France: The new anti-smoking plan does not fully appeal to associations

Presented this Tuesday morning by the Minister of Health, Aurélien Rousseau, during a press conference, the new National Tobacco Control Program 2023 – 2027 announces a series of measures intended to reduce tobacco consumption, which is still high in France. Anti-smoking associations accuse the government of having given in to the tobacconists' lobby by not including an ambitious tax component, a lever considered to be essential cost-effective in reducing prevalence.

While some of the planned measures had been recommended by civil society, such as the generalisation of plain packaging for all tobacco and vaping products or the extension of smoke-free areas, anti-smoking associations such as the National Committee against Smoking (CNCT) and the ACT-Alliance against Tobacco are surprised by the absence of a real tax trajectory for tobacco products.

A tax policy that is too feverish

Despite the statement by the Minister of Health, " the price lever is what works best ", the government announces that it will raise the price of a packet of cigarettes to €12 in 2025 and to €13 in 2026. An increase that is far too small to be effective according to the associations, which point out that to be effective, tax increases must be significant and repeated over time. This increase essentially corresponds to taking inflation into account. The CNCT recalls in its white paper that a continuous increase in taxes of 10% per year must be an integral part of any effective anti-smoking policy. This is particularly true for young people and working-class groups who are more sensitive to the financial cost dimension. For the association, this small increase in taxes is the result of significant lobbying by tobacconists, the main representatives of the interests of the tobacco industry.

Belgium has also unveiled its new national tobacco control plan and planned a significant increase in taxes on tobacco products, leading to a 25% increase in the retail price, an average increase of €2 per pack, from 1 January 2024.

Protecting yourself from interference from tobacco players

The Programme intends to continue implementing France's commitment to combating the influence of tobacco manufacturers in tobacco control policy in all sectors of the State, in accordance with Article 5.3 of the Framework Convention on Tobacco Control, ratified by France in 2004. In a press release[1], the CNCT specifies that it has been working for a long time to make the provisions of theArticle 5.3 with public decision-makers in order to protect public policies from interference by the industry and its allies, in particular the Confédération des buralistes. In France, the latter continues to lobby intensely to weaken, delay, or block all protective public health provisions.

A clear strengthening of measures around new nicotine products and industrial marketing

Several actions aimed at reducing the attractiveness of new nicotine products, particularly among young people, have been announced, in particular the generalization of plain packaging for all tobacco and vaping products. A strong measure that is still little applied on a global scale since only Israel has plain packaging for vaping products and all tobacco products (including heated tobacco). The Ministry of Health also wants to "limit" the attractive flavors present in vaping devices as well as for tobacco products currently not concerned. The issue of banning flavors had been raised in a report submitted to the public authorities by the CNCT reporting on the marketing deployed, which particularly targets the youngest.

Described as an "environmental and public health aberration," the ban on single-use and disposable vaping devices (puffs) has been included in the new plan and will be discussed in an accelerated procedure by parliamentarians starting this week. The government also wants to develop a coherent roadmap on the regulations applicable to all nicotine products, such as nicotine pouches.

Finally, with regard to tobacco products in the strict sense, it is planned to prohibit stalls in points of sale, that is to say, presenting products on shelves in view of all customers entering a tobacco store.

Expanding smoke-free spaces

The government intends to generalize the smoking ban on beaches, public parks, forests, and around certain public places, including schools, with the aim of denormalizing smoking in society. This is essentially the generalization of experiments successfully conducted in different municipalities in France. The establishment of smoke-free areas has also been shown to be effective in reducing illnesses and deaths caused by smoking and exposure to tobacco smoke.

Helping smokers quit smoking

One of the other key measures concerns access to validated nicotine replacement therapy (NRT) for smokers. The government wants to strengthen their accessibility by experimenting with the reimbursement of these medications from pharmacists, without a prescription, or by opening up remote prescriptions by health professionals from the "Tabac Info Service" system of Public Health France.

Emphasis will also be placed on prevention among vulnerable populations particularly affected by smoking.

Keywords: National Anti-Smoking Program, PNLT, anti-smoking associations, France, taxation, taxes, tobacco, lobby, plain packaging, smoke-free spaces

AE

[1] Press release, PNLT: France is moving away from its goal of a tobacco-free generationc, CNCT, published on November 28, 2023, consulted the same day