Tobacco: more than 68,000 deaths attributable in France in 2023

The latest estimates published by Public Health France[1] These figures confirm the continued major impact of smoking on mortality in France. In 2023, more than 68,000 premature deaths were attributable to it, representing nearly 11% of all deaths. Cancers accounted for more than half of these deaths, followed by cardiovascular and chronic respiratory diseases. Despite a slight decrease compared to previous years, the health burden remains considerable for a preventable cause, highlighting the need to continue and strengthen policies for the prevention and reduction of smoking.

Massive mortality, primarily from cancer.

In 2023, the estimated number of deaths attributable to smoking was just over 68,000, including 49,361 among men and 18,660 among women. Tobacco thus accounted for 16% of all male deaths and 6% of all female deaths.

Cancer is by far the leading cause of death attributable to tobacco. In 2023, nearly 39,000 cancer deaths were linked to smoking, representing 57% of all attributable deaths and more than one in five cancer deaths. While lung cancer remains the most well-known risk, the impact of tobacco extends to many other cancer sites: upper aerodigestive tract, pancreas, bladder, kidney, liver, stomach, colorectal, and leukemia. Cardiovascular diseases rank second with more than 14,000 attributable deaths (approximately 10% of cardiovascular deaths), ahead of chronic respiratory diseases (nearly 13,000 deaths), for which tobacco is implicated in more than a third of deaths. Deaths are also observed from acute respiratory illnesses and diabetes.

Taken together, these data reflect the very serious short- and long-term health consequences of smoking on all organs affected. In addition to these mortality statistics, there are also morbidity statistics, with hundreds of thousands of patients whose living conditions are significantly impaired due to smoking-related illnesses. By contributing to the development of numerous serious chronic diseases, tobacco permanently impairs quality of life, increases years lived with disability, and reduces life expectancy by approximately ten years for smokers.

Significant territorial inequalities

The impact of tobacco varies considerably across different regions. After standardizing for age and sex, the highest attributable mortality rates are observed in Hauts-de-France, Grand Est, and Corsica, with over 115 deaths per 100,000 inhabitants. Conversely, Île-de-France has the lowest rate in metropolitan France (83 per 100,000), a level approximately 40% lower than that observed in the most affected regions.

In the overseas territories, the situation appears more varied. The proportion of deaths attributable to tobacco is lower in Guadeloupe, Martinique, and French Guiana, where it remains below 5%, consistent with historically lower levels of consumption. Réunion, on the other hand, is approaching the levels of mainland France, with nearly 500 attributable deaths and a proportion of approximately 9% of total deaths. These differences reflect the social, economic, and historical determinants of smoking and underscore the need for targeted interventions.

A decline that is still too slow in the face of an avoidable burden

Current estimates are lower than those for 2015, when approximately 75,000 deaths were attributed to tobacco. This trend partly reflects the effects of prevention policies and the gradual decline in smoking among certain generations.

While France has committed to achieving a tobacco-free generation by 2032, these results serve as a reminder that every slowdown in public policy delays major health gains. High and sustained taxation, easier access to smoking cessation programs, protection of young people, strict enforcement of advertising and promotion bans, regulation of new nicotine products, and prevention of tobacco industry interference remain essential levers for sustainably reducing this rate.

Because these deaths are preventable, this situation underscores the need to continue and intensify ongoing efforts, as the National Committee Against Smoking (CNCT) points out. Achieving a faster decline, while also reducing excess mortality among certain more vulnerable population groups, requires maintaining strong, consistent, and evidence-based public policies. These policies combine a regular and significant increase in taxation, incentives and support for smokers, and strict enforcement of protective prohibitions, particularly for young people (sales to minors, advertising, aligned regulations for vaping products, and the elimination of the sale of prohibited products).

©Generation Without Tobacco

AE

[1] Press release, Smoking in France: 68,000 avoidable deaths in 2023, an encouraging decrease but still too great a burden, Public Health France, published on February 16, 2026, accessed the same day