Smoking, a social marker

In France, like in many other countries, smoking is a social marker and particularly concerns disadvantaged populations, regardless of the indicator used: income, education, professional activity. The latest consumption data published in the Weekly Epidemiological Bulletin of Public Health France^[1] confirm this situation despite recent changes. The evolution since 2000, highlights that smoking remains a powerful social marker. So, as examples:

• In 2000, the wealthiest segment of the French population had 28.31% smokers, compared to 21.11% in 2018, a decrease of 7.2 points.
• At the same time, the least well-off segment of the French population increased from 31.41% to 32.61% smokers, an increase of 1.2 points.

Take examples with professional activity: the importance of smoking among the unemployed and also according to the level of education. Several factors explain this situation including a lesser effectiveness of prevention messages for these people, lesser protection concerning smoking ban measures in the workplace for people who do not benefit from such a professional activity, an environment generally more smoker with a very strong smoking norm, lack of support for cessation treatments until recently, long-standing smoking associated with indicators of strong dependence, etc. It follows that today, smoking constitutes the main factor of social inequality in terms of health with excess mortality among these social categories in particular explainable by tobacco. This situation has thus led to the observation of a double penalty: " The poorer you are, the more you smoke. The poorer you are, the more harmful tobacco is.^[2] »This observation further legitimizes the need to implement all measures to reduce tobacco consumption, particularly those for which the effectiveness among these categories of the population is particularly relevant: strong tax policy, support for quitting, expansion of smoke-free places, de-trivialization of smoking. ©Generation Without Tobacco

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^[1] https://www.oncorif.fr/wp-content/uploads/2019/05/BEH_2019_15.pdf ^[2] Tobacco: a threat to development. https://cnct.fr/wp-content/uploads/2018/11/20170519_113532dp_cnct_jmst2017.pdf | ©National Committee Against Smoking |