Tobacco in France: a major and rising social cost

Despite a decline in smoking prevalence, the social cost of tobacco in France in 2019 was estimated at €156 billion. This cost is unrelated to the taxes collected on tobacco sales. This new assessment, published by the French Observatory of Drugs and Addictive Trends (OFDT),[1] takes into account, in particular, the increase in life expectancy in France and a more refined calculation of the costs linked to tobacco.

It is still common to hear that tobacco is a financial windfall for the State, which collects taxes that represent approximately 90% of the price of tobacco products. While in 2019, tobacco taxes brought in €13.1 billion to the State and €2.8 billion in pensions were not paid due to premature tobacco-related deaths, tobacco-related health expenditures were €16.4 billion, to which must be added the €778 million invested in prevention, repression and social spending. Thus, in total, tobacco cost the State more than €1.6 billion in 2019, or €2.3 billion of the French public deficit.

According to the latest calculations conducted for the OFDT by economist Pierre Kopp, a professor at Paris 1 University, tobacco alone has an estimated annual social cost of €156 billion. Taking into account the French population, this social cost is approximately €2,300 per inhabitant, smoker or not, regardless of age.

A complex calculation

As with previous editions, the last one dating back to 2015 (with a social cost estimated at 120 billion euros for the year 2010), this estimate of the social cost of tobacco, alcohol and illicit drugs is based on a complex calculation based on numerous data, considered as external costs: medical costs due to the treatment of pathologies, production losses due to absences from work, but also years of life lost and loss of quality of life caused by pathologies.

Public expenditures on research, prevention, repression, and social action are also included in the costs. Private costs, particularly those incurred through the consumption of products, are not included in this total, which remains focused on public expenditures.

A more detailed consideration of tobacco-related costs

Several of the indicators taken into account have evolved or been refined, which explains variations with the amounts estimated in previous editions. The increase in life expectancy is one of the most important factors: this increase is reflected, on the one hand, in the number of years of life lost; it leads, on the other hand, to an increase in the years of life requiring care and including losses in quality of life. A more precise consideration of the different types of pathologies caused by tobacco, and not only those that lead to death, has also contributed to reassessing the various costs linked to tobacco. The total medical costs associated with tobacco were thus estimated at 16 billion euros in 2019.

The number of deaths caused by the use of these products is decisive in terms of years of life lost and loss of production, which explains the significantly higher social cost of tobacco compared to that of alcohol (102 billion euros) or illicit drugs (7.7 billion euros).

Limited comparisons with previous editions

According to the author, these new parameters and numerous methodological changes do not allow for a comparison of the social costs estimated based on 2019 data and those based on 2010 data.

The author also considers that the social costs of different products cannot be added together, as healthcare data do not allow for the identification of poly-consumer users. Current data, aligned with international standards for calculating social costs, therefore offer a more precise view of the real social cost of each of the product categories studied.

Keywords: OFDT, Pierre Kopp, social cost of drugs.

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[1] Kopp P, The social cost of drugs: estimate in France in 2019, OFDT, Notes, July 2023, 15 p.