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Why can’t the French stop smoking?

France has tougher smoking laws, but the French are still lighting up at rates more than double that of the U.S.

PARIS, France –  Seated on the terrace of a neighborhood café near Paris’s Canal Saint-Martin, Fabien Jannic-Cherbonnel lights up a cigarette. With just two years as a smoker, the 24-year-old is a relative rarity in France, where the majority of smokers take up the habit in their early teens.
“I started smoking because I thought it was cool,” says Mr. Jannic-Cherbonnel, who began during an internship after college. He says the motivations were largely social. “No one came up to me forcing me to smoke. But I’m a very social person and everyone would go downstairs for their coffee and clope [cigarette] break. I didn’t want to be left out,” he says, adding that it made him “feel more adult.”

Tobacco-related illnesses remain the leading cause of death here, with an estimated 73,000 deaths annually. And despite increased taxes on cigarette sales, health warnings, and smoking bans, France counts nearly 16 million smokers.

That puts the country above average for adults who smoke in Europe – and well above the US. According to a report released in early December by the World Health Organization, 28 percent of European adults smoked daily in 2011, compared to 31 percent of French adults. Only 14 percent of American adults smoked daily in the same year.

And the number of women in France who smoke slowly rose over the past several years, with their usage increasing 3 percent between 2005 and 2011.

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The French government is aware of the public health problem on its hands. Cigarette packs are required to carry menacing warnings about health risks and often contain stomach-turning photos of the effects of smoking. Starting last month, the government levied an additional 20 cent tax on cigarette packs, in hopes of deterring purchases.

“The French are great at making laws, but no one follows them,” says Yves Martinet, president of the national committee against smoking, CNCT. The government’s plan to target people’s pocketbooks – the tax will put most cigarette packs at 7 euros, or about $9.50 – won’t be effective because people will always find ways of circumventing it, Mr. Martinet says.
“This isn’t going to change much in how many people smoke in France,” he says. “France is surrounded by countries like Luxembourg and Spain, where tobacco costs less.”
Jannic-Cherbonnel agrees. He says his urge to smoke is beyond any scare tactic, price hike, or substitute.
“We know everything there is to know about the risks of smoking, but we just don’t care,” he says.

There is something inherently French in resisting leadership and laws designed to influence behavior, says Bruno Pequignot, a sociology professor at the Sorbonne Nouvelle University in Paris. 
“The French love to hate their government. It has become a French tradition,” says Mr. Pequignot. “There is surely a link to our history [of ousting and subsequently beheading King Louis XVI in the late 1800s] but it also has to do with the public being very disillusioned with what the government can and can’t accomplish.”

This rebellious spirit could explain why fear-mongering campaigns haven’t made a big dent in smoking here. Martinet from CNCT says tobacconists continue to sell cigarettes to minors, and cafés consistently outsmart the indoor smoking ban by encasing their outdoor terraces in giant plastic sheaths – and allowing smoking.

Game-changer or unhealthy substitute?

Some view the emergence of the electronic cigarette as a positive move away from traditional smoking. It doesn’t produce second-hand smoke, for example, and a 2013 study led by researchers in the Czech Republic showed that e-cigarettes were effective in reducing smoking. 

The e-cigarette market has exploded over the past two years in France. For a fraction of the cost of a pack of cigarettes, smokers can choose an e-liquid flavor, preferred level of nicotine, and even personalize the baton.

“It is highly desirable for e-cigarettes to become trendy so they replace cigarettes and stop the tobacco epidemic of smoking-related disease and death,” says Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University of London, who led the Czech study. His team, funded by the American Science Information Center, found that e-cigarettes were “90 to 100” percent safer than ordinary cigarettes.

Arnaud Dumas de Rauly is the assistant secretary general of CACE, an organization that supports e-cigarette professionals in France. He estimates there are around 1,700 e-cigarette shops in the country and more than 150 in Paris, with 15 percent growth each month.

About 10 million – or one in five – French people have tried e-cigarettes, according to a December 2013 poll led by Ipsos, a private French research center.

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“We really want to make e-cigarettes a professional industry, with norms and certifications,” says Mr. Dumas de Rauly.

But the trendiness of the product and the lack of conclusive information on the safety of e-liquids have some officials squirming. In November, France’s Health Minister Marisol Touraine called for a study into the potential health risks of e-cigarettes, which is now underway.

Whether they’re safer or not, sociology professor Pequignot, a cigar smoker himself, says the trend won’t last in the long run, especially among heavy smokers.

“We all know smoking gives you cancer, but in the immediate moment, it’s a guaranteed pleasure,” Pequignot says. “There are so many things that are bad for you. Smoking is just one of them.”
For Jannic-Cherbonnel, it will take a shift away from the romantic image of lighting a cigarette at a neighborhood café, sipping espresso, and reading Proust before French people finally quit smoking on a large scale. But it could happen.
“When everyone around you stops smoking, it’s not cool anymore. You’re just that person who has to leave the party to go smoke.”

To be sure, France has come a long way in its smoking habits. Twenty years ago, the cigarette was allowed pretty much everywhere: the boardroom, the public bus, even on airplanes. Now, smoking is banned indoors, and electronic cigarettes are gaining in popularity as an alternative: The battery-operated baton mimics the act of smoking but expels a tobacco-free vapor and can be used indoors. But will that be enough to stamp out a habit so deeply ingrained in France?