Tobacco and Vapes Bill

Written evidence submitted by Public H ealth Scotland to the UK Tobacco and Vaping Bill call for Evidence (TVB33)

Public Health Scotland (PHS) welcomes the opportunity to provide evidence on the UK Tobacco and Vaping Bill. We strongly support the powers set out in the Bill. Smoking remains the leading preventable cause of death, health inequalities and causes a significant burden on our NHS and social care services. Tackling smoking rates and the health inequalities it creates, is a key priority for PHS. The rise in youth vaping is deeply concerning. E-cigarettes can be a gateway to smoking with all the associated known harms. Further the long-term impacts of vaping are not clear.

Increasing the age of sale for tobacco

PHS understands that most individuals begin smoking in adolescence. Therefore, we reviewed existing evidence of age restricti ng policies for tobacco to see what potential impact could be had on raising the age of sale for tobacco ( PHS,2024 ).

The review sought to identify evidence for two potential polices.

• Raising the legal smoking age each year to create a tobacco-free generation (TFG).

• Increasing the minimum legal age of sale (MLA) to 21 (MLA21) or 25 (MLA25).

In relation to the effectiveness of TFG , none of the primary studies had investigated the short - term impact on health or non - health outcomes. The review did however find from f our modelling studies that TFG could re duce the prevalence of smoking, offer cost savings and increase health adjusted life years , a lthough it may take several decades for the impact to show in the data . Further , there is evidence that combin in g TFG with other tobacco control strategies is an effective way of reducing smoking prevalence ( PHS,2024 ).

Reducing the appeal and availability of vapes to children.

The prevalence of youth vaping has risen rapidly in Scotland and across the UK . In 2022, 25% of 15-year-olds living in Scotland reported having used a vape in the last 30 days compared to just 7% in 2018 ( HSBC, 2022 ; SALSUS, 2018 ). Most e-cigarettes contain nicotine, which is addictive, and some research shows that they can be a gateway to smoking ( Scottish Government, 2024 ). Furthermore, the long-term impacts of vaping are not yet clear and h ealth professionals in Scotland have raised concerns about the health impacts of vaping in children and young people. We also note that E-cigarettes are not products that should be used by children and young people and there is no reason why they would ever need to use them .

We know from other research on health harming commodities that price and availability are key for primary prevention ( WHO, 1986 ). Public Health Scotland has worked with partners nationally and locally to set out key areas of collective action to reduce youth vaping. The position statement on behalf of the Scottish Public Health System , identified 6 key areas for action : Price, Availability, I nequalities & E nvironment, Promotion, Resilience & P ositive attitudes, and Control & Prevention , ( PHS, 2024 ) . Prohibiting the sale and supply of single use vapes in Scotland is therefore part of a preventative approach to the uptake of vaping. It should be considered in conjunction with factors such as price, availability, and product appeal eg colours and flavours. Plain , standardise d packaging would help deter young people from being attracted to vaping in the first place and contribute to reduc ing youth vaping. Other measures should include raising the age of purchase and packaging including warnings of potential harms.

PHS also advocate s for any regulations to consider the possible impact on health inequalities. A health impact assessment would enable the different impacts the policy would have to be fully understood and any mitigating factors identified.

Strengthening enforcement around tobacco and vaping sales

PHS advise that the introduction of the ban on single use vapes must be supported by a range of measures that make full consideration of associated evidence relating to health harming commodities in regard to price, promotion , marketing and availability. These should include campaigns to the public to raise their understanding of necessity for measures as well as the regulations themselves; this would also convey that further measures will be required to prevent harm from vaping and smoking. The breadth of marketing should also be considered, including social media exposure to e-cigarette related content, as portraying vaping products in a positive light is highly prevalent and has been associated with increased use

Effective enforcement will be key to the success of regulations. As mentioned, PHS identified 6 key areas of action which would support the enforcement around tobacco and vaping sales. Reducing availability, perhaps including a licence fee for shops which sell tobacco and e-cigarettes could be impactful. This a longside a ban on e-cigarette advertising and the use of plain packaging could see significant progress ( PHS, 2024 ).

Communication to the public on the reasons for regulation and the benefits to public health and the environment should be undertaken to support the implementation of the regulations.

Economic and financial impacts of the Bill

In 2022, over 8, 942 deaths and many more hospital admissions were due to smoking related disease ( ScotPHO, 2022 ). It is estimated that the cost to NHS Scotland for treating smoking related illnesses exceeded £300million and may cost over £500 million in the coming years ( Scottish Government, 2020 ) .

Smoking remains the biggest preventable cause of ill health and death. It is a key contributing factor in health inequalities, 2 5% of people living in the most deprived areas of Scotland smoke compared to 7 % in the least deprived areas

PHS supports policy that will tackle health inequalities and improve long term health and non-health outcomes for those impacted and on this basis is supportive of the proposals within this Bill.

May 2024