I am particularly glad that one of the threads flowing through this debate today has been the problem of the young and the risks that young people run when they start to smoke, particularly because, as has been pointed out, it is very easy to 848 start smoking but extremely difficult to give it up. However, another survey quoted in Which? in February last year found that the majority of teenage smokers thought that they would not become addicted. They were strongly of the opinion that they could stop it when they liked. Sadly, that opinion is not borne out in fact. That indicates the wisdom of those who included in the Children and Young Persons Act 1933 the ban on the sale of tobacco to children under 16.
Like other hon. Members, I was horrified by the results of the ASH survey, very professionally conducted, which showed that 43 out of 50 children sent into tobacconists' shops and obviously under the age of 16 were able to buy cigarettes. I do not know which I find most worrying about that survey—the ease with which children are apparently able to buy cigarettes, the casual attitude of the tobacco industry to the enforcement of the law, or the ridiculously small number of prosecutions over the years for breaches of the ban on the sale of tobacco to children.
Hon. Members have referred to such evidence as there is about the numbers of young children now smoking. Some surveys suggest that as many as a quarter of boys in the 14 to 15 age range smoke at least occasionally. I am worried about the evidence I see before my eyes of young people smoking in public. On occasions I am horrified when I collect my 14-year-old son from a South London comprehensive school to see the number of boys and girls who are not out of the school gates before they are already lighting up cigarettes and puffing away. Against the background of such evidence as there is of the risks of smoking to children, I find this absolutely horrifying.
Studies have been produced in a variety of countries to show, first, that boys who start to smoke before 15 run a five-times greater risk of dying from lung cancer than those who start after 25. These studies also show that those starting before 20 are 36 per cent. more likely to die from coronary diseases than those who do not start until after 25. The survey shows also something that many would accept—that children experimenting with smoking do not understand what the warnings against lung cancer and other diseases really mean.
849 It is in this situation that I find the conditioning of attitudes towards smoking particularly worrying. The BMA Family Doctor booklet on smoking had this to say:Many children are becoming 'conditioned' almost from birth to the expectation that they will smoke.The booklet referred particularly to the obvious evidence that the children of smokers tend themselves to become smokers, on the basis that children naturally copy what they see about them. But there are other influences as well. This may be a peripheral influence, but I do not see why the confectionery industry continues to produce sweet cigarettes and other imitative items of that sort, which simply encourage children to accept that smoking is acceptable.
There are other more insidious conditioning influences, and right at the head of these is sports sponsorship. A whole generation of young people is growing up learning to associate the best in tennis and cricket with names like Rothmans, Players and Benson and Hedges. Some of the dangers of that situation were referred to in the BMA Family Doctor booklet on smoking, which said:Millions of pounds are spent on trying to persuade youngsters that tough, successful, athletic and professionally competent people smoke cigarettes, when in fact the evidence is that in the main they do not.The author went on to say that he was asked many times why it was not possible to use professional athletes, racing drivers and other heroes of the young to get across the anti-smoking message to children and young people. He said:A few of them, of course, smoke cigarettes, but the majority we have approached do not. They do, however, appear in sponsored sport, sponsored by the tobacco trade, and therefore feel, and no doubt they are right, that it would be dishonest to take part in as anti-cigarette campaign.That underlines the insidious nature of this promotional activity by the tobacco firms.
I underline what my hon. Friend the Member for Ormskirk and other hon. Members have already said in this debate —that those who want to see stricter controls do not want it out of some puritanical killjoy attitude, wanting to ban the pleasures of others. We want to give young people a chance to make an intelligent choice for themselves, whether they smoke or not. That means that they must 850 know and understand the risks and must be protected against sophisticated advertising and promotional activities deliberately aimed at seducing them into a dangerous habit that they then cannot break. In particular, it means having the strongest possible safeguard for children, who, clearly, are not in a position to exercise choice and discretion for themselves.
On the basis of the record, I do not believe that we can rely on the tobacco firms voluntarily to undertake such a programme. We have to have the statutory framework.
I very much welcome what my hon. Friend the Minister of State has said to the House today. I wish him luck in his voluntary approach to the tobacco industry. I very much welcome his undertaking to monitor the results of that voluntary approach. I hope that, if it does not yield the progress we want, he will come back to the House for the stronger statutory powers that many of us think he needs.
§ 2.15 p.m.
§ Mr. Roger Sims (Chislehurst)
We are discussing a curious phenomenon in our society, namely, the fact that half the adult population indulge in a practice which is both anti-social and liable to injure, if not to prove fatal to, their health. It is certainly anti-social to the other half of the community—and, I think, to the whole community. How much litter is caused by cigarette packets, matches and cigarette ends? How many fires are caused by the carelessness of smokers?
It is curious that if in a social setting such as the Tea Room—referred to earlier by the hon. Member for Ilford, South (Mr. Shaw)—a number of people were gathered together and one of them produced an aerosol and proceeded to fill the atmosphere with clouds of a particularly foul-smelling and asphyxiating substance. such behaviour would be considered a little odd and certainly lacking in consideration for other human beings. But it is considered quite normal to light up a cigarette—or, even worse, a pipe—and fill not only the atmosphere but one's neighbours' lungs with rather unpleasant smoke.
The matter does not rest there, because the smoke clings to clothes and one goes 851 home smelling of the smoke. There was a time when it was the accepted practice to dress for smoking—to wear a smoking jacket. There was a time when smoking was confined to certain places. Indeed, in this House we have still a Smoking Room. Nowadays, however, as the hon. Member for Woolwich, East (Mr. Cartwright) said, it seems to be socially acceptable to smoke.
This would seem to be an area in which both official and semi-official Government bodies might use their influence. After all, if a traveller wishes to travel in fresh air, he has to seek out carriages marked "No Smoking", of which, happily, there are more.
I rather resent the implication that it is the non-smokers who are the odd ones and that there has to be special accommodation for the non-smoker. Surely it is the smoker who is the odd one out, and it is he who should be provided with the special accommodation. The Government could surely use their influence in this respect in the nationalised industries, in public places, in theatres and so on.
The most basic objection to smoking is the effect that it has on health. Figures have been quoted a number of times in the debate, and it is frightening that 1,000 people die every week from lung cancer or diseases associated with smoking. It is really frightening that today 140 people will die because they have been smokers, and that probably 10 or 12 have died while we have been having this debate simply because of having smoked excessively for a number of years.
It should be remembered particularly that of the deaths of men between 35 and 40, one in eight are caused by smoking. When we note that this figure becomes one-quarter of all the deaths between 45 and 64, the figures are even more frightening.
§ Mr. Kenneth Lewis
Will my hon. Friend contemplate the situation now existing in this country, where people are living longer than ever before? Our geriatric wards are the fullest throughout the whole of the country, and many of the people in them have smoked. The general health and longevity of the community have never been better.
§ Mr. Sims
I do not dispute that, and I am sure that the Minister of State is better equipped than I am to give a variety of reasons why that should be so. But that does not alter the fact that there is ample evidence that cigarette smoking is responsible for a large and frightening number of deaths.
When we add to that the number of operations for lung cancer, the cost of smoking in terms of human pain and grief, the man-hours lost, the cost to the National Health Service and the payment of pensions for those prematurely widowed, the cost is astronomical whether we think of the individual or of the nation.
Perhaps it is evident from what I have said that I am not a smoker, although I have many relatives and friends who smoke, some occasionally and some heavily, and I accept that they find that it meets a need and that it is difficult to stop. I do not claim any merit for being a non-smoker. I never started. On the other hand, I have to confess to an addiction to a certain well-known brand of clear mint. If I were to learn today that it contained a harmful substance I might find it difficult to cut down or to eliminate my consumption, although I hope that I should be able to do so.
I do not advocate a ban on smoking. That would not be reasonable or practicable, although it is interesting that, if we had never smoked and someone tried to introduce into this country the practice of smoking, I suspect that this House would be down upon him like a ton of bricks to prevent it.
My basic philosophy is to let people do what they wish to do and that the Government should interfere with their lives as little as possible. Therefore, if it is possible to control the smoking problem without legislation, I shall welcome that. I was pleased to hear what the Minister said earlier, and I hope that he is successful with the voluntary agreements to which he referred. However, there is a duty on this House and on the Government to take every possible step to advise smokers and potential smokers about the dangers of smoking. There are many ways in which this can be done, especially by education. The Health Education Council has had considerable 853 success recently in warning pregnant mothers of the dangers of smoking during pregnancy. It is a sobering thought, however, that we are spending £4,500 million a year on the treatment of disease and that we give the Health Education Council £1 million to cover the entire subject of preventive medicine.
We await with interest the consultative document which the Minister is to issue shortly on preventive medicine. Let us hope that, following it, this will be one area in which action can be taken without the need for legislation and that for a small increase in expenditure good results will accrue.
§ 2.23 p.m.
§ Mr. Ernest G. Perry (Battersea, South)
I congratulate my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) on bringing this subject to the notice of the House once again. I thought that the Minister of State made an extremely generous offer to the industry. I am sure that the industry, with its responsible attitude to this matter will co-operate and will be able to work out with my hon. Friend an arrangement that will be for the benefit of all those who smoke and, for that matter, all those who do not.
I happen to be in the latter category. I have been a non-smoker since I was 14 when I bought a packet of 10 Star cigarettes for fourpence. After smoking half of one of them, I threw the rest away and I have never smoked since. So I am a convinced and confirmed nonsmoker.
However, I confess that I always welcomed a smoker among my colleagues and comrades in the Indian Army in 1942 and 1943, because I knew that I could always call upon him to dislodge a leech from me with the glowing end of a cigarette. Hon. Members may not be aware that the quickest way to get rid of a leech is to put the glowing end of a cigarette against its fundamental orifice. For that reason, I was always glad to have about me people who smoked.
We are plagued today by things that we should not do. We are plagued by the fact that we should not eat so many sweets, because they damage our teeth. We should not over-eat. We should not eat too many potatoes—that is not possible today because of their price—or too many starchy foods, because they cause 854 obesity. We should not drink too much spirits, because that can cause cirrhosis of the liver. Now we are told that unless we smoke in moderation, we may get lung cancer, because it is a known fact that smoking is a contributory cause of lung cancer. Finally, this week, amongst the things that we must not do, we have His Holiness the Pope telling us—
§ Mr. Perry:—
—that if we must have sex, we must not enjoy it.
This is the stage that we have reached. We are told that if we avoid all these things, we shall prolong our lives. I ask, for what purpose?
We have heard it argued that all the complaints from which we suffer are caused by certain things and that they fill our hospitals. However, the hon. Member for Rutland and Stamford (Mr. Lewis) pointed out that today we have a great number of old people in our hospitals. If we are to prolong the lives of our people by not doing all these things, hospitals for people over the age of 70 will be chock-a-block with twice as many of them. That is the prospect ahead of us.
I do not wish to deter people from wanting to smoke. But it is the same as everything else: it is a matter of moderation in all things. The person who smokes heavily is bound to suffer, and there is no doubt that smoking is one of the prime causes of lung cancer. It is a disease which I came across when I was in the insurance business, and it is a disease that cannot be got rid of easily.
I was glad to hear the Minister say that 70 per cent. of the cigarettes consumed in this country were made here. But it was said that there might be some sort of objection from the importers of cigarettes to conforming to our medical standards or to our regulations about the permitted additives in our cigarettes. There is an easy way to get over this problem and other countries use it. If they do not conform to our regulations, we do not import their cigarettes and use only home-produced ones. It is as simple as that.
In these matters we cannot always be telling people what to do. In my opinion —and I have come across many instances —cigarette smoking can ease tension. In 855 my view, although the habit is not to be encouraged, it should be allowed. A far greater menace to our social life is the amount spent on gambling. Before we start telling people that they cannot do this and that, we ought to look at the whole gamut and make sure that we get our priorities right.
The industry has a responsible attitude. I am a non-smoker and I feel that some of the advertisements to be seen on television go beyond what is necessary. What is more, like my hon. Friend the Member for Woolwich, East (Mr. Cartwright), I think that the problem of smoking among young children is one that we ought to examine carefully. Often it starts not with the tobacco manufacturers or the cigarette makers, but in the home, where many children are encouraged at the age of 14 to have a puff of a cigarette. Education in these matters needs to be tackled in the home, which is often the scene of a child's first experience of smoking. Before we condemn the manufacturers, we want to look at ourselves and the way we live and how we encourage children to do these things.
My hon. Friend the Member for Woolwich, East told us about the school his son attends and how he often sees 14year-old children coming out of that comprehensive school smoking cigarettes. I can assure my hon. Friend that it does not matter whether the school is a comprehensive or a grammar school, Eton or Harrow. Schoolboys can be seen everywhere having a puff on the sly.
It is a serious problem of health hazards. There is no doubt that it costs the country hundreds of millions of pounds a year in health services. As a non-smoker I have a pecuniary interest. I bear in mind the £1,700 million that smokers contribute to the Exchequer while, as a nonsmoker, I contribute nothing. I realise that if the smokers did not contribute that sum, my income tax would increase. My view is, "Carry on smoking, but in moderation".
§ 2.30 p.m.
§ Mr. Kenneth Clarke (Rushcliffe)
I represent a constituency in Nottinghamshire which is adjacent to the city of Nottingham. In that city a large number of cigarettes are made, and, therefore, the well-being of the area which I represent 856 is very much affected by the well-being of the tobacco industry. I smoke fairly heavily although some years ago I transferred from smoking cigarettes to smoking small cigars in the no doubt mistaken belief—I am sure someone will demonstrate—that I was thereby killing myself more slowly.
It is not only for those reasons that I do not sympathise with all that is expressed in the motion of the hon. Member for Ormskirk (Mr. Kilroy-Silk). However, I congratulate the hon. Member on coming first in the Ballot and giving us the opportunity to discuss an interesting and serious subject.
In saying that I do not agree with the terms of the motion I do not want any hon. Member to take the view that I do not share the concern which, I am sure, all hon. Members feel about the effects which heavy smoking has had on the nation's health and health care. For some years we have known the effects that tobacco smoke can have upon health. The original rather feeble attempts to dispute the scientific evidence have now petered out and for some time now there have been warnings printed on packets and a growing general acceptance of the fact that when one indulges in smoking, especially cigarette smoking, one is running the risk of injury.
I agree with what my hon. Friend the Member for Rutland and Stamford (Mr. Lewis) said earlier. I hope that the antismoking lobby agrees that the primary duty of the Government is to ensure that the public are made fully aware of the risk they run before taking their own decision. Obviously there are many who are not content that the matter should stop there. Over the past 10 years the situation has been clearly spelt out. I do not know whether the warnings on the cigarette packets have contributed very much, but I for one would not object to the warnings being stiffened or strengthened if that were thought appropriate.
I believe that we have reached the stage where a vast majority of smokers are now aware of the nature of the risks they take when they smoke. I realise that such a situation is exasperating to those in the anti-smoking lobby, who must have originally taken the view that once the dangers were known smoking would rapidly decline. However, they 857 now find that smokers, having the full knowledge of the dangers of smoking, continue to smoke. That may be because, as the Minister has reminded us, tobacco is a dependent drug.
However, there are other attitudes to this matter. It may be that smokers realise the risk they take but that their reaction is "It will not happen to me" or they believe that they can keep their smoking down to a modest level. There is also a conscious acceptance of the risk by a number of smokers who take the view, which they are entitled to take, that "All right, there is a risk. I appreciate it, but lif[...] is full of risks, as every domestic tragedy reveals". They undertake the risk of smoking for various other social purposes. That, too, is exasperating to anti-smokers who consider it to be a foolish attitude.
However, we must consider how far we can go in trying to overrule the attitudes of some smokers and how far we are justified in going beyond the publicity about the risks of smoking and trying to introduce more severe measures in the hope that somehow we shall break through and reduce consumption. I am not one of those people who say that once the risks are known we should leave people free to do whatever injury to themselves they wish. I voted for the introduction of compulsory wearing of rash helmets for motor cyclists. At present I am minded to vote for the compulsory wearing of seat belts when that matter comes back before the House.
This is a difficult issue. We must realise that in every case we are drawing a line about how far we must go in legislating or in trying to do good to people who do not particularly want to have that good done to them. Obviously there are other activities which are dangerous. We do not ban fireworks or insist that swimming should take place under supervision and at recognised bathing points. We do not ban motor racing, mountaineering or pot-holing, which involve the conscious undertaking of a risk of personal injury and damage to health. We leave those actions to personal discretion.
When deciding where to draw this difficult line and when relating it to tobacco smoking, it is right, where possible, to bring home to the public by advertising, if one wishes, the full nature of the risk and then to see what voluntary under 858 standings one can reach with the industry or smokers about what they should do. When such action can achieve something, it should suffice. Legislation should be resorted to only if there is an overwhelming argument that we shall not make any worthwhile progress without it.
I do not want to prolong the debate by going over the disputes between the two factions about how much has been achieved by voluntary understandings with the tobacco industry. The industry has made an impressive list of changes. Since August this year, when the Minister of State made legitimate use of a strong answer in the House to try to bring more pressure on it, the industry has come forward with the response of ending cinema advertising by film when children are likely to be present in the audience.
I should like us to persevere with the voluntary approach. and it is my belief that the tobacco industry is still perfectly prepared to contemplate this matter. I can understand exasperation growing on the part of the tobacco industry, which is manufacturing a lawful product. It keeps trying to reach voluntary understandings and settlements with the Government about the obligations which should be imposed on the industry to reduce the consumption or the attractiveness of its products. However, there is no finality to this process. It is understandable why it should dawn on many people engaged in the tobacco industry that they are involved in impossible negotiations. They are being asked to give only one concession, but then we go on to the next one. There is no finality. They are entitled to feel a little exasperated and to ask how much further they will have to go. They are entitled to ask whether they are simply being had or being induced to go as far as possible voluntarily and whether there will then be a statutory power to clobber them still further.
In deciding whether the Government are entitled to go as far as what the Minister has described as a statutory and voluntary arrangement, I fail to see how the Government have made out the case for introducing statutory provisions in the particular respect which the Minister so clearly described in his speech.
As I understand it, the statutory powers which the hon. Gentleman is proposing to take relate only to substitutes and additives. The statutory power which 859 he wishes to take under the Medicines Act is to submit new substitutes and additives—not ones which are already in use, but any new ones—to the Hunter Committee. I assume that as he proposes to lay a draft Order the Minister cannot reach agreement and, therefore, feels obliged reluctantly to come to the House to ask for statutory powers. However, as I understand the position, our entire tobacco industry is voluntarily offering not to market any substitutes or additives which have not been approved by the Hunter Committee. In my view, however, the industry is not being particularly magnanimous because that will give it a positive advantage. If it brings new products on to the market, they will have had the endorsement of the Hunter Committee, and this will assure the public.
Therefore, on the face of it, the industry is offering to do what the Minister's Order will be designed to achieve. His Order will be vastly limited in scope compared with the demands of his hon. Friend the Member for Ormskirk. I cannot understand why, if such an offer has been made, the Minister wishes to take it up and say "Nevertheless, I require a legislative framework."
I turn to the difficult problem of how far one should legislate and add to the volume of Regulations which pass through this House. To do good to people who do not wish to have it done to them seems to me to have no justification.
I fear that the Minister wants his Order under the Medicines Act to establish a precedent for the use of this legislation in the case of tobacco substitutes and additives. The reason for the Order is not to achieve something which cannot at the moment be achieved by voluntary means but is to pave the way, by way of precedent, for a more stringent statutory regulation which the hon. Member for Ormskirk demands in his motion. I accept that the terms of his speech were moderate, sensible and reasonable and that he did not follow through the full implications of what the Medicines Act might do if the Order comes forward. I believe that it would be wrong for the House to legislate to give the Minister powers which he does not need if what he is trying to do is to establish an argument for a successor or for himself in future to go beyond what he 860 has agreed with the industry and has told the House today.
If the Medicines Act were used to the full it could give power to control the advertising, sponsorship, packaging and marketing of tobacco, tobacco additives and substitutes. Great damage could be done in that direction, for well-meaning purposes, but I doubt whether there would be any great effect on tobacco consumption. I shall not reiterate the arguments about the effects of advertising on consumption. The Italian and Eastern European experience has been that the main effect of control over advertising has been to restrict people to old-fashioned brands—in those countries the older and more dangerous brands.
I believe that what upsets the antismoking lobby is sports sponsorship. However, in the attacks being made on sports sponsorship there is the serious danger of grave damage being done to sport in this country purely in the interests of anti-smoking. I do not understand how hon. Members can cheerily assert that other industries will take up the tobacco industry's sponsorship of sport. There is nothing to prevent them from coming forward now. There is no suggestion that before the tobacco industry moved into the sponsorship of sport other industries were moving in. The tobacco industry does it primarily for its own commercial interests. It is a legal way of promoting brand names. For example, the Nottingham firm of John Player, with which many of my constituents are involved, is concerned in this activity. It is inescapable.
My hon. Friend the Member for Ealing, Acton (Sir G. Young), who referred to the article in the New Statesman, did not deal with the argument that a ban on tobacco advertising would be harmful to sport. Such advertising is of vast benefit to the sports which receive the money. In the present financial climate there is no alternative source of finance which any of these sports would be likely to get if tobacco sponsorship were cut down.
Motor racing is heavily backed by tobacco advertising. Cricket—a sport of which I am very fond—was saved from virtual extinction by tobacco sponsorship. I should be fearful for its existence if it lost its tobacco sponsorship.
861 In addition to these big spectator sports, a great deal of money from tobacco advertising goes into angling—a major public participation sport indulged in by millions of people. Rugby league, a regional sport, also gets a great deal of sponsorship. A major tennis tournament in Nottingham which attracts many international stars, in addition to Wimbledon, is supported entirely by tobacco money. Unless there is an overwhelming argument for reducing the level of cigarette smoking, the only result will be great damage to the enjoyment of millions of people by depriving those sports of their sponsorship.
The arts will also be affected. For example, the Arts Council will be deprived of the Conductor of the Year award, which gives young conductors not only a prize but a two-year contract with an orchestra in order that they may develop their talents. That would be a serious loss.
§ Dr. Owen
The hon. Gentleman implies that there is an intention to stop tobacco sponsorship of sport and the arts. I assure him that the Minister responsible for sport has made it clear that that is not the intention. The intention is to discuss a code of conduct to try to agree a policy on future growth.
§ Mr. Clarke
I was reassured by what the Minister of State said and I am further reassured by his clarification now. My remarks are more aptly directed to other hon. Members who clearly remain hostile to sports sponsorship. The Government's position as expressed today by the Minister is far more reassuring than it was a few months ago. I mean no disrespect to the Minister of State, but the Minister who is responsible for sport will apparently in future take over the discussions on sports sponsorship with the tobacco industry.
§ Dr. Owen indicated dissent.
§ Mr. Clarke
The Minister indicates dissent. I trust that he will retain some interest in sports sponsorship.
§ Mr. Clarke
Before giving way to the hon. Gentleman, may I ask him to confirm a point which I took as being most 862 encouraging from my understanding of his speech? He suggested that sports sponsorship should perhaps be shifted to safer brands and be used, as it were, to draw attention to low tar content brands for safer smoking. He said that the only change he would contemplate would be the ending of sports sponsorship which was directed to high tar content cigarettes. That was my understanding of that passage in his speech. If that is so, I shall be less fearful of his intervention in discussions with the industry about sports sponsorship.
§ Dr. Owen
I do not want to prolong the debate. My right hon. Friend will be negotiating on behalf of the Government as a whole. Indeed, I negotiate with the industry on behalf of the Government as a whole. I do not want to prejudice my right hon. Friend's discussions, but the strategy for promotion covers sports as well as everything else. Other issues will no doubt be raised in this peculiar problem relating to sports sponsorship and concern at its recent growth.
§ Mr. Clarke
Clearly the hon. Gentleman speaks for the Government as a whole, but he seems to confirm that the Minister responsible for sport will be leading for the Government in discussions with the industry on this subject. I am reassured, because that will to a large extent safeguard the future of sports sponsorship. I cannot imagine that the Minister responsible for sport will need the powers under the Medicines Act to further his dealings with the industry. Statutory control over advertising and sponsorship will not be required if voluntary agreement can be reached.
The motion suggests making use of the Medicines Act to give statutory powers to control advertising, marketing and, inevitably, such things as sports sponsorship. I suggest that the Medicines Act is an inappropriate vehicle. It would be even more inappropriate if the Minister responsible for sport rather than the Minister of State, Department of Health and Social Security were to use it. I trust that no Minister will contemplate the use of legislative powers. Adequate safeguards are being made voluntarily. Therefore, I cannot see the reason for any draft Order of any kind coming before this House in the next few months.
§ 2.57 p.m.
§ Mr. Eric Ogden (Liverpool, West Derby)
I agree with much of what was said by the hon. Member for Rushcliffe (Mr. Clarke). With my hon. Friend the Member for Battersea, South (Mr. Perry), he seemed to bring a breath of realism which I thought had been conspicuously lacking from earlier parts of the debate.
§ Mr. Ogden
I said "earlier". My hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) is right to point out that I was not in the Chamber when he made his speech, but my hon. Friend should be aware that he is from time to time surrounded by a cloud, if not of heavenly angels, at least of other witnesses.
My hon. Friend the Member for Brent, South (Mr. Pavitt), as others who have taken part in tobacco debates well know, has always taken a keen interest in and expressed strong opposition to smoking. As the Government Whip in charge of the business of the day, he is now confined to a rôle of silence. That might be unfortunate for the Minister of State, but it is fortunate for the view that I want to put forward. I hope that my hon. Friend will continue the tradition that Government Whips in charge of business maintain silence and do not try to indicate support or dissent.
I begin with a few words about my personal interest in the motion. Once again I shall try to dispel the continuing illusion of some hon. Members and some people in Liverpool that, because my name is what it is and because there is a tobacco company with that name on the borders of my constituency, I own, control, or have any major financial interest in or link with that company. Fortunately, or unfortunately, that is not so and I have said so on many occasions. The facts are that the tobacco industry is proud of its work in its products, and I am modestly proud of the work that I try to do. We share that degree of pride in our endeavours and we have no more links than that, financial or industrial.
I declare that I smoke tobacco. It is known that, as an ex-coal miner, I take 864 snuff. In this debate my patron saint is St. Buno, but I have no other interest to declare.
I claim some knowledge of the tobacco industry because of local circumstances, and certainly some knowledge of the Medicines Act. My hon. Friend the Member for Brent, South and I were members of the Standing Committee that discussed in detail the Medicines Bill of 1968.
My hon. Friend the Member for Ormskirk is my constituency neighbour and I know at first hand his enthusiasm, his diligence, his hard work and his constant source of new ideas and his endeavours on behalf of his constituents, not only locally but nationally. However, I have to say to him, and I hope that he will not think me patronising or offensive, that I do not think his motion is one of his best ideas. It is possible and it is ingenious, but I believe undesirable and unnecessary. I shall not go into details, because I object in principle to the use of the Medicines Act 1968 for this purpose. The Medicines Act 1968 was a major piece of legislation that we were all proud to support. Those who happened to support the measure and those who opposed in part, all agreed that the Bill, with its 136 clauses and eight schedules, was a major and important endeavour.
When the Standing Committee came to Clause 105, which is the kernel of the motion now before the House, hon. Members were understandably desirous of making progress. Having got three-quarters of the way through the Bill, and having done a lot of work, hon. Members wanted to make progress. We all supported Clause 105(1)(a) and (b), but there was no suggestion, so far as I can recall, that it was then the intention of the then Minister of the Department of Health, of the Committee or of Parliament that Clause 105 should be used to control other matters not medicinally or pharmaceutically closely allied and linked. It was not intended, so far as I can recall, to be a vehicle to control alcohol, nicotine, caffeine, or other substances.
§ Mr. Ogden
So far as I can recall, no. No one said "There is a way 865 through. We have a Medicines Bill. Will you go through a whole list and say that you will not use this Bill to control, for example, Concorde noise, or motor car gas emission?" We were mainly concerned with the control and safety of medicines and pharmaceutical products, and the assurance referred to by the hon. Gentleman was neither sought nor given.
§ Dr. Vaughan
Does the hon. Gentleman agree that tobacco was specifically mentioned during the Committee stage of the Bill?
§ Mr. Ogden
My hon. Friend the Member for Brent, South was a member of the Committee and he probably mentioned tobacco not only on Clause 105, but on Clauses 1 to 10 and on every other clause all the way through to 136. The majority and minority opinions on the Committee agreed that the Bill was not to be used for the purposes proposed here. It was not intended to be used for this purpose, and I do not think that anyone can deny that.
The use of the Medicines Act would be a misuse in this context. There ought to be other ways of doing what my hon. Friend requires. A logical extension of what my hon. Friend is proposing is to go for regulations and further legislation —which some hon. Members might want —to say that tobacco will be on sale only at general list or restricted sale outlets, or will be available on the poisons list, and that a licence will be required for the sale of snuff, cigarettes, pipe tobacco and chewing tobacco and that tobacco will be available only through registered pharmacists and on National Health Service prescription. That is the logical extension of what is being proposed. I am not suggesting that that is what the Minister wants or intends, but somebody else could bring about that state of affairs.
I recognise that in a debate such as this the Minister is in something of a difficulty. If he comes in late, we accuse him of holding back information. If he comes in too early to provide information, we ask what point there is in continuing the debate, because he has made up his mind and we wonder whether he will take any notice of what we say. I do not ask him to read everything that every hon. Member says today, I ask him to get his officials—the other "cloud of wit- 866 nesses" who, officially, we do not know are present—to make a precis of what hon. Members say and then read it so that he gets a general impression of the debate and not just parts which he may favour.
I listened with care when the Minister said that he had come to a voluntary agreement with the tobacco industry. The industry's representatives are from an industry that is really in two parts. There are those who are essentially British-owned and British-controlled, and there are those whose interests go wider and who are in part responsible to other Governments.
I do not believe that the agreement with the tobacco industry is entirely voluntary. When a Minister goes to an industry and says that he wants an understanding, that he wants some progress, he knows, and the industry knows, that he has in his pocket proposals for legislation, or rules, or regulations which, in effect, say that if the industry does not do what the Government want, the result will be achieved by the use of compulsory powers.
I ask my hon. Friend to bear in mind some of the comments that were made from these Benches, not just by me alone, but by others, when we talked about a voluntary agreement with the trade unions on wages. There was a good deal of comment from these Benches, on what was meant by the word "voluntary". I do not think that in this case my hon. Friend can claim to have a voluntary agreement with the tobacco industry. He has its reluctant consent, but no more than that.
I suggest that confrontation by any part of the Department ought to be avoided and that co-operation is much better. I am sure that in saying that I have the support of the hon. Member for Reading, South (Dr. Vaughan). If this agreement could have been obtained in 12 months' time, that would not have been too high a price to pay to get it on a voluntary basis rather than use the threat of compulsion. We do not want an epidemic of confrontation to spread through the Department of Health and Social Security.
If my hon. Friend wants to bring in a Bill to control the manufacture and sale of tobacco products, he would be better advised—and I say this in as friendly a manner as I can, because I have a great deal of respect and admiration for the 867 way in which he has conducted his duties since he took over his office at the Department—to bring in a Bill entitled "Tobacco Manufacturers (Sale and Control) Bill" and let the matter be dealt with openly and honestly rather than use other measures—or should I say misuse other measures?—to get what he seeks. I ask my hon. Friend to consider that.
As for the British tobacco industry—at times the industry shows little pride in its product. It seems to accept the accusation, made from both sides of the Chamber today, that its only interest is in profit. There is no shame in providing an industry with profit to invest, and the industry provides employment, on Merseyside and elsewhere with reasonable terms and conditions of employment.
At times the industry shows as much backbone as is found in a soggy lettuce. It prefers to defend to taking the initiative. In the labelling of cigarette packets, for example, the industry brought the situation on itself, because many months before the late Sir Gerald Nabarro suggested that course, the industry was unable to agree about what to do. It eventually agreed action that could have taken place much earlier.
I join with those who have emphasised that it is the misuse of tobacco that causes damage and not the use. That argument also applies to the misuse of drugs and motor cars. Damage is also caused by the misuse of alcohol, aeroplanes, aspirin, barbiturates, sweets, animal fats and food. Therefore, I ask the Minister to have some doubts about the effectiveness of legislation and control by regulation. I ask him not to misuse the provisions of the Medicine Act in the way he proposes, and to have a little more faith in the intelligence of people to decide and control their own actions.
§ 3.2 p.m.
§ Mr. Peter Bottomley (Woolwich, West)
I should like to pick up two points made by the hon. Member for Liverpool, West Derby (Mr. Ogden). It is no use saying that it is the misuse of tobacco that does damage and causes danger. We should be addressing our minds to the amount of tobacco smoked.
If only there had been proper agreements reached with the tobacco industry in the past, there would have been no 868 need for back-up legal powers. At present we appear to be relying on voluntary agreements that, as has already been said, are not voluntary at all.
Let us go a stage further and examine the evidence suggesting that a ban on cigarette advertising would lead to relatively more consumption. We have only to look at the evidence in Italy and Eastern Europe where such advertising has been banned to see that consumption has risen. In the free capitalist countries, as they have been described, such as the United Kingdom or United States, where there is a relative freedom to advertise tobacco products, consumption has fallen. That fact is more likely to be linked to an argument about the relative standards of living in the various countries. As with the consumption of food, one discovers that as standards of living increase, so does the amount of smoking. With food the situation tends to level off and eventually consumption drops. It is the richer and better-educated people who smoke less. If we can do more to increase standards of living and education, we shall achieve as much as we would by imposing a blanket ban on tobacco advertising.
One hon. Member asked why the tobacco industry had agreed to restrictions on advertising. Presumably that happened because the industry believed that those restrictions would be beneficial and that fewer children would take up smoking if cigarette advertisements were curbed in the cinema. If that is the case, we must remember that children are still able to see such advertisements on posters in the open air. However, judging by the number of children who attend cinemas these days, it seems that they would see more advertisements in the open air than in the cinema. A 25-year programme aimed at reducing the amount of smoking rather than a ban would be desirable. It would include an intent to reduce the amount of openly-displayed tobacco advertising.
On the subject of sponsorship, it may be that many smokers cannot afford the price of admission to a motor racing circuit or a tennis tournament because they are spending £3 a week on smoking. The opportunity is open to them to cut down this undesirable and expensive habit so that they may be able to pay for what they enjoy—presumably the 869 entertainment of the sport—rather than reduce their life expectancy and enable profits from the consumption of tobacco to be used to subsidise that entertainment. There ought to be much more education so that people realise that smoking costs most smokers £150 a year. That could well go towards something that would improve peoples' lives, something in their home, or some form of education or of savings.
The saving that would accrue to people who reduced their smoking would increase as the tax on cigarettes increased—I hope faster than the general rise in prices. I know that that is rather like saying that if a person walks to work rather than going by bus, he saves 8p and if he goes by bus rather than taxi he saves more.
Will the Minister have discussions with the Chancellor of the Exchequer with a view to removing the cost of smoking requisites from the retail price index? If we are to increase the tax upon these requisites, there is much to be said for taking them out of the index. Inflation has followed from increases in indirect taxation. If such increases were taken from the index, they would not have inflationary repercussions on the rest of the economy.
§ 3.7 p.m.
Mr. Alan Lee Williams (Hornchurch)
I begin by heaping praise upon my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) for the manner in which he has moved his motion dealing with this infinitely complex subject. The hon. Member for Woolwich, West (Mr. Bottomley) illustrated how complex this can be when he spoke of tobacco advertising. In Eastern and Central Europe, where there is no such advertising, there is, I understand, a large cigarette manufacturing industry. The evidence suggests that smoking is prevalent in those countries. Therefore, the effect of advertising ought to be qualified. I share the concern of my hon. Friend the Member for Ormskirk and the Minister of State that there should be control on advertising. All I want to do is to illustrate the complexity of this issue.
My hon. Friend the Member for Loughborough (Mr. Cronin) made a powerful intervention, as he always does. I thought that on this occasion, however, he over-simplified the issue, particularly 870 when he asked how we could expect cigarette manufacturers to ask the Minister to reach a suitable agreement since the aim of the manufacturers was to make the maximum profit. My hon. Friend argued that it would be incompatible with that aim for the manufacturers to try to reach an agreement restricting their profits. He said that in such circumstances the shareholders would sack the directors.
However, it is possible that, conversely, the shareholders might sack the directors if they got the company into a position where it was in collision with the Government so that the Government, with the agreement of the House, were forced to bring forward penal legislation. In any case, it can be applied in many other areas. Therefore, the profit motive is not the crucial argument.
The way in which the motion has been moved has enabled my hon. Friend the Minister of State to telescope a number of events. There is no doubt that, with no pressure at all, or little public discussion, the companies would be slow to react. It is, however, fair to point out that public opinion has been alerted for a number of years and therefore the companies have responded—they have not gone far enough and the Minister of State indicates that he wants them to go faster—because the interests that they represent would be threatened if they did not attempt to reach a compromise. Therefore, I hope that it will be possible, on the basis of the draft order which the Minister of State mentioned, to work out a voluntary agreement. It is far better to reach a voluntary agreement than a compulsory agreement, particularly if it is a satisfactory voluntary agreement.
My hon. Friend the Member for Loughborough, using all his authority as a medical consultant, said that more than 100,000 deaths could be attributed to smoking. My hon. Friend the Member for Ormskirk was much more modest; he mentioned a figure only half that size. But even one death too many cannot be accepted. The difference between my hon. Friends shows that there is a great range of opinion about the figures.
As there are profound implications for the level of taxation, for employment and, above all, for individual liberty—in other words, people doing what they want to do, knowing the risks—I hope that this debate and the way in which most hon. 871 Members have spoken will enable my hon. Friend the Minister of State to reach is vital because of the dangers.
§ 3.13 p.m.
§ Mr. Kilroy-Silk
I am grateful for having had the opportunity of raising this subject. I think that all hon. Members who have participated in the debate will accept that it has been interesting, informative and, most important, very responsible. We have had some lighter moments. Some flat earthers have suggested that because their fathers were 90 although they smoked, there was no problem, but, on the whole, hon. Members have taken the issue seriously.
I welcome the announcement of my hon. Friend the Minister of State that he will take legislative power in particular to control tobacco substitutes and additives. I hope that the order will be laid before the House very soon. I welcome also the measures that he is taking to achieve further voluntary agreements. There will be continued pressure on him to ensure that such agreements are concluded on the lines advocated today.
I emphasise to my hon. Friend the Minister of State and to the industry that they are on probation. The Minister of State said that he would lay before Parliament the report of the Hunter Committee and annual reports on the progress of negotiations towards voluntary agreements. I assure him that those reports will be carefully scrutinised, and we shall seek opportunities to debate them in the House. Like my hon. Friend, I regret that he has not been able today to announce further legislation. I believe that he will require the reserve powers. I am not convinced that he will not eventually have to ask the House for them. However, that is a matter for another time.
In view of the Minister's statement and in view of the measures that the industry has taken to try to meet the points made by the Government and in the debate, I beg to ask leave to withdraw the motion.
Motion, by leave, withdrawn.