APPLICATION FORM FOR A DEBATE IN BACKBENCH TIME

The Backbench Business Committee meets in public every sitting Tuesday at 2.30pm to hear representations
from Members for debates in backbench time. Please complete this form and email it to
bbcom@parliament.uk by 5pm on the preceding Thursday.

See notes at the end of this form for guidance on your application. For applications related to e-petitions or
Select Committee Statements, please contact the Committee staff.

LEAD MEMBER/S1

Rt Hon Kevin Barron MP

TOPIC2

That this House welcomes the Governments publication of the new tobacco control plan.

MEMBERS WHO WANT TO TAKE PART IN THE DEBATE3 (see guidance overleaf; use additional
sheet if necessary)
Bob Blackman, Dr Sarah Wollaston, Virendra Sharma, Caroline Lucas, Norman Lamb, Martyn Day, Dr
Andrew Murrison, Sandy Martin, Dr Paul Williams, Caroline Flint, Neil Coyle, Jim Shannon, Antoinette
Sandbach.

WHAT TYPE OF DEBATE ARE YOU APPLYING FOR?4

General debate (on a motion for the adjournment or That this House has considered [topic])

In the Chamber In Westminster Hall (Thurs) In either In Westminster Hall (Tues)

Debate on a substantive motion (expresses an opinion; can give rise to a division; Chamber only)

Draft text of substantive motion

N/A

SUGGESTED TIME TO ALLOW FOR DEBATE5

3 hours. NB We would prefer to avoid the week of 9-15th October 2017 as it is Baby Loss Awareness
Week.

ANY FURTHER INFORMATION TO BE CONSIDERED BY THE COMMITTEE6 (use additional sheet if necessary)
On 18th July 2017 the Government published its new Tobacco Control Plan for England, Towards a
Smokefree Generation. [1] The publication of the new Plan includes a renewed commitment to tackling
smoking and ambitious vision of a smokefree future, where fewer than 5% of the population smoke,
which is welcomed. Although the majority of the Plan is health-related it also covers reserved matters
such as tobacco taxation, illicit trade and international relations. Now the Plan has been published, the
members who have put their name to this bid believe it is important to consider how it can be
 APPLICATION FORM FOR A DEBATE IN BACKBENCH TIME
implemented most effectively and deliver greatest benefit. It is worth noting that there is strong cross
party political support for government action to tackle smoking, as well as from the public with 76%
supporting continued government action to limit smoking. [2]

Since the introduction of the last Tobacco Control Plan smoking rates have fallen from 20.2% [3] to
15.5% [4] and if this rate of decline can be sustained a smokefree generation could be achieved by
2030. However, the Plan highlights the fact that smoking remains a public health epidemic and that:

There are still 7.3 million smokers in England, with more than 200 people a day dying from
smoking related illness which could have been prevented.
The difference in life expectancy between people in the poorest and richest social groups in
England is about 9 years on average, and the difference in smoking rates accounts for about
half this difference.
Smoking costs our economy in excess of 11 billion a year, including 2.5 billion to the NHS,
5.3 billion to employers (because of lost output due to sickness and smoking breaks), 4.1
billion to the wider society due to lost output. There are further costs including around 760
million from increased social care costs to local councils.
Over the next five years until the end of 2022 the Plan sets out targets to:

Reduce smoking prevalence among adults from 15.5% to 12% or less

Reduce the proportion of 15 year olds who regularly smoke from 8% to 3% or less
Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

The Plan sets out specific commitments including to:

Continue to use mass media campaigns to promote smoking cessation and raise awareness of
the harms of smoking.
Reduce the inequality gap in smoking prevalence between those in routine and manual
occupations and the general population
Provide access to training for all health professionals on how to help patients quit smoking.
Promote links to stop smoking services across the health and care system and full
implementation of all relevant NICE guidelines by 2022.
Support pregnant smokers to quit in line with NICE guidance.
Implement comprehensive smokefree policies, including integrated tobacco dependence
treatment pathways, in all mental health services by 2018; and improve data on smoking and
mental health; in order to better support people with mental health conditions to quit smoking.
Maximise the availability of safer alternatives to smoking.
Maintain high duty rates for tobacco products to make tobacco less affordable.
Continue to uphold its obligations under the WHO Framework Convention on Tobacco Control.
Ratify the Illicit Trade Protocol to the WHO FCTC.
Review measures and activities which are affected by the UKs exit from the EU.

The previous Tobacco Control Plan was extremely successful, reaching and surpassing all national
targets.[3] Nationally, adult smoking rates have declined to a record low of 15.5%, with smoking rates
among teenagers also at their lowest ever level. However, this picture belies serious health inequalities
which expose the most vulnerable groups in society to excess morbidity and mortality caused by
tobacco.

Among individuals in routine and manual socioeconomic groups the smoking rate rises up to 26%,
 APPLICATION FORM FOR A DEBATE IN BACKBENCH TIME
among the unemployed its 35%, 40.5% among those with a serious mental illness, up to 77% among
people experiencing homelessness and over 80% among prison populations. This brings the dual
burdens of poverty from the expense of tobacco and ill health from the carcinogens and tar. When net
income and tobacco expenditure is taken into account an additional 1.4 million households fall below
the poverty line including over 300,000 dependent children. [4]

There are also severe regional inequalities linked to tobacco. The South West has seen its smoking rate
fall to an impressive 13.9%, while in the North East the rate is around 25% higher. This variance
contributes to a divergence in health outcomes, and the prevalence of lung cancer in the North East is
close to double that in the South West.

The tenet that people with mental health conditions should be treated with parity of esteem attracts
broad support, and the principle was made explicit in both Conservative and Labour manifestos in 2017.
Compared with the general population, life expectancy among those with mental health conditions falls
short by 10 to 20 years. The single biggest cause of this is the greater prevalence of smoking among
the latter group. In 1970, the general adult smoking rate stood at 40%, and strong governmental action
has since helped cut this by more than half. Now, the rate of smoking among those with mental health
conditions remains 40%. To see an equitable decline in smoking - and in smoking-related death
strong national leadership is needed.

People with mental health conditions do have on average higher levels of addiction. However, smoking
has a significant effect not only on mortality, but also on the efficacy of psychoactive medication, and
this would suggest that abandoning this group to tobacco addiction and its associated harms is not a
tenable position. Indeed, people with mental health conditions who smoke are no less likely to want to
quit than the average smoker.

As the NHS seeks to cope with an aging population amid funding pressures, preventative measures
become ever more important. This was made clear in the NHSs Five Year Forward View, which
advocated a radical upgrade in prevention and public health. With tobacco use still the foremost cause
of preventable premature death in the UK, the publication of a new Tobacco Control Plan would make
clear the Governments desire to achieve this upgrade in prevention.[5]

The Five Year Forward View also points out that smoking patterns are influenced by, and in turn
reinforce, deep health inequalities which can cascade down the generations. Without continued
Government leadership and effective implementation of the Tobacco Plan, these health inequalities
could become more deeply entrenched across the country.

An example of this is maternal smoking, which in 2010 caused 19,000 babies to born with low birth
weight, and which increases the likelihood of the child taking up smoking in later life. As maternal
smoking is also the lead modifiable risk factor for stillbirth and a major cause of Sudden Infant Death
syndrome, working to reduce its prevalence will be key to achieving the Health Secretarys ambition to
reduce the rate of stillbirths and neonatal mortality in England by 50% by 2030. According to recent
data, the rate of smoking at the time of delivery has stagnated, with a drop last year of only 0.1%.
Providing pregnant women the support they need to quit can be a central pillar of the Governments
strategy to reduce the health inequalities caused by smoking.

In order to achieve the vision of a smokefree generation, the Plan calls for a shift in emphasis from
national to local action. But this comes at a time of severe government cuts in public health funding
which threaten successful implementation of the Plan.

The last Spending Review in 2015 announced cuts in public health funding of 3.9% a year amounting to
a real terms reduction of at least 600 million a year by 2020/21, on top of the 200 million in year cut to
the 2015/16 budget.[6] A November 2016 survey of local authority tobacco control leads in England [7]
 APPLICATION FORM FOR A DEBATE IN BACKBENCH TIME
found significant budget cuts for smoking cessation services and that in a growing number of authorities
there is no longer a specialist stop smoking service accessible to all smokers. A recent analysis by the
Kings Fund found that in 2017/18 local authority funding for wider tobacco control faces cuts of more
than 30% and that stop smoking services is one of the top four services in absolute planned cuts (16
million). [8]

Collective action by local authorities working together on tobacco control, as encouraged by the Plan,
has been very effective in the North East [9] and can deliver economies of scale. However, local
authorities facing such severe cuts cannot deliver public health improvement without support from the
NHS. The Plan sets out a clear role set out for the NHS in supporting smokers to quit. The NHS must
now live up to the commitment set out in the Five Year Forward View to a radical upgrade in prevention
and public health. [10]

While public health is a devolved responsibility this Plan also covers important reserved matters such as
tobacco taxation, illicit trade in tobacco and international policy so this debate is relevant to MPs across
the UK. Colleagues from across all parties believe it would be beneficial to hold a 3 hour debate to
discuss how the new Tobacco Control Plan can support the Government in achieving its ambition to
reduce health inequalities across our society.

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017

[2] Smokefree: The First Ten Years. ASH. June 2017. Opinion research carried out by YouGov for ASH. Total
sample size was 12696 adults. Fieldwork was undertaken between 16th February 2017 and 19th March 2017

[3] HM Government. Healthy Lives Healthy Futures: A Tobacco Control Plan for England. March 2011.

[4] ASH. The Stolen Years. 2016

[5] Statistics on smoking in England: NHS Digital 2017

[6] Impact of the 2015 Spending Review on health and social care. Joint submission to the Health Select
Committee by the Nuffield Trust, Health Foundation and the Kings Fund. 17 December 2015

[7] A survey of local authority tobacco control leads in England November 2016, conducted by ASH, funded by
Cancer Research UK

[8] David Buck. Chickens Coming Home to Roost: local government public health budgets for 2017/18. Kings
Fund 12 July 2017.

[9] Fresh North East. Achievements.

[10] NHS England. Five Year Forward View. October 2014.

GUIDANCE NOTES

1. Lead Members are those making the application and their co-sponsors; typically one, two or three Members
who will lead the debate. They cant be Ministers of the Crown, parliamentary private secretaries or
principal opposition front-bench spokespersons. Members seeking debates should plan to attend a meeting
of the Committee to present their application.

2. The topic will be the title of the debate. It should be expressed briefly, and in neutral terms.
 APPLICATION FORM FOR A DEBATE IN BACKBENCH TIME
3. Members who want to take part in a debate should not be Ministers of the Crown or principal opposition
front-bench spokespersons. Please do not copy lists of names from related EDMs or membership of APPGs
the Members listed must have explicitly given their support for this debate application. Use an additional
sheet if necessary. The Committee will use the list of names to gauge the likely level of cross-party interest in
a debate. (As a rough guide, a 3-hour Chamber debate would normally require at least 15 backbench
speakers.)

4. Types of debate: A general debate is one that takes place on a neutral, un-amendable motion and does not
usually give rise to a division. If you are proposing a substantive motion, please feel free to contact the Clerks
of the Committee for advice on wording. Substantive motions can only be taken in the Chamber.

The Committee can allocate one 90 minute debate each Tuesday morning in Westminster Hall, in addition to
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Paper), an indication of the likely responding Department and the date on which the debate is sought would
be helpful; this can be included in the box for any further information.

5. Suggested time: Typically 90 minutes, 3 hours or 6 hours (the latter represents a full days debate in the
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the day will depend on the discretion of the Chair, and on other business including ministerial statements
and urgent questions.

6. Additional information: The Committee will select topics for debate based on all or some of the following
criteria: topicality, the amount of time available and requested, why it is felt important for a debate to be
held, when the topic was last debated (and how much interest there was on that occasion), breadth of
interest across all parties, and why such a debate is unlikely to be secured through other routes. As
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Westminster Hall, depending upon the availability of time for debates.

For applications related to e-petitions or select committee statements, please contact the staff of the Committee.

Please note that the Committee is normally unable to make firm allocations of debates more than nine days in
advance of the debate taking place. However, early applications are helpful, especially if you would like to express
interest in a particular week or month.

CONTACT
The staff of the Committee can be contacted for any queries through bbcom@parliament.uk or on extensions 1881,
3751 or 2903.