A year after the implementation of the National Plan to Combat Tobacco, and on the occasion of the launch, in November, of the 9th edition of Tobacco-Free Month, associations are returning to these effective measures but which forget the categories of smokers precarious.
While November 1 launched the start of the tobacco-free month, November 28 will be the opportunity to celebrate the first anniversary of the announcement of the National Tobacco Control Program 2023-2027 (PNLT). Presented at the time by the short-lived Minister of Health and Prevention Aurélien Rousseau, this plan aimed to shift the fight against smoking into high gear and promised strong measures such as strengthening tobacco control. ban on the sale of tobacco and vaping products for minors, the pack of cigarettes increased to 13 euros in 2027 and the increase in outdoor spaces free of tobacco. Actions which should make it possible to achieve the objective stated since 2014, a first tobacco-free generation by 2032.
If the measures announced suit organizations linked to the fight against tobacco, their execution sometimes makes people cringe. In April 2024, the Addiction Federation sounded the alarm by publishing an article titled: “Towards the first tobacco-free generation? Yes, but not without taking into account social inequalities.” Seven months later, concerns remain. “Overall, the measures proposed by the PNLT are very good. Regulations are being put in place and the situation is moving in the right direction, the objective of a first tobacco-free generation by 2032 seems achievable, concedes David Saint Vincent, member of the Addiction Federation office. But we must put this progress into perspective, because in the most precarious social categories, the rate of smoking stagnates or even increases slightly. Be careful that they are not forgotten in this project.”
The price increase divides
Among the precarious, those largely forgotten are especially adults already addicted to tobacco, who seem to be little taken into account by the PNLT measures. And the increase in the price of the package is the perfect example to illustrate this phenomenon. “It’s an interesting measure that works to repel young people, but for adults who already smoke, who are in a pro-smoking environment, it doesn’t work, explains David Saint Vincent. And if these people are already struggling financially, they might just end up spending even more money.”
An observation that Catherine Simonin, administrator of the National League Against Cancer, who is part of the PNLT coordination committee, does not share: “We can clearly see that tobacco is still widespread among the most disadvantaged populations. When it is too expensive, people stop and make an appointment with the tobacco specialist. Raising the price is not punishing them, but helping them, because if their health deteriorates, care will be even more expensive.”
“From education to health at all levels”
On the other hand, the two specialists agree on one point, there are gaps in awareness, whether on the consequences of smoking for health or on the solutions that exist to quit – such as the reimbursement of nicotine substitutes (patches, tablets, etc.) and appointments with the tobacco specialist. “We need to provide health education at all levels, not just among young people. If you quit smoking, it’s never too late to feel the benefits. supports the administrator of the National Cancer League. And on the side of the General Directorate of Health (DGS), member of the PNLT Steering Committee, we agree in the same direction: “The PNLT 2023-2027 aims to continue and intensify prevention campaigns aimed at stopping smoking.”
David Saint Vincent goes further in his criticism and points out communication which does not take into account the most disadvantaged social categories and contributes to widening inequalities. “The messages passed are not suitable for everyone. We must make more efforts to make quitting smoking more attractive, forgetting the codes of Parisian bohemianism and ensuring that we reach populations who, until now, did not feel concerned by prevention and awareness campaigns. awareness.” A parameter that the DGS seems to have taken into account since it announces that it is planning “to evaluate actions and develop communication processes by adapting certain messages according to the profiles of target populations and their level of information in order to improve their effectiveness”.
“Vicious circle”
If certain actors such as Fédération Addiction are concerned about measures which could leave the most precarious behind, the DGS points out that “the most precarious populations also have specific actions which will be deployed within the framework of the PLNT 2023-2027, for example the inclusion of the question of quitting smoking in all “moving towards” approaches with regard to towards these populations, as well as the promotion of smoking prevention actions with charitable associations and institutions supporting return to employment and retraining.
The challenge now is to take action as quickly as possible because, if inequalities continue to widen, the objective of a first tobacco-free generation from 2032 could be doomed. “It’s a vicious cycle. If vulnerable smokers are forgotten, they will pass on their bad habits to the younger people they frequent and all the profits gained will be lost. concludes David Saint Vincent.
