After decades of policies targetting illicit drugs, the French drug addiction policy has progressively switched to incorporate a concept of " addictive behavior ", including alchol, tobacco, pharmaceuticals and even behaviors such as gambling. Among the French general population, alcohol and tobacco uses are by far the most important health risk factors, with a very high burden of morbidity and mortality. Illicit drugs have very low prevalences except cannabis, with the highest prevalence in Europe, among adults as well as among adolescents. However, actions have long been implemented to tackle illicit drugs uses, in particular intraveinous drug use regarding its role in the HIV infection, with harm reduction tools such as opioids substitution treatments or needle exchange programs. While continuing this harm reduction policy, public authorities have strengthened measures towards alcohol, and moreover towards tobacco use with many legal and public health improvements. The goals are to reduce tobacco visibility (smoking bans in public places and even in pubs and restaurants), tobacco accessibility (price increase, ban on sales to minors...) and also to develop helps for those who wish to quit. The objective is to " denormalize " tobacco until there is a whole tobacco free generation in 2032 in France. One the one hand, this aim does not seem too irrealistic as the last general population survey results show a recent decrease in the tobacco smoking prevalence, as well as a decrease in social inequalities in tobacco use. One the other hand, the implementation of an harm reduction approach for alcohol, tobacco and cannabis remains to build.
Auteur : Beck François, Lermenier-Jeannet Aurélie, Nguyen-Thanh Viêt
Bulletin du Cancer, 2019, p. 1-9