Ratified by France in 2004, the WHO Framework Convention on Tobacco Control (FCTC) was developed in response to the global spread of the tobacco epidemic.
Although tobacco control has been a public health priority for several decades, the results were not considered sufficient.
That is why France has recently adopted a number of measures, including:

• An increase in tobacco prices, which serves as a powerful deterrent to taking up smoking and a strong incentive for smokers to quit.

• Reimbursement for nicotine replacement therapies, which, since 2018, have been 65% reimbursable—like any other prescription medication. Supplemental health insurance plans cover the copayment for these medications.

• The implementation of a social marketing strategy (Smoke-Free Month, “pregnant woman” pictogram on cigarette packs, introduction of plain packaging with larger health warnings) to encourage and help smokers quit, reduce the appeal of tobacco among young people, and better inform pregnant women.

• A ban on smoking in public places and children’s playgrounds

• A ban on flavors and additives (such as menthol capsules) that are particularly appealing to young people.

• The creation of a tobacco prevention fund.

• The 2018–2022 National Tobacco Control Program, which outlines 28 actions to be implemented over the next five years.

Major Laws

The Veil Act of July 9, 1976, was the first major legislation explicitly aimed at combating the harmful effects of smoking. It primarily targeted advertising, established smoking bans in certain public spaces, and mandated the inclusion of the warning “Dangerous Abuse” on cigarette packs. This came 11 years after the United States, where health warnings first appeared on cigarette packs in 1965. This law helped stabilize tobacco consumption, which had been on the rise until then.

The Évin Law of January 10, 1991, concerning the fight against alcoholism and smoking, brought about a profound shift in social norms regarding smoking and led to a decline in consumption. It significantly strengthened the legislative framework:

• By promoting higher cigarette prices

• By establishing the principle of a smoking ban in public spaces (including train stations and public transportation, except in areas expressly designated for smokers; these areas are defined by decree)

• By banning all direct or indirect advertising for tobacco and tobacco products (including at all sporting events in France, and this applies to television broadcasts of events abroad, requiring networks to take all necessary measures to conceal such advertisements)

• By prohibiting any free distribution (except at tobacco retail outlets)

• By banning all tobacco-related sponsorship activities

• By prohibiting the sale of tobacco to those under 16

• By authorizing—under certain conditions—organizations involved in tobacco prevention to bring civil actions in court

The decree of November 15, 2006 (effective since February 1, 2007) amends the Évin Law and extends the smoking ban to other public spaces:

• All enclosed and covered public spaces or workplaces

• Healthcare facilities

• On all public transportation

• Throughout the entire premises (including open areas such as schoolyards) of public and private elementary, middle, and high schools, as well as facilities intended for the care, education, or housing of minors

Certain types of establishments (bars, hotels, restaurants, tobacco shops, casinos, gaming clubs, and nightclubs) had until January 1, 2008, to comply with the new regulations.

Ordinance No. 2016-623 of May 19, 2016, establishes plain
packaging. Introduced in 2016 (Ordinance No. 2016-623 of May 19, 2016, transposing Directive 2014/40/EU), plain packaging is characterized by:

• a single, uniform color for all cigarette and rolling tobacco packages, regardless of brand;

• the same rules for displaying the brand on packaging;

• combined health warnings (text and images) expanded to cover 65% of the package (compared to 30% to 40% previously), in accordance with the Tobacco Products Directive of April 3, 2014.

Public health policies

Tobacco prevention in France is addressed in public health laws as well as in government plans and cancer control plans.

Cancer plans

Since 2002 and the “war on tobacco” declared by President Jacques Chirac as part of Cancer Plan I (2003–2007), and since 2004 with the creation of the National Cancer Institute, the fight against smoking has expanded significantly. It was during this first Cancer Plan that sharp and repeated price increases (+42% between 2002 and 2004) took place to discourage tobacco use, and the Bertrand Decree of 2006 was enacted.

The 2004 Public Health Act included two objectives directly related to tobacco:

• to reduce the number of daily smokers (particularly among young people and social groups with high prevalence);

• to reduce secondhand smoke in recreational settings and the workplace, and to eliminate it entirely in schools.

The inclusion of illustrated health warnings on cigarette packs (decree of April 15, 2010), the strengthening of smoking cessation support policies (the reimbursement amount for nicotine replacement therapies increased from €50 to €150 for pregnant women in September 2011), and the strengthening of protections for minors against smoking (in 2009, the ban on sales to those under 18 was extended, replacing the previous ban on sales to those under 16) were thus implemented under Cancer Plan II (2009–2013).
A third Cancer Plan (2014–2019) was launched on February 4, 2014. Objective 10 of this plan calls for the implementation of the National Tobacco Reduction Program (PNRT).

The National Tobacco Reduction Program 2014–2019

This plan, launched in 2014, aimed to reduce the number of smokers by 10% over five years and was structured around three key areas of intervention:

• Protecting young people and preventing them from starting to smoke

• Helping smokers quit

• Addressing the tobacco economy.

Measures were implemented, such as the creation of a tobacco prevention fund.

The National Tobacco Control Program (PNLT) 2018–2022

is a continuation and expansion of the 2014–2019 National Tobacco Control Program, all of whose initiatives were completed before its conclusion.

The PNLT aims primarily to protect young people, combat social inequalities by supporting the most vulnerable, and provide support to women, particularly those who are pregnant.

The PNLT’s objectives are as follows:

• By 2020, reduce the proportion of daily smokers among 18- to 75-year-olds to less than 24%.

• By 2022, reduce the proportion of daily smokers among 18- to 75-year-olds to less than 22%.

• By 2022, reduce the proportion of daily smokers among 17-year-olds to less than 20%.

• By 2027, reduce the proportion of daily smokers among 18- to 75-year-olds to less than 16%, representing five million fewer smokers compared to 2017.

• By 2032, ensure that children born since 2014 become the first generation of non-smoking adults (<5% of smokers).

The PNLT outlines 28 actions to be implemented over the next five years.

Health warnings

In France, the health warnings or “warnings” that can be seen include:

• “Smoking kills”

• Tobacco smoke contains more than 70 carcinogens.

• Smoking causes 9 out of 10 lung cancers.

• Smoking causes mouth and throat cancer.

• Smoking damages your lungs.

• Smoking causes heart attacks.

• Smoking causes strokes and disabilities.

• Smoking clogs your arteries.

• Smoking increases the risk of going blind.

• Smoking damages your teeth and gums.

• Smoking can kill the baby you’re expecting.

• Your smoke is dangerous to your children, family, and friends.

• Children of smokers are more likely to become smokers themselves.

• Quit smoking: stay alive for your loved ones.

• Smoking reduces fertility.

• Smoking increases the risk of impotence.

Illustrated health warnings

Since April 2011, cigarette packs have also featured graphic color photos (as in a number of countries: Belgium, the United Kingdom, Australia, and Canada, etc.). Several images were selected from a list proposed by the European Union. The contact information for Tabac Info Service is also printed on the packs.