Why is smoking no longer declining in France?

In France, one in four adults admits to being tempted by at least one cigarette a day, according to the latest report from Public Health France (SpF) published on Wednesday May 31 on the occasion of World No Tobacco Day. And despite efforts to combat smoking, the French are struggling to embark on a tobacco-free life. In 2019, the country had 24% daily smokers, according to SpF. But until 2022, this prevalence has not seen a significant decline. How to explain that the French have not eased off tobacco in the past three years?

One thing is certain, the aftermath of the Covid pandemic has its share of responsibility: “we know that stress is strongly linked to smoking. However, the pandemic has had material and psychological consequences linked in particular to the organization of daily life and work, but also to the increase in depressive disorders”, explains Romain Guignard, in charge of scientific expertise in health promotion at the unit. addictions from Public Health France. This generalized anxiety, which was accompanied by a deterioration in living conditions or even a loss of employment, would therefore have contributed to the interruption of the decline in smoking by discouraging smokers from quitting. “But it is also the fact that certain field actions related to smoking could not be carried out during this period”, points out Romain Guignard.

A similar finding could be observed in Italy and the Netherlands, which reinforces the Covid hypothesis on the persistence of smoking, while tobacco consumption has continued to decline in the United States even during the pandemic. “Remember that the Anglo-Saxon countries have had a much lower prevalence than France for the past twenty years with a significant decrease in recent times, particularly in the United States where the prevalence of smoking is between 10 and 15%. Nevertheless, the situation is not comparable to France for several reasons, in particular cultural ones”, emphasizes Romain Guignard.

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Among the other factors involved, Public Health France points to the influence of the social context and more particularly the disparities in terms of education and income: the prevalence of smokers is twice as high among non-graduates or people with a diploma. lower than the baccalaureate (31%) than holders of a higher diploma (17%). It is also higher among unemployed people (42%), than among employed workers (26%) or students (19%). “Material insecurity does not encourage thinking about the future. However, quitting smoking requires planning,” observes Romain Guignard. “Initiatives aimed at reducing social inequalities could contribute to a more rapid decline in smoking,” he continues. This last point is also "a major challenge for the third national program to combat tobacco", announced Public Health France in its report.

One of the key tobacco control strategies has also been the steady increase in the average price of cigarette packs. However, this has not experienced a significant increase between 2021 and 2022 where other products have seen their prices rise with inflation. "The price of the package may act as a deterrent and the fact that it escaped inflation may have played on the persistence of smoking, but this is only a hypothesis", suggests Romain Guignard. In any case, the government is banking on this financial lever: with a first increase of 20 to 90 cents on several brands of cigarettes since May 1, 2023, in 2024 no pack of cigarettes should cost less than 11 euros. What deter more and more smokers.

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But for other anti-tobacco measures, such as awareness campaigns, doubt continues to hang over their real effectiveness. “A reassessment of the policies already in place and a multiplication of preventive measures could reverse the trend”, assures Olivier Smadja, tobacco specialist at Public Health France. "Improving care, systematizing the healthcare system, and better compliance with the ban on the sale of tobacco to minors are much-awaited measures in the next national plan led by the Ministry of health ".

For the rest, with the Covid being behind us, health professionals can only encourage smokers who say they want to quit: “World No Tobacco Day is the right day to quit your last cigarette and start a new life. But it's never easy, so don't hesitate to talk to those around you or to professionals, ”concludes the tobacco specialist.