Alcohol, tobacco, illicit substances: a “social cost” estimated at several hundred billion euros per year

It is a belief well anchored in the collective imagination: tobacco and alcohol kill, but their consumption brings more to the State than it costs it. The assertion is however more than inaccurate, according to a note from the French Observatory of Drugs and Addictive Tendencies published on Wednesday. "Despite the revenue from taxes levied on alcohol and tobacco and, despite the savings from unpaid retirement pensions, the cost of care exceeds the amount of these revenues", argues Pierre Kopp, professor of economics at the university. Paris 1 Panthéon Sorbonne and author of the note.

The institution, which relies on data collected in 2019, estimates that taxes on tobacco and alcohol, which brought in 13 and 4 billion euros respectively, are much lower than the cost of treatment. These amount to 7.8 billion for alcohol and 16.5 billion for tobacco, not counting miscellaneous social expenditure and prevention. “The public deficit caused by alcohol and tobacco is respectively 3.3 billion and 1.7 billion”, figures the study. With regard to illicit drugs (cannabis, opioids, cocaine, etc.), on which the State collects no revenue, the observation is just as instructive: by adding end to end the cost of care, prevention and repression, the net bill for public finances exceeds 2 billion euros.

The note is therefore salty, and not only for the State. The whole of society pays dearly for risky consumption, whether regular or only occasional. In addition to the cost for public finances, the report invites to take into account various externalities, such as the economic value of the years of life lost in the event of premature death - based on the Quinet report, which sets the value of the year of human life at 115,000 euros -, the loss of quality of life caused by various illnesses linked to consumption, and production losses for companies. All of these dimensions establish the social cost, i.e. “the value of the resources that society deprives itself of because of drugs”. In other words, this indicator “measures the monetary cost of the consequences of the consumption and trafficking of legal (alcohol and tobacco) and illegal drugs during an average year of the decade”. In 2019, this peaked at 156 billion euros for tobacco, 102 billion for alcohol and 7.7 billion euros for illicit drugs. That is more than 265 billion euros.

The discrepancy in “social cost” between different drugs may be surprising. It is, however, logical: the more “lethal” a drug is, the higher its social cost. The external cost, i.e. that of lost lives, lost production and quality of life, concentrates the bulk of the "social cost", when the impact on public finances represents only a marginal part. . However, the external cost of tobacco is much higher than that of alcohol because “the number of deaths caused by smoking is 1.8% greater than that caused by alcohol consumption”. Another key to explanation is the number of daily or “problematic” consumers, estimated at 3.5 million for alcohol and 13 million for tobacco. For illicit drugs, the addict quota is more difficult to establish. The study only mentions regular opioid users, who would be 300,000 in France.

"The reduction in mortality does not result in a very sharp drop in the social cost", finally underlines the note. Between 2010 and 2019, deaths related to alcohol, tobacco and illicit drugs fell by -16%, -7% and -23% respectively. At the same time, the social cost of alcohol fell by only 11%; that of illicit drugs barely 6%. The explanation is arithmetic: improving the care provided to patients increases the survival time and therefore the cost of treatment, while contributing to the lengthening of the average lifespan of the population. On arrival, the benefits of the fall in mortality are neutralized.

Still, these “good” figures caught the attention of Pierre Kopp, in particular those related to tobacco. “This result gives encouraging signs to a public policy that has made it possible to significantly reduce tobacco consumption,” notes the economist, who for several years was the lawyer for the National Committee against Smoking. He recalls, in passing, that the results are less significant in terms of illicit drugs and alcohol consumption. "Drugs impoverish the community," the economist once again reminded AFP on Wednesday. Would La Bercy have anticipated the call from the foot of the Observatory? A few weeks ago, Bruno le Maire hinted that an increase in alcohol taxation was strongly considered by the executive, and this from the start of the next school year.