“We must move forward on the path to reducing risks”

LAddictive behaviors affect us all. They have a significant impact on public health and cause a deterioration in the quality of life as well as serious family, social and professional handicaps. Alcohol is responsible for 49,000 deaths per year in France, and cigarettes are responsible for 75,000 deaths. This is why, since the 1er November, the 8e edition of No Tobacco Month. This support is essential, because quitting smoking for a month increases the chances of quitting cigarettes by five.

However, if Public Health France recalls that 1.2 million people have participated in the operation since its creation, it is clear that the number of smokers is no longer decreasing. France still has 15 million. Multiplying the price of the pack by three in twenty years only reduced smoking prevalence by four points; far from the objective of reducing the number of smokers. How can we see anything other than a failure?

The time has come to no longer punish smokers, but to understand and support them. We must face this reality in the face to put an end to the tyranny of the ideal and propose what already works abroad. In October, African Global Health brought together the 2e African conference on health risk reduction, whose participants, coming from more than 80 countries, addressed in particular the management of addiction.

Read also: Tobacco: with one in four adults smoking daily, consumption remains stable in France

Applying a risk reduction policy is also the conclusion of a recently published report from the Parliamentary Office for the Evaluation of Scientific and Technological Choices (OPECST). Deputies and senators recognize that a smoker does not always have the ability to quit their nicotine addiction, and that a third way, complementary to prevention and withdrawal, has its place. They note that this strategy, as close as possible to the expectations of addicted people, has already proven itself for the management of other addictions (notably heroin addiction), and abroad, such as in the United Kingdom and Sweden, for smoking.

As early as 2019, another assembly, the Economic, Social and Environmental Council (CESE), already called for the establishment of a risk reduction policy for alcohol and tobacco. The recent alcohol prevention campaign “It’s the base” shows that this is starting to be done for alcohol, but nothing about smoking!

“Vape bashing”

Concretely, how to do it? If nothing is ever simple when it comes to health, especially when it comes to addictions, there is no shortage of avenues. Alongside recognized nicotine replacement treatments (gums, patches, etc.), “emerging products”, as the World Health Organization calls them, can offer credible options to smokers to quit cigarettes and reduce the risk of developing diseases linked to smoking with combustion. Each of these new products can correspond to a smoker profile, depending on their habituation. OPECST also specifies that aromas, other than that of tobacco, can play a key role.

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