Stabilization of smoking in France in 2020

The French Public Health Barometer indicates a pause in the decline in smoking, but an increase in smoking among disadvantaged populations, prior to the COVID-19 crisis.

Unveiled on the occasion of World No Tobacco Day on May 31, the latest figures on tobacco consumption published by Public Health France sound a warning. After several years of declining smoking prevalence between 2014 and 2019, they show a relative stagnation in consumption and confirm the weight of social disparities.

Increase in daily smoking among disadvantaged populations

The 2020 edition of the French Public Health Barometer was, due to the health crisis, exceptionally carried out in two stages, first from January 8 to March 16, 2020, then from June 4 to July 28 [1]. In total, 14,873 people were interviewed, making it one of the main large-scale surveys in France, although it is based on self-reported data. This year, 76-85 year-olds were included in the survey; for the sake of comparison with previous years, the results are mainly analyzed for the 18-75 age group.

In 2020, 31.8% of 18-75 year olds declared themselves to be smokers (36.2% of men and 27.7% of women); 25.5% were daily smokers (29.1% of men and 22% of women), while there were only 24% in 2019. This increase was deemed insignificant by the authors, who, however, point to a significant increase (from 29.8% to 33.3%) in daily smoking among the third of the population with the lowest incomes. This variation is seen both in terms of monthly household income and in the level of education or professional activity of the respondents. The prevalence of daily smoking decreases as monthly household income rises.

Regarding the electronic cigarette, the proportion of people who have already tried it increased from 34.4% in 2019 to 37.4% in 2020; 5.4% of people reported current use and 4.3% daily use, similar to 2019.

A trend that predates the health crisis

The interpretation of these results minimizes the impact of the 2020 lockdown on these increases in consumption. Most of the survey took place before the first lockdown, leading the authors to estimate that the increase in consumption occurred between 2019 and March 2020. They attribute this increase to the context of the social crisis, which has been noticeable since the end of 2018 with the Yellow Vest movement and affects disadvantaged communities more. They conclude that it is necessary to re-establish the conditions favorable to a decrease in smoking, by strengthening actions aimed at the most vulnerable populations.

Other studies have also shown that the consequences of the first lockdown on tobacco consumption were very variable: some people increased their consumption, but many reduced or stopped their tobacco use during this period. In the spring of 2020, the decline in consumption continued. A year later, the impact of the new lockdowns and the length of the health crisis, however, seem to have increased the consumption of tobacco (and psychotropic medication) among the most psychologically fragile people [2]. A trend that will only truly be verified through the studies that Public Health France will publish in 2022.

Keywords: Health Barometer, France, Covid-19, Health crisis, tobacco consumption, prevalence,