France remains addicted to tobacco. Cigarette sales have been increasing since January, despite the introduction of the neutral package. And nearly a third of the population smokes. Yet countries like Ireland and Australia have managed to convince their people not to smoke. How did they do it?
The number of cigarettes sold in France increased by 21.1% between January and July, despite the introduction of the neutral package. It is too early to draw any conclusions about the effectiveness of this government measure. However, France still has more smokers than many Western countries – one third of its population.
The weekly epidemiological bulletin (BEH) published on 30 May by the French public health agency, Agence Santé publique France, stated that the proportion is ”significantly higher than in neighbouring countries. Germany has about a quarter of smokers, such as Spain, Belgium and the Netherlands. Italy and Great Britain have about one-fifth of them. »
Globally, the number of tobacco victims, revealed on 5 April, 6.4 million deaths in 2015 alone, is alarming. Between 1990 and 2015, the number of deaths attributed to tobacco use increased by 4.7% worldwide, according to the Global Burden of Disease study conducted by a global consortium of hundreds of scientists and published in The Lancet. One in four men and one in 20 women smoke every day.
Yet a handful of countries like Ireland and Australia, or a nation like Scotland (Great Britain), have managed to dissuade their inhabitants from smoking. How did they do it? By deploying a wide range of radical measures, which now set an example to combat nicotine addiction.
France has already adopted one of these measures, the neutral cigarette package, which has been in force since 1 January. But our country is now in the middle of the ford. If it does not act simultaneously on the other levers, in particular by imposing a succession of very sharp price increases, the results may well… not be there.
180 signatory countries to the smoke-free treaty
One out of every two smokers will die from smoking, says the World Health Organization (WHO). The economic cost of tobacco-related diseases worldwide is estimated at $422 billion (about’ 400 billion), according to a study published on 4 January in Tobacco Control magazine. It is therefore understandable that the WHO urged governments, as early as 2003, to discuss together how best to combat this scourge. To date, 180 countries have ratified the United Nations treaty on tobacco control, the Framework Convention on Tobacco Control.
The strategy adopted by the Convention is based on banning tobacco advertising, raising prices through taxes, protecting non-smokers from passive smoking, educating and informing about the dangers of tobacco, and helping to stop smoking.
Fighting Tobacco Industry Strategies
In 2016, the 7th Conference of the Parties to the Convention (i. e. ratifying countries), COP7, also called for combating ”tobacco industry strategies that undermine or distort tobacco control”.
Dublin introduced a ban on smoking in public and collective places in 2004. Its smoke-free law is considered to be one of the strictest in the world.
Among the signatories, some have distinguished themselves by achieving the feat of making young people’s cigarettes look old-fashioned and discouraging the vast majority of adults from smoking. Ireland, for starters. The Dublin government introduced a ban on smoking in public and collective places in 2004. Its smoke-free law is considered to be one of the strictest in the world, as it bans bars, pubs, restaurants, clubs, but also workplaces, public buildings, company vehicles, trucks, taxis and vans. In addition, it extends to a perimeter within 3 metres of these sites.
In pubs, improvements in air quality and improved respiratory function of customers and bartenders are evidenced by several studies, such as the one conducted a year after the ban, the report of the Irish Tobacco Control Authority or the Irish Department of Health.
Fall in the proportion of smokers in Ireland
The application of the smoke-free law has brought the smoking prevalence rate in Ireland down rapidly from 29% in 2004 to 18.6% by 2016, according to the Irish Ministry of Health. By comparison, this rate has only slightly decreased in France, from 30% in 2004 to 28% in 2016 – it has been stable since 2014, according to the French Monitoring Centre for Drugs and Drug Addiction (OFDT). The next target is ”Ireland without tobacco” in 2025, i. e. less than 5% of smokers in the population.
Scotland followed Ireland closely, voting two years after the ban on smoking in public and community places. Its application reduced the prevalence rate of smoking among Scots from 26.5% in 2004 to 21% in 2016. In 2016, Scotland went further by banning adults from smoking in their cars in the presence of underage children. This should save 60,000 children a year from the risks of passive smoking,”said MP Jim Hume, who initiated the legislation.
Australia adopted the neutral cigarette package in 2012.
Another tobacco control champion is Australia. The main strength of this country? Adoption of the neutral cigarette package in 2012. The already moderate smoking prevalence rate decreased further from 16.1% in 2011-12 to 14.7% in 2014-15.
This country now intends to combine the neutral package with an annual tax increase of 12.5% each year for four years. The package of cigarettes, currently at €16.80, will then increase to €27… €27 in 2020. The goal is to fall below 10% of smokers by 2018.
Tobacco industry fights back
With their aggressive anti-smoking policies, these countries elicit reactions from tobacco manufacturers. The manufacturers, known as Big Tobacco for the five largest companies (Imperial Tobacco, British American Tobacco, Philip Morris, Japan Tobacco International, China Tobacco), are suing countries adopting, for example, the neutral package. They are suing for infringement of intellectual property and freedom of trade as well as for the risk of counterfeiting, on the grounds that these packages are easier to copy.
For example, Japan Tobacco International filed a complaint in Ireland against the neutral package in 2015. The decision has not yet been rendered.
On 4 May 2016, the European Court of Justice (ECJ) rejected Philip Morris International and British American Tobacco’s action against the new European law generalising the neutral package.
In France, the site of the Seita cigarette factory, a subsidiary of Imperial Tobacco, in Carquefou, near Nantes, closed in January 2015.
Philip Morris dismissed complaint against the neutral package
In Australia, Philip Morris was dismissed from a similar complaint in December 2015 by the Investment Arbitration Tribunal over intellectual property rights. He was condemned to remove the logo and renounce the graphic charter of his brands.
In France, where are we? In the early 2000s, our country first played a role in raising prices, which caused tobacco sales to fall by about a third. As Professor Gérard Dubois points out in the Journal of Respiratory Diseases, the sharp rise in tobacco prices in 2003 (8.3% in January, 18% in October) and then in 2004 (8.5% in January) led to a 12% drop in smoking prevalence over the same period, with the number of smokers falling from 15.3 million to 13.5 million.
Subsequently, the increases, which were much more moderate, had very little effect, as shown by the study published in 2013 by the epidemiologist at the Gustave Roussy Institute Catherine Hill. On this point, the February 2016 Court of Auditors’ report is clear:”Stronger and more continuous price increases must be imposed. The Court of Auditors therefore recommends that a policy of sustained price increases be implemented over time by using the tax tool at a sufficient level to bring about an effective and lasting reduction in consumption. Exactly what was decided in Australia.
Price increases too modest in France
France is still a long way off the mark. On 20 February, the price of rolling tobacco rose by an average of 15%, or between €1 and €1.50 per package. For their part, cigarette packages continue to sell for between €6.50 and €7, with manufacturers having waived price increases despite tax increases.
On 10 March, it was the decision taken to increase only the price of the cheapest cigarettes, with an increase of 10 to 20 euro cents per package. Prime Minister Édouard Philippe, however, made a commitment in his general policy speech on 4 July to raise the price of the package from around €7 to around €10.
The neutral package alone is unlikely to ultimately lead to a reduction in the proportion of smokers. Indeed, it is the combination of several measures that leads to efficiency. If France wants to hope one day to serve as an example for other countries in its tobacco control efforts, it will have to learn from countries such as Australia or Ireland and take other much more radical steps.