Summary

In France, tobacco is the leading cause of preventable death and the leading risk factor for cancer. However, following an unprecedented decline in smoking rates between 2016 and 2019, prevalence has stabilized, with regional variations.

Despite these regional disparities, the characteristics of smokers remain largely consistent:

• the prevalence of daily smoking is much higher among people without a high school diploma or with a diploma below the high school level, among the unemployed compared to those who are employed, and among people with low incomes; these differences in prevalence lead to significant disparities in mortality and morbidity and highlight the persistence of health inequalities linked to tobacco use;

• the desire to quit smoking is associated with being male, being over 35 years of age, reporting financial hardship, experiencing a major depressive episode within the past year, and not reporting significant monthly binge drinking (API)*; Attempts to quit within the past year are associated with being male, being under 35 years of age, having a high school diploma or higher, and not reporting daily alcohol consumption. The desire to quit and attempts to quit are significantly less frequent among women, though the differences remain modest.

These characteristics show that it is important to continue adapting prevention measures, not only to encourage socio-economically vulnerable smokers to attempt to quit, but also to better help them turn these attempts into successful cessation.

This Grand Est epidemiological report, intended for regional stakeholders, aims to provide key regional indicators for the planning and evaluation of local tobacco prevention policies, based on data from the 2021 Santé publique France Barometer. An article addressing inter-regional comparisons will be published in the coming months.

Daily smoking in the Grand Est region in 2021:

• 27% of people aged 18–75 reported smoking daily, compared to 30% in 2017 (non-significant difference). The difference in smoking prevalence between men (28%) and women (27%) was small.

• The proportion of daily smokers remained higher among 18- to 30-year-olds (34%) and among people with low incomes (32%), as observed in 2017.

• The desire to quit smoking was reported by 58% of daily smokers, and 24% had attempted to quit within the past year.

Vaping in the Grand Est region in 2021:

• 39% of those aged 18–75 reported having tried vaping, with this rate being higher among those aged 18–30 (61%) and 31–45 (49%), and only 4% reported vaping daily.

* at least 6 drinks on a single occasion