Rising prices, bans in new public places, measures against vaping: strengths and weaknesses of the new anti-smoking plan

“A first generation of adults free of tobacco in 2032”, such is the stated (and ambitious) objective of the Minister of Health, Aurélien Rousseau, as he presented the new anti-smoking plan on Tuesday morning. The latter will last until 2027. France still has nearly 12 million daily smokers today, or around a quarter of the adult population, a figure which has remained stable since 2020. Responsible for 75,000 deaths each year, the However, tobacco takes all the first places: leading cause of early mortality, leading cause of cancer mortality, it is also the leading cause of preventable cardiovascular mortality.

“It is a scourge that concerns us all. Tobacco weighs on our solidarity system, underlined Aurélien Rousseau. It costs the public accounts much more than it brings in taxes. Everyone loses. » According to the latest report from the French Observatory on Drugs and Addictive Tendencies (OFDT), released this summer, tobacco brought in a little more than 13 billion euros in tax revenue in 2019, compared to the 16, 4 billion spent to treat the health problems it caused the same year.

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The ministry's plan of attack is based on two pillars: an increase in prices and the multiplication of places where smoking will now be prohibited, in particular on the beach, in the park, in the forest or around schools. The minister's entourage is counting on an effective ban no later than September 2024. The amount of the associated fine has not yet been specified, but it is, as an indication, 68 euros on a station platform.

“There already exist more than 7,200 tobacco-free spaces across 73 departments, but this is the result of a movement driven by the municipalities. From now on, this principle becomes the rule,” explained Aurélien Rousseau, who thus wants to strengthen the “debanalization” of tobacco. This measure was unanimously welcomed by anti-smoking associations, who had already largely welcomed the ban on smoking in bars and restaurants (since January 1, 2008) as well as in schools and universities (February 1, 2007).

Some public health specialists, on the other hand, are much more circumspect about the increase in taxes imposed on tobacco, considered limited. The average price of 11 euros (for a pack of 20 cigarettes) will gradually increase to 12 euros at the start of 2025, then to 13 euros during 2026, a total increase of around 2 euros. An increase deemed “disappointing” by Professor Loïc Josseran, president of the Alliance Against Tobacco. “We are very far from the mark, we will only gain 1.50 euros by 2027, since the best-selling pack of cigarettes in France currently costs 11.50 euros. However, for it to be effective, the tax lever must lead to an increase from 50 cents to 1 euro every six months,” he told Le Figaro. According to Professor Josseran, the announced measure should have no impact on the level of smoking among young people. “The tobacco-free generation in 2032, I don’t believe in it,” he said, bitterly.

This initiative, which could have come into force from 2024, will only be applied from 2025, for fear of discontent among smokers. “Adopting a tax measure in a period of high inflation is likely to be understood as a measure to hit purchasing power,” defended the minister.

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If increasing prices is undoubtedly the most effective measure, many specialists believe that only clear and repeated increases are likely to influence smokers. In Australia, the price of a pack of cigarettes increased by 60% between 2017 and 2020 to reach 25 to 30 euros. A truly dissuasive cost which has made it possible to drastically reduce the number of smokers. In 15 years, the prevalence of smoking has been divided by three. Now, the country has only 10% smokers.

Aurélien Rousseau wants to use the coming year to motivate the troops to stop smoking. Nicotine replacement treatments (patches, gums, etc.) will soon be able to be purchased directly in pharmacies, without a prescription. They will continue to be reimbursed on prescription by Social Security. “Quitting cigarettes is not an easy thing, I fully understand that,” he conceded. The key to quitting is to be helped, not just made to feel guilty. »Curiously, there is no question of encouraging smoking cessation through electronic cigarettes, quite the contrary. “The neutral package will be extended to vaping products and we want to limit the authorized flavors,” said Aurélien Rousseau.

“The plan is generally in the right direction, but we are very supportive of vaping products. Some people have been able to quit smoking thanks to this. On this point, there is room for discussion,” confides Professor Amine Benyamina, addiction psychiatrist and president of the French Federation of Addictology. Although the effectiveness of e-cigarettes for quitting smoking is still the subject of debate, their risks are much lower than those of tobacco. “Compared to tobacco and its preferred mode of consumption (combustion), e-liquids have the advantage of canceling, or significantly reducing, the risks of occurrence of serious pathologies, mainly cancers”, underlined in 2016 the High Council of Public Health.

The government finally wants to strengthen the fight against “off-channel and cross-border” purchases and work on “tax harmonization of tobacco products in Europe”. He also showed the desire to tackle new nicotine-based products, such as sachets - a novelty to put in the mouth, without tobacco - and "puffs", these disposable electronic cigarettes. “These are colorful and fun products that target young people, even very young people, with a lot of marketing,” said the minister, who describes “puffs” as “an aberration, both from the point of view of public health and of the environment ".