Preet Kaur Gill
MP for Birmingham Edgbaston · Labour (Co-op) · United Kingdom
“Gentleman will understand that this is an independent process, and it is not for the Government to comment on, nor intervene in, individual applications. I am aware that the right hon. Gentleman has also called for the inquiry to be paused or suspended while the CCRC is reviewing Miss Letby’s application.”
“The hon. Member makes some important, valid points. Of course, the Countess of Chester hospital will want to know the outcome of the inquiry. As she rightly says, the CQC has been in and has made lots of recommendations, especially because of the inadequate rating.”
“On top of their grief, they have been subject to a level of press scrutiny that would match anything we have faced as Members of this place. They have been left in limbo, waiting for answers.”
“In addition, we will legislate in this Parliament to enable the Health and Care Professions Council to begin to operate a statutory barring system for senior managers. The mechanism will enable the Health and Care Professions Council to prevent senior NHS leaders whose conduct is unacceptable from working again in senior roles.”
“The inquiry is now in the report-writing stage, and I have every confidence that the chair will consider all the evidence when drawing conclusions and writing her report and recommendations. I do not consider that there is a case to either amend or expand the terms of reference, based on the information currently available.”
“In March 2025, the chair refused the application and set out her reasons in detail. For transparency, that has been made available online. In her judgment, the chair considered, among other things, the question of fairness, and she was satisfied that the inquiry process had been fair and would not become unfair because there is a possibil…”
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“Q In 2023, your company identified shops selling vapes with illegal capacities and nicotine strengths. What have you found through some of your work? Mr Lawson: We looked at stores in Liverpool, Manchester and London. We did this with a few different media outlets—the BBC, Sky News and The Guardian . We found that you could buy illegal products quite easily on the market and that they were available in almost every store you go into. Some of those were post office stores that were selling those products, so there was no way for customers to determine which products would be legal or illegal. We were able to expand on testing in relation to trading standards, and we found that around 77% of products that we tested exceeded the 2 ml limits in the Tobacco and Related Products Regulations 2016, which set the UK limit on volume.”
“Q Were those vapes being marketed to children or to adults, or was it a mixture? Mr Lawson: I think it is quite easy to characterise the products. They are generally quite large in size. They normally have cartoon figures on them, such as Rick and Morty from Netflix. A lot of them are branded with cartoons like that— sometimes The Simpsons are used. Generally, they have flavours characterised by trademarked brands, such as Skittles. These are all prohibited under the tobacco and related products regulations as they resemble food products, but they also exceed tank volume and nicotine content, too.”
“Q In your opinion, does the Bill do enough to address the sale of vapes with illegal capacities and nicotine strengths? Will it give Government the powers they need to address future trends in this area? Mr Lawson: From the products we have tested, 78% of those are already deemed illegal based on the tobacco and related products regulations, which are the current regulations in the UK, so enforcing those regulations more stringently would have removed most of the products that people are now using. Implementing new regulations on top of regulations that are not currently enforced may not be effective in reducing the number of those products being sold on the market.”
“I did hear some of the last answers, but there is a very simple step: when it is applied, the MHRA notification scheme works fairly well. Most of the products that we test are not on the notification system—they are not on the MHRA’s portal. There is no check from a retailer or an importer that the products must be on that portal, so there is a bit of an issue there; you can effectively bypass the entire notification process by importing products and selling. Additionally, if the products do not contain nicotine, they are not subject to MHRA regulations.”
“Q You mentioned that your company is doing testing of products. One of the things that we heard just before your evidence was that what comes into the UK market obviously is not tested before it comes out, and we know that the illicit and non-compliant market is growing hugely. Can you talk us through what you do when you test your product? Where does it go? Mr Lawson: The main driver behind testing has been to support trading standards in taking enforcement action against illegal products in the market. The testing has therefore focused on two main areas. One is the tank volume, the 2 ml, and the other is the nicotine strength, the 20 mg/ml, so the testing looks entirely at whether products are simply complying with the regulations.”
“Q How are those products coming into the market? Mr Lawson: They are being illegally imported. The majority of products are not produced in the UK; I would imagine that most products, if not every product produced here, would be compliant. These are products coming in from Shenzhen in China, generally. They are being illegally imported and illegally sold, so the question around taking enforcement action against the manufacturer may be fruitless, because you will not be able to enforce penalties against a Chinese manufacturer.”
“What we see now is a circumvention of products from the US to the UK, so these large tank sizes, cartoons and characterising flavours are products that were in, or were generated in, the US market and which are now coming to the UK, because the UK is a bit more of an open market for products to be sold. We can see that happening in Europe and some other countries as well, where products are now being trickled into the countries that have less stringent enforcement action.”
“Q Are they imported illegally in bulk? Mr Lawson: I assume so. I am not sure whether Kate Pike from trading standards has given evidence, but trading standards has been involved in seizing quite a lot of products, particularly in Manchester, where there are container-loads coming straight in from China. The other thing to mention is that vaping has been around in the UK for 14 or 15 years. It is only in the past two years that youth use has been a concern. This has come from the US, where youth use has been a concern for five or six years. The US has implemented new regulation that has prohibited almost all flavours.”
“Q We heard yesterday that with tobacco, you have track and trace. Do you foresee that if we had a track and trace system for vapes, it should largely address some of this? Mr Lawson: My personal opinion is that if the current regulations were enforced thoroughly, most of the issues we see today would not be a problem. If we go back two or three years, I would say that almost all products on the market would be compliant. We did not see large tanks or these characteristic products that are now illegal. If the Tobacco and Related Products Regulations 2016, which are the current UK regulations, were implemented or enforced properly, we would see a huge reduction in youth use, because those products that appeal to the youth would not be on the market.”
“I would also urge you to be really cautious with any evidence or data that is presented to you, because we know from our past work—we did detailed work on standardised packaging when that came in, for example—that the industry will manipulate the evidence and data in its favour. Finally, I urge you to make the legislation as watertight as possible.”
“We also need to be aware of the third parties and front groups through which the industry operates. The tobacco industry has lost its credibility, so it works through third parties—organisations such as the Institute of Economic Affairs, and often through retail groups. I urge you to be cautious about who is approaching you, and to ask who really funds them. We need to be aware of amendments, too. I think we can be certain that the industry is working quite quietly this time, because, over the past few years, it has claimed to have changed. I think we need to be careful of the amendments that are coming in. Push against any industry efforts to delay the legislation.”
“Once it is implemented, they will also work to circumvent it and find loopholes, so we need to ensure that the legislation is watertight. We know that from past work we have done, such as with the ban on menthol, when the industry tried to introduce menthol cigarillos as a replacement for cigarettes by bringing in menthol accessories such as menthol cigarette papers and filters. In terms of recommendations, I would say that you really need to be on guard against the arguments of the tobacco industry. Having looked at these over many pieces of legislation and in many jurisdictions, we can tell you that the tobacco industry’s arguments do not come true. They may be plausible on the surface, and I am happy to talk about them in more detail, but they do not come true.”
“What is really worrying is the emerging evidence, both from animal models and human studies, that exposure to nicotine at a young age, such as vaping in teenagers, can effectively rewire the brain and increase the risk of addiction in the long term. For these companies, it is the perfect business model: they can addict them young, and then move them on from one product to another. We need to be very concerned about that. What is perhaps most relevant is the overwhelming evidence that these companies will fight the legislation at every stage. We refer to this simply as block, amend, delay: they will try to block the legislation; if it goes further, as it is doing now, they will push to amend it and weaken it; and then they will push to delay it, including through litigation.”
“We know that the tobacco industry has historically manipulated cigarettes to make them as addictive as possible. In fact, if you look at tobacco industry documents, they are quite clear on that: “The base of our business is the high school student.” We know that the key reason we are facing these problems with new products such as vapes is that tobacco companies were under threat. We had done a good job on tobacco control globally, and smoking rates and cigarette sales were coming down; now, globally, those sales and rates are stagnating. The industry is fighting back, if you like. That is why we are seeing a whole host of new addictive products.”
“That is not only a direct problem, but, in a way, a wider system problem. Those industries cause this huge harm, but they do not actually meet the costs of that harm; instead, the individuals who are affected, we as taxpayers and Governments end up paying for those healthcare costs, and so on. We know that even the tobacco industry, despite high excise rates, does not fully meet the costs of the harm it causes, and this incentivises further harm. I would love to talk in detail about that—perhaps another time. In relation to this Bill specifically, it helps us to understand a few issues. It helps to explain why we have a problem with smoking and youth vaping, because tobacco and vaping companies will market to children and make their products as attractive as possible.”
“Q My question is to you, Anna. You and your colleagues have examined the ways in which what you term “unhealthy commodity industries”, such as tobacco companies, achieve their aims. Can you tell us a bit more about that, and how it relates to the measures in the Bill? Professor Gilmore: We do work on unhealthy commodity industries, which include tobacco, alcohol, fossil fuels and ultra-processed foods. This is increasingly an issue, because what kills us, increasingly, are the products and practices of these corporations. The products of just those four industries account for at least a third of global deaths every year. Obviously, their aims are to maximise profits, and we now know that their practices are incredibly similar in the way in which they lobby, market, use public relations to massage reputations and buy access to Governments.”
“There is some balance to be had on vaping because we need to reduce vaping in never-smokers, particularly young people, but still allow e-cigarettes to be available for smokers who are using e-cigarettes to quit. It is important to remember that they are obviously not the only quit product. It is important that we do not lose sight of the role of pharmaceuticals, which are actually more important, but there are some smokers who do quit with vaping products. There is that balance. I am happy to talk in detail about some of the things that I think could or should be in those secondary regulations, if that helps.”
“Q On that, do you think that Government regulation in the Bill is sufficient, and will it improve public health? Professor Gilmore: Yes, absolutely. I think the primary legislation is important for the smoke-free generation and to help address smoking, particularly among young people, and to de-normalise smoking. We know from past measures that de-normalising smoking can be important. What is useful are the powers to introduce secondary legislation. We are dealing with quite a lot of uncertainty in this area, and evidence is emerging all the time. What is useful is the ability to introduce some legislation and then further legislation later depending on the impacts and as new evidence emerges. What is key is getting that secondary legislation right. Obviously, it has the potential to reduce smoking and vaping.”
“We do not know whether the rates would go up again, but I think that means that if we can put a lid on it through the Bill, there is a very good chance that we could get the vaping rates down again.”
“If you have not had a chance to look at the smoking toolkit study, go to smokinginengland.info. The study gives you a month-by-month analysis of key parameters, including things such as vaping and vaping in particular age groups. I do not want to bang on about vaping too much, because the key thing is smoking; but as is often the case with what they call a diffusion of innovation, when you look at the data you will see an acceleration and things look as though they are going in a terrible direction, and then at some point other factors kick in. For the last couple of months, vaping rates, particularly among never-smokers—the key people we are interested in—and young never-smokers have plateaued.”
“Q Robert, can you talk about the UCL smoking and alcohol toolkit studies’ findings on public views on smoking cessation and measures in the Bill? Professor West: Yes. Probably even better is the ASH survey, particularly in relation to public views on the policies being proposed. What is interesting about both surveys is that, as many of you will be aware, there is widespread support for what some in years gone past might have seen as quite a draconian Bill that phases out smoking. That is testimony to how far we have come with the policies we have adopted, with credit to successive Governments—all Governments have kept their foot on the accelerator in addressing the issue, and it has paid off. Probably for the first time in any country in history, we are in a position where this is a serious, viable option in terms of public sentiment.”
“Q Ann, do the measures in the Bill equitably benefit all people affected by tobacco and vaping products? Professor McNeill: As I mentioned in my opening comments, the people affected by the Bill will be people who are vaping and/or smoking, people who might take them up, and people around them. It will certainly drag down smoking uptake. My main issue is around encouraging people who smoke to stop, given that more people from disadvantaged groups smoke. As long as we maintain the focus on smoking with the Bill and provide support for smokers to stop—that includes vapes, which are effective tools—then yes, it can drive down the health inequalities caused by smoking.”
“It would seem likely to us that people could quite reasonably become addicted beyond the age of 21, but the legislation would prevent that from happening because of the rising age across the course of life.”
“Q We have heard compelling evidence, and we will hear again from the health sector today. Lots of people will say that the Bill could essentially just raise the age of sale from 18 to 21, but we have heard good evidence for why that is not the case. For the record, what would you say to the people who think we will not be able to do the age verification, which we know already exists in Scotland? Sir Francis Atherton: To echo what Sir Chris said earlier, nicotine is uniquely addictive, and it is addictive across all ages. Simply raising the age to 21 may have a limited effect and may well not have a long-term effect. The tobacco industry is incredibly adept at adapting its tactics to target smokers, whatever their age.”
“Q Do you want to say anything about age verification? Sir Francis Atherton: Age verification is a relatively simple matter if there is to be a cut-off at 2009. It is much clearer to retailers that that would be the age at which people would not be eligible to buy tobacco products.”
“A further 6,000 were booked where the mother was a former smoker. These are still really significant numbers. Of course, as Sir Michael has just said, this not only has implications for the mother and the health of the pregnancy; it has longer-term implications for the baby as it develops and grows. We know that anything that we can do to reduce the number of women in these age groups who are coming to pregnancy as smokers will have a beneficial effect not only on them and the health of their pregnancy, but on the health of future generations.”
“In Northern Ireland, rates of smoking in the most deprived areas are over three times the rate in the least deprived. As a consequence, lung cancer rates are two and a half times higher in the most deprived areas. If we look at pregnancy, pregnant women in Northern Ireland in the most socioeconomically deprived areas are five times more likely to smoke than those in the less socioeconomically deprived areas. The consequences for their health, and for the health of their children and unborn child, are very significant. They are addicted to a habit that is causing them harm and their unborn child harm. Professor Sir Gregor Ian Smith: To add to Sir Michael’s data, in Scotland in 2023, there were just over 50,000 pregnancies; 11% of those pregnancies—that is 5,500 pregnancies—were booked where the mother was recorded as still being a smoker.”
“They wish to get rid of the smoking in pregnancy, and they cannot because their choice has been removed. What is clear is that the age band at which the greatest amount of smoking in pregnancy occurs is the youngest women. People who have babies in their late teens or early 20s have by far the highest rate of smoking. Those, therefore, will be the ones who would be positively affected by this Bill the most quickly, because then they would not be going into a pregnancy already addicted to smoking, with all the consequent harms for their baby and subsequent child, which may be lifelong. I do not know whether any of my colleagues want to add to that. Professor Sir Michael McBride: One of the most concerning aspects of smoking tobacco is the health inequalities that it accentuates.”
“Q One facet of the Khan review recommendations that was touched on a little yesterday is the measures to protect pregnant women and unborn babies. What will be the impact of the Bill on pregnant women and unborn babies, and when do you think the target could be met? Professor Sir Chris Whitty: Shall I have a first go? One of the first groups to be enormously positively affected by the Bill will be pregnant women and their unborn children. I know you will be hearing from the chief midwife, but briefly, stillbirth, premature birth, “small for dates” babies and birth deformities are all things that happen as a result of smoking. It is extraordinarily dangerous. All mothers want the best for their children; but, to reiterate, smoking is so addictive that people’s choices have been removed.”
“The figures for the Republic of Ireland are somewhere in the region of 18%. There is absolutely no doubt that we have the same socioeconomic drivers, in terms of social deprivation and health inequalities, that are fuelling this. Should the Bill succeed and pass into legislation, I see this as a once-in-a-generation opportunity to make a significant change to protect future generations and their children from all the harmful consequences of smoking tobacco and other forms of tobacco use.”
“One of the reasons is that we have deep-seated sociodemographic problems in Wales, which you have been referring to. Given the inequity that we see, meeting the needs of current smokers from those really deprived socioeconomic groups is really quite a challenge. We are doing everything we can in Wales to try to address that through “Help Me Quit” and smoking cessation support, but we really need to prevent the next generation from coming on board with smoking. Professor Sir Michael McBride: Just following on from Sir Frank’s comments, you are absolutely correct that, while population prevalence of smoking sits at around 14% at the moment—behind the 12% in England and the 13% in Wales—we are doing slightly better than Scotland at the moment, which is sitting at about 15%.”
“Q Finally from me, and this question is for Frank and Michael, the latest ONS figures in 2022 show smoking prevalence in Wales and Northern Ireland remaining constant rather than continuing to fall in the way that it did in England and Scotland. Do you think Wales and Northern Ireland have specific challenges related to smoking prevalence? Sir Francis Atherton: It is certainly true that we are not going as fast in Wales as we would like to see. Smoking prevalence has dropped, from about 22% in 2020 down to 13% at present, but our target is to reach 5% by 2030, and we are not currently predicting that we will meet that target unless we go further and faster. We believe that this Bill will enable us to do that. You asked for the reasons.”
“It is important that we continue that. My understanding is that wherever we have been successful in reducing demand, which the Bill intends to do, the illicit supply also decreases. We would expect that to be a consequence of the Bill. Professor Sir Chris Whitty: One of the many talking points of the cigarette industry is, “Well, any kind of downward pressure on cigarettes would lead to an increase in the illicit market.” All the evidence shows that the reverse happens. When you bring in reduced demand, the illicit market decreases.”
“We heard really good evidence yesterday from the union. This is my concern: where can people access support and information? We already have a generation of kids addicted to vapes that are marketed as having 0% nicotine, but we know that there is nicotine contained in them. What would you say to that? Sir Francis Atherton: There is some messaging going on through the various Governments. In Wales we have a “No Ifs. No Butts.” programme, which tries to work at an individual level, to alert people to the dangers that we have been discussing, and with wider society, about the dangers and links between illicit tobacco and illicit vaping and organised crime. Bringing that awareness to the population is really important for those two reasons. We work with trading standards to try to tackle the issue of illicit tobacco and vapes.”
“Q We should all be concerned about the increase in the use of vapes by young children, so it is important that the Bill will ban the sale of vapes to under-18s. It will also close the loopholes for under-16s, because we know that vapes are being marketed and given out for free. That is the issue we must address. My concern with the Office for Health Improvement and Disparities being disbanded is on public health messaging. Parents and families are really concerned that some of their children are going through a number of these vapes per day or per week, and they do not know what is a safe amount. There is a growing illicit vape market, but how would parents know what is illicit or what the Medicines and Healthcare products Regulatory Agency has notified as being compliant? Where is the public health messaging to support schools?”
“At present, we see a relatively small number of admissions into hospital as a result of vaping, but that is growing; it has grown over the last few years. Clearly, as you discussed earlier, the evidence base that these products are not safe is growing.”
“Q You have raised concerns about the rise in youth vaping. You have said that this needs to be nipped in the bud. Do you think the measures in the Bill will lead to decreased rates of youth vaping? Professor Sir Stephen Powis: Yes, I do. As you have heard from the chief medical officers, vaping has a role in tobacco cessation and supporting those who want to quit smoking. That is the guidance from the National Institute for Health and Care Excellence, which we follow and support in the NHS. Evidence is increasing that starting vaping and the use of nicotine-based alternatives to smoking is likely not to be safe. As far as the NHS is concerned, we would support the limited use within smoking cessation, but we have real concerns around the impact that vaping might have over time.”
“Q You have mentioned the smoking cessation services we already have within the NHS, but there is no equivalent for vapes. Do you think there could be a case for these schemes to be made available for young people or pregnant women? Kate Brintworth: Our position on vapes is that they are a tool for those who are already addicted to smoking. As Chris outlined earlier, this is a way of supporting people to move away from cigarettes. We would then expect that to be part of their journey to becoming a nicotine and smoke-free household.”
“Q There is a growing industry in illicit substances, in terms of the vapes available in the market. Is that where you are seeing some of the impact with children in terms of hospital admissions? Have you seen any adverse reactions? Professor Sir Stephen Powis: Yes, we have. If you look at admissions recorded in our statistics related to vaping, you will see that they are in the hundreds. They are relatively low, and of course much lower than smoking, but as I think you have heard from the chief medical officers’ evidence, these are not safe products. We are at the early stages of the evidence-base building around their impact. I think we should be nipping this in the bud. We should not be waiting for those admissions to increase and for those effects to be seen.”
“There is a large range of conditions that are impacted by smoking, and it will be extraordinary for those clinicians of the future not to have to do what we have done—tell patients and their families that people are going to die prematurely. That is an extraordinarily difficult thing for clinicians to do. Those are preventable diseases, and this Bill will prevent them.”
“Mental health issues in our young people and children are well-known and well-described, and smoking simply exacerbates them. There is great potential, even in the early years, in the passage of this Bill for an impact on conditions that we see and manage in the NHS. Over the long term, that potential impact is extraordinary on those conditions, which number over 100. You may know that I am a kidney doctor, but you may not know that smoking can impact on kidney disease. The kidney, like any organ, is supplied by blood vessels. When smoking impacts on the health of blood vessels and causes vascular disease, that can reduce the bloody supply to the kidney, which can cause kidney failure and lead to dialysis and transplantation.”
“It is not about just lung cancer; you have heard about the impact on cardiovascular disease, and clearly, chronic obstructive pulmonary disease would again become a rare disease for the clinicians and the patients of the future. This Bill can also have an early impact on diseases that affect young people. Asthma is a disease not caused by smoking but a condition exacerbated by it. We see such admissions particularly over the months when asthma is worse and when there are respiratory infections, which are no doubt exacerbated by smoking. In mental health, smoking doubles the risk of developing depression. More than one in two people with severe mental health conditions smoke, and the life expectancy of those with mental health conditions is reduced because of smoking.”
“It impacts the NHS at all levels: almost every minute of every day there is a hospital admission related to smoking; there are over 100 GP appointments every hour for smoking-related disease; and 400,000 admissions a year are related to or associated with smoking. You have heard the chief medical officers briefly talk about the impact on specific diseases. Lung cancer is the one that everyone knows about, and 80% of lung cancers are caused by smoking. This Bill has the opportunity to transform lung cancer from a common disease into a relatively rare disease, and one that clinicians of the future will not see in any way as commonly as clinicians of my generation.”
“Q Would you like to say anything about admissions of young people in relation to smoking? Professor Sir Stephen Powis: I will make a few broad comments on smoking, if I can. Seventy-eight years ago, Parliament passed the National Health Service Act 1946, which led to the formation of the NHS on 5 July 1948. In my view, the legislation that you are considering here today is one of the most important—possibly the most important—pieces of legislation since the passage of that Act. Why? Smoking has an extraordinary impact upon the health of the nation, and of course directly upon the NHS. To put that into a bit more context—you have heard some of this already, but maybe I will provide some more detail—smoking is associated with, or causes, over 100 individual conditions that are managed and treated within the NHS.”
“Nicotine makes you small and, if you are born small, you are already on a trajectory for all the non-communicable diseases that Kamila and her colleagues will see in primary care: cancer, heart disease, stroke and hypertension. From the paediatric perspective, there are issues. Children do not concentrate so well when they are addicted to something, so their attention in school is changed. That will affect their learning outcomes and their future economic productivity. The devices sometimes set on fire, so if you have one in your mouth, it can create burns. Fortunately, there are few serious life-threatening complications, but you might have heard of popcorn lung, which is fortunately rare but is very serious. With popcorn lung, when you look at the lungs on a scanner, it looks like they are full of holes.”
“I had a patient who sadly has passed away now with end-stage lung disease caused by smoking. The difficulty we had keeping her as well as we could at home was that she could not have home oxygen because she continued to smoke. It was a massive difficulty for her to stop smoking, even though it was causing her to virtually strangle herself. That just shows what a difficult thing this is. Professor Turner: To follow on briefly, you might think that children do not demonstrate some of the impacts that Kamila has just described, but that is not the case. Following on from the conversation before, nicotine is not good for you. If you are a foetus inside of your mam, it will cause uterine arteries to spasm and effectively strangle you—reduce the oxygen to you. We know that vaping contains nicotine.”
“Q The point of this Bill is to call time on a system that privatises the profit from nicotine addiction but socialises the social costs. What is the impact that you see on your profession, which we know is already stretched on the frontline in terms of managing long-term chronic illness associated with smoking? Professor Hawthorne: Smoking-related illnesses cost the NHS about £2.5 billion a year. Everybody knows that lung cancer goes with smoking, but what I am really seeing is awful chronic obstructive airways disease. I work in a deprived area. Many of my patients have smoked ever since they were teenagers and find it very difficult to stop. Every winter, they come to see me repeatedly with severe chest infections that require courses of steroids and antibiotics and sometimes hospital admissions. It is really difficult.”
“Q Do you think that the Bill goes far enough to protect young people from the harmful effects of smoking and vaping? Professor Turner: Yes, absolutely. The tobacco industry knows that, at the age of 15, we as a species are at the sweet spot for becoming addicted to nicotine for life. The proposed Bill will effectively stop that. Protecting our children from becoming addicted to something that will shorten their lifespan by 10 to 15 years has to be a good thing for us as a responsible society to do.”
“Q Finally, what are the harms of vaping to those who have never smoked? Professor Hawthorne: We know that vaping can cause people to start smoking; it can lead to smoking. We do not have much evidence—I think you have been told this already this morning—as to what the long-term effects of vaping are. We have known about smoking damage since the work of Sir Richard Doll in the 1960s, so this is relatively new. We know there are chemicals in what people are inhaling—that is what causes the popcorn lung—but it is actually only one particular chemical that has been linked, and there are lots. Since 2016, vapes have not been allowed to actually have that chemical any more, but there are other chemicals, and we still do not know what long-term effects they might have.”
“Because we know nicotine is in all nicotine-containing vapes, whether licit or illicit, it is harmful regardless of what the other components might be. It is likely that those other components add to the harm, but there is substantial and well-described harm from nicotine addiction to us as human beings.”