WEDNESDAY 9 FEBRUARY 2000

RT HON ALAN MILBURN and MS YVETTE COOPER

  1300. In my own local primary care unit, which is in South Leeds, which encompasses an HAZ, one of the things they have found works most successfully, or is working most successfully, is where a person has a counsellor to whom they can constantly refer.
  (Mr Milburn) Yes.

  1301. They have tried giving the service of a counsellor and they do not limit the time during which a person can be contacted. They have found setting up a positive relationship like that, in which a person can keep coming with questions and in which a counsellor can keep in touch, is effective over a period and they say it is very helpful. It is backed up at the moment by the television advertising campaign which you have got "Do not give up giving up". They say that has strengthened their people. It is the continuing availability of the person to go to for the counselling.
  (Mr Milburn) I do think that is right. One of the things that people find is that they try very hard to give up and then, as in Mr Burns' case, they relapse and when they relapse they have to feel there is some help for them to carry on. That is why I think some of these specialist services that we are beginning to provide will produce their own dividends in time. We will need to assess very carefully how well they are working. We will try to supply what information we can to the Committee if that is helpful. We will try to get some early evidence if that is helpful.

  1302. Would you consider making some of the experiments a two week experiment, say, because it did strike me, Secretary of State, when you had your exchanges with Mr Burns that you were very much relying on logic and Mr Burns said your logic is okay but if people are operating on logic they would not be smoking anyway, so that is the drawback. Since financial gain can be part of the motivation, it is expecting a considerable amount of very close logical thinking that right from the first day the saving is going to be put for more patches. I doubt if that would happen. I think somebody might go and blow it on something. At one time my generation would have said, "Go and buy a new hat", but people do not wear hats now, but the equivalent. Would you consider perhaps asking the people who are engaged in the work on the ground their opinion after a certain lapse of time? We met on Tyneside very good people doing smoking cessation work and I would very much like to feel that you were asking their opinions as to whether two weeks would be more cost effective than one week, because that is what Simon Burns was really on about. I am not asking you for a commitment to do it but will you just think this over with that possibility in mind?
  (Mr Milburn) We do and certainly will continue to talk to the people who provide the services on the ground. It is very important since they have the face-to-face contact and are having to provide these services, sometimes in difficult situations, that we get an assessment back from them about what is working and what is not. So there is no reason why we cannot ask that question.

  1303. Can I move on to stopping children smoking? There is a lot of anecdotal evidence that children up to about the age of 10 or 11, if they have any views on smoking, seem to be violently anti; whether they learn that from school or whatever I do not know. But the statistics available seem to suggest that over the last ten, twelve years, in the age group 11-15 the number of children smoking or who have smoked has risen from about 8 per cent to 13 per cent. Has your Department commissioned any work on why that might be and why children start smoking, the reasons for it and have they weighted each factor to see which is more important than another in the whole thing?
  (Mr Milburn) No, we have not, but I think we probably need to do that. That is important. The figures are pretty stark. As I remember, in 1988 about one in five 15 year old girls was smoking, the figure in 1998 is that one in three 15 year old girls is smoking. That is a very, very big increase. There has been work done. From the Teenage Smoking Survey which was undertaken, I think, in 1988 we do have some evidence about the reasons the children themselves cite for taking up smoking. You will be aware of that from the information which has been provided but, if not, I can tell you. 75 per cent of the teenagers surveyed in 1988 said they wanted to see what it was like, 9 per cent said they wanted to fit in with friends, 8 per cent said that friends suggested trying it, 3 per cent wanted to look more grown up and 2 per cent said they wanted to be seen as a smoker. There was a very important study in 1990 about the factors which would put at risk an individual in terms of becoming a smoker, and the factors which Eileen Gordon listed in the study, Why Children Start Smoking, were as follows: being a girl, because girls smoke more than boys; having brothers or sisters who smoke; having parents who smoke; living with a lone parent; having relatively less negative views about smoking; not intending to stay on in full-time education after 16. That is pretty old data, in all frankness, and I do think it is something we will need to consider within the Department, and what we will probably be doing is commissioning new research about why children are taking up smoking, and then trying to unpick the reasons. You will know we have targeted a good part of this £50 million advertising campaign particularly at younger people, in large part because, frankly, we believe the cigarette companies target at least part of their advertising at young people, or it certainly seems to have an effect on young people. The tobacco companies are putting millions and millions of pounds into tobacco advertising, I am pleased to say for the first time the Government is going to put millions and millions of pounds too into advertising so that people learn perhaps it is not a good idea to start smoking.

  1304. There are lots of figures and we have both used some in the last five minutes about the percentage of 11 to 15 year olds who may be smoking. You, Secretary of State, used figures on the proportion of 15 year old girls who smoke, but do you actually have precise figures on what is the average age that people start smoking in this country; up-dated ones?
  (Mr Milburn) I do not. What we do know is that the figures which are available suggest that of 11 year olds approximately 1 per cent are smoking. When I say "smoking", as I remember the methodology, it says that a regular smoker should be classified as a person who has at least one cigarette per week. By the time they get to 15, as I remember the figures, it is 19 per cent of boys and 29 per cent of girls. So something happens between 11 and 15 based on those figures. Whether it is 12, 13 or 14, I do not know, but we need to unpick some of that in order that we can best target our interventions.

  1305. Can I move on to the whole question of where children obtain cigarettes from? I do not want to go into the whole question of retail outlets, because my colleague, Mrs Gordon, will be raising that in a minute, but perhaps I can go to the other areas. Has your Department done research or got research on where children obtain cigarettes from? Also, one of the loopholes in any law on any minimum age for buying cigarettes is the question of vending machines because, of course, if they are in a public place then no one can control who uses them unless you have somebody standing there the whole time or enhanced technology to stop children from using them. Would you consider banning vending machines to cut off that source of supply or making the arrangements for the placement of vending machines different from the almost carte blanche system we have at the moment?
  (Mr Milburn) The figures suggest that 16 per cent of those 11 and 12 year olds I was talking about who smoke say they obtain cigarettes from these machines compared to 29 per cent of 15 year olds. As far as the siting of these machines is concerned, at the time we published the White Paper the Department entered into discussions with the operating companies who supply these vending machines, and we got an agreement from them that in future where these machines were sited would take full account of the fact that too many under-aged kids were getting their cigarettes from these machines and that there should be proper monitoring, they should be sited within the vision of the staff within the pub or wherever it was. It is also important to say that there are very strong legal powers right now on the statute book which we would like to see invoked more often, because it is clear that a lot of kids get their cigarettes under age, illegally, from vending machines. It is also the case that the law of the land in the Children and Young Persons (Protection from Tobacco) Act 1991, says that magistrates can order the removal of a machine if it can be shown that it is being used by even one person under the age of 16. So, as with so many other things in this whole arena, people often call for a toughening of the law or changes in the legal age, but the real issue here is about enforcement and ensuring better enforcement. As you know, we have entered into lengthy discussions with both the Local Government Association and the organisation representing the trading standards officers to ensure some of the things which should be being done under the law are actually being done precisely in order to avoid this problem of young people illegally obtaining access to cigarettes.

  1306. Certainly research we have been supplied with suggests that the largest proportion of packets of ten cigarettes are bought by younger smokers. If your Department were to commission evidence or were to accept the authenticity of existing evidence that that was the case, would you consider in any shape or form banning the production of packets of ten cigarettes? I understand that long before I was born you could buy individual cigarettes or much smaller packets.
  (Mr Milburn) That was stopped. You certainly could buy ones and twos, any number.

  Chairman: There is another division. We will have to adjourn.

  The Committee suspended from 5.25 pm to 5.32 pm for a division in the House

  Chairman: Colleagues, welcome back. Secretary of State, I am not sure whether you had finished that last answer. You have probably forgotten what the last question was.

  1307. It was about packets of ten cigarettes—
  (Mr Milburn) Yes, you were saying that you used to be able to get them in ones and twos.

  1308. If there was evidence to suggest that the evidence that is available at the moment is accurate, that a large proportion of the people who buy packets of ten are children or young people, would you consider banning them or seeking to have them stopped from being produced in that format?
  (Mr Milburn) I think we would need to look at that. I think we would also need to look at whether or not forcing people to buy bigger packets of more cigarettes would not have some perverse consequences. If we were forcing people to buy 20 rather than tens that would seem to defeat the objective of getting people to smoke less. Let us have a look at the evidence. The important thing about this is that it is in statute so it would require primary legislation were we to make a change of that sort.

  1309. We have had evidence that it has been the common practice of licensing justices when giving permission for children's rooms in pubs to make it a condition that these have to be smoke free. That seems very sensible. It has been tested in court a number of times because sometimes licensees have appealed and in all but one case the magistrates have won in the Crown Court. We have had evidence that the Magistrates' Association has issued guidance to magistrates that they should stop doing this, which seems quite extraordinary. Are you aware of this as a controversial area? Would you have an opinion on it? If you are not aware of it, will you look into it and preferably exert whatever influence you have on the Magistrates' Association for them to stop issuing such guidance?
  (Mr Milburn) I am not aware of that and I am slightly surprised by it.

  1310. By the way, the evidence we have had is absolutely incontrovertible.
  (Mr Milburn) I would be happy to look at that if the Chairman could make that available to us. I am surprised at that for two reasons. We have been in discussions with the so-called hospitality sector, the pubs, the clubs, the restaurants and so on about how we can ensure that people who want it can take advantage of a smoke free environment and the people who do not want it can take advantage of a smoking environment. I would have thought it is absolutely in the interests of the industry to provide precisely that sort of choice to people and increasingly that is what people are demanding. It seems to me to be a sensible thing to do. We have some very good outline agreements with the industry in the Public Places Charter that we have been negotiating which suggests ways that it can be beneficial either to segregate smokers from non-smokers or else to provide suitably ventilated areas so that people are not having to consume somebody else's smoke. That makes sense from a public health point of view and probably from the sector's point of view. They are going to attract customers if people feel that they are in an environment that they choose to be in rather than one that they are forced to be in. I will have a look at what the Magistrates' Association have had to say about that.

  1311. Secretary of State, you made the point in relation to young people and smoking that something happens between 11 and 15 that we are not entirely clear about. Obviously one assumes what happens is that puberty occurs. One of the areas that we have looked at in relation to concern over girls and young women smoking is the extent to which this is determined by their concern over their weight. Minister, do you want to respond on that point and say whether you have looked at that? Clearly you have never had a problem yourself, but some of us have! It seems to be an issue that genuinely affects the choices of girls. We have had debates within the Committee and I know Dr Stoate takes a different view from other medical colleagues as to whether that is a factor or not. If it is a factor, and it certainly seems to be, what strategies have you developed or are you developing to address particularly girls in those circumstances?
  (Yvette Cooper) It is certainly a theory and it sounds very plausible. We have not got clear evidence. We were talking earlier about the fact that what we need is more up-to-date research on what is happening now compared to ten years ago because clearly cultural attitudes among teenagers move very fast and so we do need up-to-date attitudes and I think that is one of the things that we have to make sure is part of the research that we do into why teenagers are smoking now. If it turns out to be an important factor then it is something that we will need to pick up as part of the tobacco education campaign. One of the challenges we have as part of the tobacco campaign in terms of teenagers is finding evidence on what works for teenagers. We do have evidence about different kinds of strategies and different kinds of things that work in terms of helping adults give up, but there is not any strong evidence about particular easy things that you can do that will just help prevent teenagers starting in the first place. We need to make sure the education campaign that we launch is as closely linked as possible to what we know about why they are starting in the first place and if that is something that comes out of the research we will take that on board as part of the campaign.

  1312. Have you looked at turning this whole thing the other way around, that is if young women are concerned about their appearance perhaps one might have a strategy that looks at the detrimental effects on appearance in a number of ways arising from smoking. We have had evidence from a number of sources about the effects on skin, breath, voice, a whole range of areas. Is that something that you are looking into with a view to a positive strategy of pressing young women because clearly that is an area that is very very worrying at the present time?
  (Yvette Cooper) That is certainly one of the kinds of strategies that has been used by the HEA as part of their anti-smoking campaigns. I do not know if you have seen the one that has a jar of skin cream and then a cigarette being stubbed out in the jar of skin cream, which is exactly the right kind of advert for women's magazines, picking up on exactly that theme. It is certainly something we can consider as part of drawing up an effective campaign.

  1313. We know if children are brought up in a family that smokes they are more likely to smoke themselves. I think this would indicate that any education programme should get at the adults around the children as well. I was thinking especially of the role models that children have and partly the super models and the pop stars. Has there been any move to involve them in a health education campaign?
  (Yvette Cooper) There was a recently completed programme, a Respect programme, which was an education programme for teenagers, which does seem to have been well-received by young people. It happened at the same time as a drop in teenage smoking prevalence but what we do not know is whether there was a causal link. Part of that approach was to involve role models, especially sport and soap celebrities, to make it not about Government or politicians talking about smoking but about role models. It also included sponsors—Sega and Puma—and that is exactly the kind of thing we need to evaluate and possibly build on the success of that. These are things which have been tried and certain elements we need to look at building into the next stage of the campaign in the future as well.

  Mrs Gordon: Could I go back to the issue of retail sales? The research indicates that children's main source of supply of tobacco products is the small retail outlets—the shop on the corner, the local newsagents—and we have received evidence of confused messages between health authorities and magistrates on the priority to be given to tackling such illegal sales. We were told by a trading standards officer in Newcastle that magistrates were often reluctant to sentence retailers who sell cigarettes to children with the toughest penalties available, and it was said that the Magistrates Association had issued guidance to this effect. We are trying to get evidence of that for the Committee from the Magistrates Association. I wonder if you could comment on that? What are you doing to ensure there is more effective policing of this area? What weight do you attach to the various industry-sponsored proof-of-age card schemes?

  1314. I do not think Eileen was in the room when we touched on the Magistrates Association issue. We are waiting for some information from them on this general area.
  (Mr Milburn) It is important to remind the Committee and various enforcement agencies that there are quite stringent powers on the statute book for repeated sales and indeed sales to children under 16 years of cigarettes. The maximum fine is £2,500. That is the fine on the statute book now. Sadly, the average fine is about a tenth of that at £250. So it is not as if the power is not on the statute book, the problem is one of enforcement, and I do think this is an area which the Committee might want to bear in mind and we will certainly bear in mind too in our discussions with the Magistrates Association following receipt of the information. So there are things which can be done here. We also know that although local authorities are under an obligation to carry out regular enforcement procedures as far as sales of cigarettes are concerned, some do not. We know, for example, one of the things which best works in detecting whether or not retailers are selling cigarettes to under-age kids is by using children as tests—to send children out on a properly defined basis, so to speak. But we know, from the evidence we have, that just over half of the local authorities do that, even though it is very effective in detecting which particular retailers are selling cigarettes to under 16 year olds when they should not. It is precisely that which we have been discussing with the Local Authority Coordinating Body on Trading Standards and the Local Government Association to make sure the best of practice which can detect all these problems and deal with them actually happens.

  1315. The half who are not doing this are not meeting their statutory obligations, are they?
  (Mr Milburn) Indeed.

  1316. I have been in touch with my trading standards officers in Havering and one of the things they mentioned to me was the variability of ages for regulations—the Licensing Act is 18, for tobacco sales it is 16. I wonder if you had thought about whether it would be a good idea to make a standard age restriction?
  (Mr Milburn) I heard with interest the fact that one of the companies concerned had suggested that here, which frankly makes me rather suspicious. I might be slightly old-fashioned about these sort of things. Sure, it is worth considering, but the history of this, both in this country and elsewhere in the world, is littered with getting powers on the statute book and then them not being enforced. The issue from my point of view is about one of enforcement and making sure that the range of powers which are already there are properly enacted and dealt with. There is some way to go there. I do believe there is a real willingness on the part of trading standards officers, local authorities and others to really get to grips with this and start to make a real difference out there. I do not under-estimate for a moment, incidentally, how difficult it must be as a shop-keeper confronted with a child who comes in and having to determine whether or not they are 15 or 16 in determining whether or not to sell cigarettes to them. I do think that the proof of age card issue is one we need to look at very, very carefully. I do think it would be advantageous all-round if the various proof of age card schemes were perhaps integrated. There is the Portman Group scheme, there is an ID scheme in Wales, there are other schemes, and I think it might be more sensible from everybody's point of view and the retailers' point of view too to have a single proof of age card scheme across the piece.

  1317. I have had information about the Citizen Card scheme and other schemes. They are all quite good but it is very, very patchy and obviously there needs to be a national scheme so there is no argument when a young person goes into a newsagent and asks for cigarettes and they are asked for a proof of age card. If that was statutory, do you think it would make it easier for enforcement?
  (Mr Milburn) I am not sure there are any great advantages in whether it is statutory or not, but I do think that what would be helpful is to co-ordinate the number of proof of age card schemes around. That must be pretty confusing and we would be looking to see what we can do to better integrate these various schemes, so that perhaps in the future we can have one rather than several competing against one another and in the process confusing everybody.

  1318. Would you talk to the Department of Education about making these available through schools, for instance?
  (Mr Milburn) Yes. The one you mentioned—

  1319. The Citizen Card.
  (Mr Milburn)—has been made available through schools. There are about 3,000 schools registered with it. I cannot say that the up-take has been brilliant and it is not just about making this available, it is about making sure actively the teachers and the schools and the other organisations promote it if it is going to work.