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 epidemiological report on the Pays de la Loire region, intended for regional stakeholders, aims to provide key regional indicators for planning and evaluating local tobacco prevention policies, based on data from the 2021 Public Health France Barometer. An article addressing interregional comparisons will be published in the coming months.

Daily smoking in the Pays de la Loire region in 2021:

• 22% of people aged 18–75 reported smoking daily (25% of men – 20% of women). Smoking prevalence remained stable compared to 2017. A non-significant downward trend in daily smoking was nevertheless observed between 2017 and 2021 among women (-1.9 percentage points) and in the 18–30 age group (32% versus 25%, or -6.8 percentage points). Among low-income adults, one-third were daily smokers (+1.7 percentage points).

• The desire to quit smoking was reported by 60% of daily smokers, and 32% had attempted to quit within the past year.

Vaping in the Pays de la Loire region in 2021:

• 38% of 18- to 75-year-olds reported having tried vaping, primarily those aged 18 to 30 (61%). Only 6% reported vaping daily.

* at least 6 drinks on a single occasion