The new Secretary of State for Health has a large and difficult in-tray to grapple with, but it is now crucial he does not let COVID-19 force other major health issues further down the pile, argues Bob Blackman.

Our new Secretary of State for Health has a lot to get to grips with, but as Chairman of the All-Party Parliamentary Group on Smoking and Health, I know that it's vital he does not let transforming the public's health slip to the bottom of the pile.

Our recent report clearly demonstrates that achieving the Government's ambition of a Smokefree 2030 will help build back better after COVID-19, as well as delivering on our manifesto commitments to level up, reduce inequalities, and increase healthy life years by five by 2035.

Finding the funding to deliver will not be easy, but the APPG has a solution which we believe a former Chancellor of the Exchequer committed to low taxes should find attractive, as it will not increase government spending. This is a US-style 'polluter pays' approach to tobacco control, which the Government has already promised to consider.

Brexit gives us the powers to implement this approach while preventing the manufacturers from passing on the costs to consumers. This is what manufacturers do with tobacco taxes, enabling them to make extremely high profits. For example, Imperial Tobacco, which sells around four in ten of the cigarettes smoked in the UK, made net operating profits of 71% in 2019. It is estimated that a 'polluter pays' levy could raise £700 million in the first year which could fund both the measures needed to deliver a Smokefree 2030 and help finance a public health "levelling up" fund.

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Funding measures to help smokers quit is vital, but preventing children getting addicted in the first place also requires tougher regulation. The experts say the greatest impact would come from increasing the age of sale from 18 to 21, something the APPG is calling on the Government to consider. This is not about criminalising smoking; it is about restricting access, making it illegal for an adult to sell cigarettes to, or procure cigarettes for, young people under the age of sale.

There is a clear rationale for treating smoking differently to other age-restricted activities, because smoking is highly addictive and tobacco is the only legal consumer product which kills when used as intended. Such is its addictive quality, that for every three young smokers, only one is likely to quit before they die. Young adults know the risks of smoking, but their decision-making is immature; that is why car insurance for young drivers is so expensive, and why very few smokers start after they reach 21.

Tobacco manufacturers have long recognised the importance of this age group. To quote Philip Morris in 1986: "Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20)…" Modelling carried out by University College London for the APPG shows an age of sale of 21 would reduce smoking rates among young adults aged 18 to 20 by nearly a third, equivalent to 95 thousand fewer smokers in the first year of introduction.

The UK, home to the tobacco industry, led the way into the tobacco epidemic in the 20th Century. In the 21st Century, we are now showing global leadership in forging the path out. I urge the new Secretary of State to cement our place as a world leader on tobacco control by introducing an ambitious Tobacco Control Plan which includes a US style 'polluter pays' levy, and a commitment to consult on raising the age of sale for tobacco to 21.

Public opinion is on our side, with three quarters supporting the Government's ambition to be Smokefree by 2030 as well as the levy on tobacco manufacturers, with fewer than one in ten opposing either measure. Indeed, a large majority of people who voted Conservative in the 2019 election back all of the regulatory measures in our report including increasing the age of sale to 21, with minimal opposition.

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