Tobacco and Vapes Bill

Written evidence submitted by The British Thoracic Society to The Tobacco and Vapes Public Bill Committee (TVB20).

1. Executive Summary

· Exposure to tobacco smoke can cause a variety of lung diseases and cancers and many people who smoke will die early.

· The Bill will encourage more people to quit smoking, which will improve their health.

· Smoking is linked to health inequalities and lung disease disproportionately affects the poorest and most vulnerable members of society.

· The Tobacco and Vapes Bill supports the government's prevention agenda and will improve the health of the nation, now and in the future.

· A reduction in smoking-related diseases will lead to billions of pounds in cost-savings.

· The restrictions on smoking outdoors will reduce health risks to others.

· Vaping can support treatment for tobacco dependency. Anyone under the age of 18 years and people who have never smoked shouldn’t vape.

2. About the British Thoracic Society

2.1 The British Thoracic Society (BTS) is a professional body of 4,500 respiratory specialists from

around the UK. BTS works to raise awareness of the impact of lung disease, champion the respiratory workforce, deliver education and continued professional development to the respiratory team, and develop clinical guidance to improve standards of care. BTS wishes to submit to the call for evidence as it believes the Tobacco and Vapes Bill will contribute to reducing the harm from smoking-related diseases and prevent young people from ever taking up smoking and vaping.

3. Submission

3.1 The harms of tobacco dependence are well documented. Exposure to tobacco smoke can cause and worsen lung conditions such as COPD and asthma, as well as conditions that make breathlessness worse, including heart disease and many cancers. About half of all lifelong smokers will die early, losing, on average, about ten years of life. Every year, 64,000 people in England die from smoking, and thirty times as many suffer from smoking-related diseases1.

3.2 Stopping smoking causes immediate improvements in respiratory health. The introduction of this Bill, alongside the expansion of tobacco dependency programmes, will encourage and support more people to quit.

3. 3 Tobacco dependency is one of the leading causes of lung disease, which is the third biggest killer in the UK2.. In the UK, there were 506,100 hospital admissions due to smoking in 2019/203. Lung disease also disproportionately affects the poorest and most vulnerable members of society. In the UK, the areas of greatest health inequality are also those with the highest rates of smoking. We would like to see funds targeted to the areas where they are needed the most.

3.4 The passing of this Bill into UK law will send a clear signal that the Government takes prevention seriously and is not afraid of challenging urgent and present threats to our population.

3.5 New and tougher legislation alongside a strong, well-funded national plan to support people to break free from their dependence on tobacco is vital to achieving a healthier nation. Stopping children from ever starting smoking will improve the health of the nation. Preventing future generations from damaging their lungs and shortening their lives due to the harms of tobacco dependence will spare families from the trauma of seeing their loved ones die prematurely from smoking-related illnesses.

3.6 A reduction in the number of people with smoking-related diseases will also deliver significant future cost-savings for the UK. In 2023, smoking cost the UK economy £93 billion while only £8.4 billion was raised from tobacco taxes.4

3.7 Additional proposals to extend the smoking ban to outdoor spaces, such as playgrounds and hospitals, and restrictions on areas where people can vape will further support efforts to end tobacco dependence. Prior audits of hospital smoke-free grounds conducted by BTS (2016, 2019 and 2021) showed poor adherence to hospital smoke-free policies5. The measures set out in the Tobacco and Vapes Bill will support the reduction of health risks to the patients, staff and children who use our hospitals.

3.8 BTS supports measures to address underage vaping and proposed legislation to end the targeted advertising of vaping products to under 18s. BTS believes people who do not smoke should not vape.

3.9 For people who smoke, vapes should only be used as part of a tobacco dependency quit attempt, and clinicians play a key role in providing accurate and consistent information. BTS supports healthcare professionals to minimise harm, and in this context, we believe vaping is more likely to be effective when provided alongside behavioural support from a Tobacco Dependency Advisor. Patients who use vaping as part of their tobacco dependency treatment plan should be advised to reduce their vape usage at the appropriate time and ultimately stop altogether.

3.10 As outlined in the BTS Clinical Statement on the Medical Management of Inpatients with Tobacco Dependency6, the Society does not support the use of vapes to treat tobacco dependency by anyone under 18 years of age. People who do not smoke should not vape.

3.11 BTS calls for increased investment in tobacco dependency services and awareness campaigns. BTS will continue to support tobacco dependence programmes across the four nations by producing clinical guidance, promoting education and highlighting opportunities for quality improvement7.

REFERENCES

1. Action on Smoking for Health. Health Impact of Smoking of Core20 plus5. 2022. Accessed here.

2. Action on Smoking for Health smoking disease statistics 2024 Accessed here

3. Asthma + Lung UK A mission for Lung Health Report 2024. Accessed here

4. Landman Economics for Action on Smoking & Health. Total and net costs of smoking to public finances, England and UK: 2023. 2024 . Accessed here .

5. BTS National Smoking Cessation Audit Report 2021: Management of Tobacco Dependency in Acute Care Trusts.  Accessed here .

6. British Thoracic Society , Clinical Statement on the Medical Management of Inpatients with Tobacco Dependency, 2024 Accessed here

7.  Information on  BTS’s Quality Improvement for Tobacco Dependency can be found on the BTS website, and further resources are available on the Respiratory Futures website  here .

December 2024.