The fight against smoking: what strategy?

Two strategies are currently in conflict to meet the public health challenge of the fight against smoking. On the one hand, the zero-tobacco method, which aims to completely eliminate tobacco consumption, even if it means implementing coercive levers (prohibition, price increase, aggressive communication, etc.); on the other hand, a method known as risk reduction (or harm reduction ), whose objective is to minimize the harmful impact of smoking on health. Overview

Smoking is a global scourge,

who kills every year more of 7 million people worldwide, according to the World Health Organization (WHO) . For several decades, the authorities have tried to stem cigarette consumption, through various legislation and communication campaigns. Acting on cigarette consumption is therefore the most powerful lever in terms of public health, to save lives and improve the health of millions of people.

In France, if the increases of prices associated with the measures of the Evin law (which prohibits in particular the consumption of tobacco in the public places), made it possible to make disappear the tobacco of the coffees and restaurants, the effects on the consumption are still too weak: in 2016, 22.4% of French adults used tobacco daily, for a European average of 21% (19% in the United Kingdom).

Like the French model, many Western countries have followed in recent decades a punch approach based on the taxation and stigmatization of smokers.

Public policies of which the efficiency is today challenged e, in favor of a more conciliatory vision, where carrot and stick can coexist. To achieve the goal of tobacco control, the focus is now on accompanying smokers to help limit their consumption and the harmful effects of smoking.

English and Americans are at the forefront of these new tobacco control practices, imitated by the Czechs and the Portuguese, who are now tackling the problem from the angle of risk reduction (“ harm reduction “). With convincing results

In practice, this method tends to limit the laws and campaigns that make smokers feel guilty, on the basis that they have been subject to them for years. , without information on the harmful effects of tobacco changing their behavior. On the contrary, the proponents of “ harm reduction ” aim to empower and support smokers, by proposing solutions and concrete alternatives.

The example of Stoptober is in this respect eloquent: this event federates in Britain, every year, 10% of smokers, who accept to play the game and quit for a month. Impressive results, when we know that the chances of quitting smoking are 5 times greater after a first long stop.

This year, the British government went one step further: Derivatives, such as patches, nicotine gums, or e-cigarettes were offered to smokers to succeed their bet. Again, the idea here is to be pragmatic: these products are certainly harmful to health, but much less (95% less harmful for example for the e-cigarette, according to the English Ministry of Health) that cigarette

In France, where the zero-tobacco approach is still omnipresent among the actors of the fight against smoking, we try to reproduce in November the Stoptober, with the “month without tobacco”. It is sad to note that the initiative does not meet the same success as the other Channel

Because through Stoptober and, beyond, an approach of ” harm reduction “, the English managed to significantly reduce the number of smokers. Great Britain is now the European country where the least tobacco is consumed, explains the researcher in addiction at the University of Frankfurt, Heino Stöver, interviewed by the journalist Mathias Puddig.

England is a good indicator: on the European map of smoking, Germany ranks 33rd out of 34 countries, while England is in first place square. They managed to reduce the share of smokers to 17% thanks to a set of measures – political price, tax policy, access policy, promotion of the e-cigarette. In Germany, this figure is 27% “says the German scientist.

What to see emerge, in the medium term, a consensus around from an approach of “ harm reduction “, to give a second wind to the fight against smoking.

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1 Comment

  1. Smoking is harmful for health, we all know. Still people smoke. But for those who do not smoke, there is a big problem that they are still passive smokers while living with smokers. I liked this blog on very important topic. Thanks for sharing it.

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