France: Plain packaging?

March 12, 2012

The French government has been given a 10 point plan to tackle the country’s high prevalence of smoking, which at 29% is the highest in Europe. The aim is to halve tobacco consumption by 2025.

A report commissioned by the Ministry of Health and delivered to parliament on 1 March calls for a cross department policy to reduce dependence on tobacco in France, to be led by the prime minister. It recommends a new tax on tobacco companies, according to their volume of sales, and ringfencing a portion of tobacco sales taxes to pay for preventive and treatment strategies.

The report also calls for price rises and plain packaging for all tobacco products. The French policy of compensating tobacco retailers for falls in sales should also be abandoned, says the report.

The report is in line with an opinion paper from the French High Council for Public Health, released on 25 January, which recommended increasing taxes on tobacco by at least 10% instead of the average 6% during recent years.

Yves Bur, an MP for Bas-Rhin in Alsace, who wrote the report, told the BMJ that the government’s tobacco strategy over the past decade has been “disappointing,” littered with “contradictory policies.” An antitobacco hardliner, Mr Bur is a member of the Union pour un Mouvement Populaire (UMP), the right wing party of Nicolas Sarkozy.

Despite key measures in recent years, such as a 40% rise in the prices of cigarettes in 2003-4 and a ban on smoking in public places in 2008, smoking among the French population has been rising since 2003 after 20 years of falling prevalence. It rose by 2% between 2005 and 2010 to 29%. In the UK about 22% of adults smoke.

Smoking peaks among 20-25 years olds, with rates of 43% in men in this group and 39% in women. The rates among 15-19 years olds are 27% and 21%, respectively.

“Tobacco kills 60 000 people each year in France, three times more than road accidents. However, fighting tobacco has never been a public health priority,” said Mr Bur.

He added, “The tobacco industry always intervenes to delay measures and decisions. It interferes through politicians and by claiming that tobacco retailers are part of local business which should be protected. Yet tobacco retailers have seen their turnover increase by 35% since 2002 [because of price increases], and since 2003 the state has paid them a total of €1.1bn [£0.9bn; $1.5bn] as compensation for the increase in the price of tobacco. So the state spends money to maintain a pool of smokers.”

Responding to the report, the health minister, Xavier Bertrand, said that he was “more determined than ever” to reduce tobacco dependence.

However, with a presidential election looming on 22 April to 6 May, followed by general elections in June, some politicians may be reluctant to confront the powerful tobacco lobby. On 2 March the French Society of Public Health called for all presidential candidates to take a stand on tobacco control.

Source: BMJ 2012;344:e1647 (March 6, 2012)