Trends in tobacco smoking and consequences on health in France.
OBJECTIVE
This paper describes the trends in tobacco sales and smoking prevalence in the French population, estimates the consequences of smoking on the mortality of this population, and discusses governmental actions: anti-tobacco campaigns, a ban on advertising, restriction of smoking in public places, and price increases.


METHODS
Sales data were collected from the French tobacco monopoly, smoking prevalence data from surveys conducted by several institutes, and mortality statistics by cause from the Institut National de la Santé et de la Recherche Médicale.


RESULTS
Tobacco sales increased from 3 g per adult per day at the beginning of the century to a maximum of 6.8 g in 1975, then decreased by 10% between 1991 and 1996. Since the early 1950s, the proportion of smokers has been on the decline in the male population and on the increase in the female population. In France, 60,000 deaths are attributable to tobacco smoking. These deaths represent 12% of the total mortality. The advertising ban has been enforced and the recent price increase has led to a drop in sales.


CONCLUSIONS
The consequences of tobacco smoking on the health of the female French population will increase for another 30 years, because of the increase in female smoking observed in the recent past, whereas the epidemic is leveling off in the male population.
Département de Biostatistique et d'Epidémiologie, Institut Gustave Roussy, Villejuif, France. hill@igr.fr
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D000328:Adult; D002423:Cause of Death; D003431:Cross-Cultural Comparison; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000517:prevention & control; D008297:Male; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality / Q000639:trends; D016540:Smoking Cessation