Background and Objective. Among the many initiatives implemented in France since the 1991 Evin Law to combat smoking, the national health insurance system has offered partial reimbursement for smoking cessation medications, up to 50 EUR per beneficiary per year. The lack of impact of this measure on smoking prevalence raises questions about its ability to remove financial barriers to accessing medical smoking cessation and about the merits of 100% coverage. To inform public policymakers, this study aims to estimate the cost-effectiveness of 100% coverage for smoking cessation compared to the annual flat rate of €50, from the perspective of the health insurance system. Method. A Markov model was used to estimate the costs and survival of two cohorts of 1,000 smokers representative of daily smokers in France aged 15 to 75, one receiving 100% coverage and the other the current flat rate of 50 EUR. The cost-effectiveness of 100% coverage was estimated using the incremental cost-effectiveness ratio (ICER), expressed in euros per life-year gained (EUR/LYG), over the time horizon of each cohort’s life expectancy. Finally, a Monte Carlo-type probabilistic sensitivity analysis was conducted to account for uncertainty related to the model parameters. Results. The ICER for the 100% coverage strategy in the baseline scenario, compared to the current flat rate of 50 EUR, was 1,786 EUR/QALY. The sensitivity analysis showed that, in 99% of cases, the ICER was less than 2,725 EUR/QALY. Conclusion. Compared to other cardiovascular disease prevention measures reimbursed by health insurance, 100% coverage for smoking cessation appears to be the most cost-effective measure, which supports its implementation. (R.A.)