• Since 1987, the World Health Organization has dedicated one day to tobacco control.
  • In 2022, the France had 12 million daily smokers. A level of smoking that remains "high" according to Public Health France, which publishes this Wednesday a study on smoking.
  • What needs to be changed in terms of prevention to be more effective in France? And in the world? Elements of answer with Jean-Michel Delile, president of Fédération Addiction and Josée Lapalme, postdoctoral researcher in public health and social inequalities at the University of Montreal.

It was necessary to see them Didier and Bernard, fighting against their cigarette impulses by repeating the famous sentence: "Tobacco is taboo, we will all overcome it. " A quarter of a century after the famous slogan of the Unknowns, taken from the film Le Pari, Santé publique France published this Wednesday a study on smoking in France on the occasion of World No Tobacco Day.

The France has "12 million daily smokers" in 2022, a stable but high figure. With 75,000 deaths attributable to it in 2015, tobacco is the leading cause of preventable death. Above all, as in recent years, the organization notes an inequality: the most socially disadvantaged smokers are more numerous. In this context, what levers should be used during prevention campaigns to dissuade and support smokers?

Listening rather than stigmatizing

"The more smoking declines, the more it focuses on populations with the most psychological and social vulnerabilities: young people who have dropped out of school, who have lost their jobs, and people who are precarious," says Jean-Michel Delile, president of Fédération Addiction, which advocates targeted campaigns for this type of audience.

In Quebec, one of the regions most restrictive of smokers, the authorities have opted for two options. "Denormalization, that is, changing social norms in relation to smoking. Smoking should no longer be seen as desirable but repulsive, says Josée Lapalme, a postdoctoral researcher in public health and social inequalities at the University of Montreal. The other axis is to go through the laws. »

In La Belle Province, since 2015, it is forbidden to smoke on the terrace, in children's playgrounds, inside a car in the presence of a child under 16 years old... As a result, consumption has decreased, but social inequalities in smoking have widened.

Multidisciplinary support

Hence the importance of being relevant during prevention campaigns. "When you want to change norms, you can quickly slip into morality. We start by saying that the cigarette is disgusting. Then there is a perverse effect. We realize that it is ultimately the populations of precarious smokers who will be stigmatized. Anti-smoking strategies can increase inequalities, or at least not change them," says Josée Lapalme.

Faced with smokers who accumulate social difficulties and are less accessible to prevention messages, the approach must be personalized. "It requires that health centres, which were more focused on monitoring drugs and alcohol, open up to problems related to smoking, because they have multidisciplinary teams that would support these vulnerabilities," says Jean-Michel Delile. It requires strengthening the support of care with something that would no longer limit to prescribing patches but that allows to take these psychological and social vulnerabilities. »

For greater efficiency, Josée Lapalme believes that the problem should not be isolated. "For disadvantaged people, you have to go talk to smokers, realize that it's a topic related to other issues [poverty, racism, inequality], and be able to give broad access to smoking cessation resources [medications, etc.]."

An entire generation of young non-smokers by 2032 is the government's roadmap. An achievable goal according to Jean-Michel Delile, provided "to maintain the effort and update the prevention messages".

  • Health
  • Smoking
  • Cigarette
  • Quebec
  • Precariousness