My Lords, I am delighted to take part in this debate. Before I start, I shall not miss this opportunity to chide both Front Benches. I have spoken about this in the past and tabled many amendments on different health Bills. The last time that I tried was with the Labour Government. The Minister taking the legislation through was not the noble Lord, Lord Hunt, but the noble Baroness, Lady Thornton. I did not succeed on that day in getting my amendment through. Obviously, the government Benches were not going to support me, but I did have the support of the noble Baroness, Lady Barker, who is not in her place and who was the Front Bench health spokesman of the Liberal Democrats. I did not have the support of the noble Earl, Lord Howe, at the time—hence I did not succeed.
However, I am delighted to congratulate the Government on having, in a step-wise fashion—and as a result of efforts made by many other noble Lords, including the noble Baroness, Lady Finlay, and the noble Lord, Lord Faulkner—reached a place where they can bring forward an amendment to address the public health evidence that plain packaging will make a difference to the uptake of smoking of cigarettes, in particular by children. I am particularly delighted that the government amendment includes not just external packaging but internal packaging. I remember my
days as a young medical student, when one would rush out and buy Sobranie Black Russians because the cigarettes were wrapped in nice black paper with gold tips. At the same time, we would also buy a packet of Sobranie Cocktails to impress the ladies we were taking to dances because they came in multicoloured wrappers—so packaging makes a difference, even to a young medical student .
I am therefore delighted to see the Government’s amendment. I have no doubt whatever that Sir Cyril Chantler, whom I know well as a friend, will be absolutely meticulous in looking at the evidence. I am convinced by the evidence and I hope that he will be, too.
Let me turn to the issue of smoking in cars when children are present. I have taken the trouble to look at all the evidence about second-hand smoke in confined spaces. I have looked at the public health evidence from the Surgeon General of the United States, from Australia, from New Zealand and from Great Britain—both epidemiological and observational studies. The findings are quite interesting: undoubtedly, second-hand smoking is harmful. It is harmful to children—more so because their metabolic rate is higher, so any injurious substances that they inhale are bound to have a greater effect. It is harmful also to adults, particularly older people who have respiratory conditions or cardiac disease. It is harmful also to pregnant mothers who do not smoke, among whom there is a higher rate of still-births and infant deaths because of the epigenetic effects of the inhalation of injurious substances during their pregnancy. It is worse if they smoke during their pregnancy, but even if they do not, the effect of second-hand smoke is harmful to them.
There is further evidence, mentioned by the noble Lord, Lord Ribeiro, that some of the injurious substances in tobacco smoke persist on certain surfaces for a very long time. So this issue is not just about smoking when there are children in a car; it is also about making that car harmful to children because injurious substances persist. That also applies to any confined space. So the question is: what legislation will have the greatest public health effect? Will it be legislation that stops smoking in cars when children are present? Will it be legislation that bans smoking completely? Of course, it will be the latter, but that will not be possible—such legislation is too draconian. Could it be a good educational programme that teaches people that if you smoke in front of children, whether in a confined space or in an open space, or if children just see you smoking, that is wrong and harmful?
I was accused by my wife of smoking 20 to 40 cigarettes a day. All young doctors smoked in those days; it was the thing to do. Not all doctors smoke these days. When I saw my daughter, who was 11 months old, watch me lighting a cigarette, it was the day that I stopped smoking. She might object to me giving her age, but she is past 40—just, and she is a cancer doctor, so she understands these things. I felt that her observing me lighting a cigarette would be as harmful to her as her taking up smoking. The issue that we should therefore debate is what would have the greatest public health gain, whether for children—more importantly for children—or for young adults, older people and pregnant mothers.
The amendment of the noble Lord, Lord Ribeiro, seeks more targeted education and some consultation to find the evidence. The amendment of the noble Lord, Lord Hunt, seeks to have on the statute that a regulation must be brought in. I was talking about regulations pertaining only to cars. The evidence that I have looked at would suggest that we should ban smoking in cars completely, because that way there would be no possibility of anybody smoking in cars and leaving injurious substances behind that may harm children. That may or may not be a better deal than that proposed by the noble Lord, Lord Hunt, but my plea is, “Let us look at what would be the best public health gain”.