What We Do
Smoking is the leading cause of preventable death in France and is one of the main risk factors for cancer, cardiovascular disease, and respiratory diseases. The prevalence of smoking declined overall from the 1970s through 2005. Since the launch of the first National Plan to Reduce Smoking (PNRT) in 2014, the prevalence of daily smoking among 18- to 75-year-olds has fallen from 25% to 18% in 2024.
Men continue to smoke more than women, but over the long term, the gap has narrowed considerably. Smoking is also a marker of social inequality: in 2024, 21% of daily smokers were among those without a high school diploma or with a diploma below the high school level, compared to 13% among those with a diploma above the high school level.
In this context, the public health challenges are:
to continue regularly measuring smoking prevalence in France and to study its determinants
to develop initiatives targeting smokers to encourage and help them quit, as well as initiatives aimed at young people to discourage them from starting
to reduce smoking rates among the most disadvantaged social groups.
Monitoring trends in smoking and its consequences
One of Santé publique France’s missions, in collaboration with other stakeholders, is to generate knowledge that informs action. To help design and evaluate public policies to combat tobacco use, two levels of surveillance are implemented at Santé publique France: studies measuring smoking behavior and those focused on monitoring its consequences. These systems enable, in particular:
regularly measure morbidity and mortality attributable to smoking
provide national and regional estimates of smoking prevalence (every two years starting in 2024)
to assess the impact of tobacco prevention initiatives.
The goal is also to make these surveillance data available to regional partners so they can adapt tobacco control policies at the regional level.
Behavioral data are derived from various surveys conducted by Santé publique France and its partners.
The Santé publique France Health Barometers are telephone surveys designed to measure the health-related knowledge, attitudes, beliefs, and behaviors of people living in France. Established in the 1990s by the French Committee for Health Education (CFES), they are now conducted by Santé publique France and provide a wide range of health indicators, thereby contributing to the development of public policies at both the national and regional levels. More than twenty editions have been published to date, covering topics such as addiction, nutrition, mental health, cancer, infectious diseases, sexual health, and more. The Santé publique France Barometers enable the analysis of health behaviors according to criteria such as age, gender, and socioeconomic status... key information for defining the targets of social marketing initiatives.
Since 2014, the Santé publique France Barometers have made it possible to estimate annually the prevalence of smoking among adults in France, a key indicator during a period of strong public commitment to the fight against smoking.
Learn more:
The prevalence of smoking among young people is primarily measured through surveys conducted by the French Monitoring Center for Drugs and Drug Addiction (OFDT), namely:
The EnCLASS survey is a merger of the HBSC (Health Behaviour in School-aged Children) and ESPAD (European School Survey Project on Alcohol and Other Drugs) surveys. It was conducted in 2018 by the French Monitoring Center for Drugs and Drug Addiction (OFDT) and the medical department of the Toulouse Regional Education Authority, with support from UMR1027 Inserm-Université Toulouse III and contributions from the French Ministry of National Education (DGESCO, DEPP).In 2018, this survey involved nearly 14,000 middle school students, 8,400 high school students, and 900 fifth-grade students. Compared to previous surveys, the online data collection and larger sample size will allow each major region to compare key indicators with those of the rest of France.
The Escapad survey was launched in 2000 by the French Monitoring Center for Drugs and Drug Addiction (OFDT) in partnership with the Directorate for National Service and Youth (DSNJ). The survey is conducted during Defense and Citizenship Day (JDC) and focuses on late adolescence. It provides an overview of psychoactive substance use among 17- and 18-year-olds and, thanks to its repeated administration using the same methodology, tracks changes in these patterns during late adolescence in metropolitan France and in the overseas departments and territories.
Prevention initiatives to encourage smoking cessation
Santé publique France, together with its partners, designs and/or implements initiatives or programs to encourage and help smokers quit:
Smoke-Free Month is a national campaign to support smoking cessation that has been organized since 2016 and is part of a social marketing initiative. It is a collective challenge aimed at encouraging and supporting smokers in their efforts to quit smoking for 30 days, from November 1 to 30 each year, through community-based communication and prevention initiatives. Tobacco-Free Month takes place in two phases:
during the month of October, a large-scale communication campaign is launched (television, radio, billboards, internet, etc.) and awareness-raising activities are organized to recruit participants: information days (for company employees, students, schoolchildren, healthcare staff and patients, pregnant women, etc.), smoking status assessments, and smoking cessation consultations...
During the month of November, support initiatives are implemented to assist with quitting smoking: smoking cessation workshops, events, sports challenges, flash mobs...
Led nationally by Santé publique France, Tobacco-Free Month is organized in each region by the Regional Health Agencies (ARS), with the support of a regional ambassador organization, a steering committee, and the ARS’s partners in the fight against smoking.
Other communication campaigns are regularly launched by Santé publique France, for example during the “New Year’s resolutions” period in January or on World No Tobacco Day on May 31.
Tabac Info Service is a multi-channel remote support service
The 39 89 hotline (free service + cost of a call), available Monday through Saturday from 8 a.m. to 8 p.m., offers support from the same tobacco specialist throughout the smoking cessation process via phone appointments.
A personalized e-coaching program that provides advice from tobacco specialists through notifications and activities. E-coaching is available in app stores and as a desktop version
The website offers information on smoking, its consequences, and treatments, as well as the opportunity to ask a tobacco specialist a question and access a directory of tobacco specialists.
A Facebook page where you can connect with a supportive community of former smokers and smokers who want to quit.
Initiatives to Prevent Youth from Taking Up Smoking
Santé publique France supports the implementation of programs aimed at reducing the appeal of tobacco among young people, preventing them from taking up smoking, and supporting those who quit.
For example, the Assist program (A Stop Smoking in Schools Trial), which has been in effect in the United Kingdom since the early 2000s, has been piloted in France. This school-based program, designed for 12- to 13-year-olds (7th graders), aims to reduce smoking initiation through the influence of influential peers (“ambassadors”) identified by the students themselves. Once trained, the peer ambassadors’ role is to influence their classmates during their daily interactions and, in particular, to dissuade them from starting to smoke.
The effectiveness of this program has been demonstrated in the United Kingdom; its acceptability and feasibility have been established in the French context.
In addition, Santé publique France supports the rollout and monitoring of several prevention programs that have been proven effective in preventing, delaying, or limiting young people’s initiation into smoking: GBG [Good Behavior Game], Panjo, and PSFP [Family and Parenting Support Program]. More generally, Santé publique France is deeply committed, alongside the ministries responsible for Health and National Education, to implementing the National Intersectoral Strategy for the Development of Psychosocial Skills in Children and Youth.
Furthermore, the Directorate General for Health, which leads the development of evidence-based prevention in line with the recommendations of the National Health Strategy, has tasked Santé publique France with establishing a French registry of validated or promising interventions, where evidence-based interventions regarding smoking can be consulted.
Santé publique France develops:
Communication tools on smoking, its consequences, and its treatments, intended for the general public
Universally accessible communication tools on smoking. These include a booklet and a series of four videos covering motivations for quitting, addiction, effective treatments, and smoking cessation for pregnant women.
Sharing knowledge and expertise internationally
Since 2022, Santé publique France has been developing an International Knowledge Center on Tobacco, in accordance with Article 12 of the World Health Organization Framework Convention on Tobacco Control (FCTC). Established in partnership with the WHO and the Ministry of Health, the Center targets decision-makers and professionals (including civil society organizations) working in the field of tobacco control.
Objectives
The objective of the Knowledge Hub is to promote knowledge transfer among stakeholders, primarily from countries that are signatories to the FCTC, in order to strengthen the implementation of effective education, communication, training, and social marketing initiatives in the fight against tobacco.
WHO FCTC Knowledge Hub for Public Awareness : a dedicated website
The Knowledge Hub’s website offers content in French and English and is continuously updated to contribute to knowledge-sharing among FCTC Parties.
It compiles a list of information, prevention, and social marketing initiatives that have already been implemented and proven effective. It provides methodological resources for their implementation and evaluation. The Agency is thus gradually developing training programs, seminars, and other methodological tools aimed at helping Parties that wish to do so strengthen their capabilities in these areas.
Through the Knowledge Center, Santé publique France also offers customized technical assistance to the Parties to the FCTC to support them in implementing and evaluating actions related to Article 12 of the Convention, upon request.
Information accessible to everyone
Health prevention accessible to everyone
In relation to
COPD and chronic respiratory failure
thematic dossier
Chronic obstructive pulmonary disease is a chronic respiratory condition caused, in the vast majority of cases, by smoking. It has a significant impact on patients’ quality of life.
thematic dossier
Cardiovascular disease and stroke
Les maladies cardio-neuro-vasculaires regroupent un ensemble de troubles affectant le cœur et les vaisseaux sanguins.
