Electronic cigarette use in France in 2014.

OBJECTIVES: The aim of this study was to investigate electronic cigarette use in France with a special focus on its relationship with tobacco smoking. METHODS: The 2014 Health Barometer is a telephone survey of 15,635 individuals which provides a status update regarding electronic cigarettes use in France. RESULTS: In 2014, 25.7 % of 15-75-year-olds had tried e-cigarettes. Among these, 23.4 % were current vapers (6.0 % of 15-75-year-olds). Among vapers, about half were daily vapers (2.9 % of 15-75-year-olds). Smoking prevalence was high among those who vape: 83.1 % were smokers (74.7 % were daily smokers) and 15.0 % were former smokers. Four out of five vapers considered that they had reduced their cigarette consumption through e-cigarette use. Vaping ex-smokers represented 0.9 % of 15-75-year-olds, which are approximately 400,000 people. This figure represents an initial estimate of the number of smokers who have successfully stopped smoking, at least temporarily, thanks to e-cigarettes. CONCLUSIONS: E-cigarettes in France were on the whole used by smokers. The e-cigarette could have helped several hundreds of thousands of individuals to quit smoking, at least temporarily.

[Determinants of the intention to abstain from or reduce alcohol, tobacco or cannabis use among 15-25 year-olds]. / Déterminants des intentions de rester non-consommateur ou de réduire ses consommations d’alcool, de tabac ou de cannabis chez les 15-25 ans.

OBJECTIVE: This study was designed to identify the sociodemographic and psychosocial factors (based on the theory of planned behaviour) associated with the intentions of young people to remain non-smokers and refrain from experimental cannabis use, and their intentions to reduce drinking during a party, quit smoking and reduce cannabis use among users. METHODS: 3,652 young people aged 15 to 25 years were interviewed by means of an on-line questionnaire. The sample was recruited from an internet access panel and constructed according to the quota method applied to the following variables: gender, age, region, habitat and head of family occupation. RESULTS: Each of the psychosocial determinants {attitudes, norms and control) helped to explain the subject's intention not to smoke and/or use cannabis. The presence of a prohibition norm in the family was also associated with a decreased intention to experiment with cannabis. Among substance users, attitude determined the intention to quit or reduce the use of the three substances {tobacco, alcohol and cannabis) and control was involved in the intention to reduce drinking and quit smoking. Finally, norms only influenced the intention to reduce drinking during parties. CONCLUSION: This study demonstrates the importance of considering psychosocial factors to explain health behaviours and to identify and propose interventions. These results support the priority given to smoking prevention, justify the value of early interventions and confirm the importance of considering social inequalities in health when developing prevention programmes.

Tobacco smoking surveillance: is quota sampling an efficient tool for monitoring national trends? A comparison with a random cross-sectional survey.

OBJECTIVES: It is crucial for policy makers to monitor the evolution of tobacco smoking prevalence. In France, this monitoring is based on a series of cross-sectional general population surveys, the Health Barometers, conducted every five years and based on random samples. A methodological study has been carried out to assess the reliability of a monitoring system based on regular quota sampling surveys for smoking prevalence. DESIGN / OUTCOME MEASURES: In 2010, current and daily tobacco smoking prevalences obtained in a quota survey on 8,018 people were compared with those of the 2010 Health Barometer carried out on 27,653 people. Prevalences were assessed separately according to the telephone equipment of the interviewee (landline phone owner vs "mobile-only"), and logistic regressions were conducted in the pooled database to assess the impact of the telephone equipment and of the survey mode on the prevalences found. Finally, logistic regressions adjusted for sociodemographic characteristics were conducted in the random sample in order to determine the impact of the needed number of calls to interwiew "hard-to-reach" people on the prevalence found. RESULTS: Current and daily prevalences were higher in the random sample (respectively 33.9% and 27.5% in 15-75 years-old) than in the quota sample (respectively 30.2% and 25.3%). In both surveys, current and daily prevalences were lower among landline phone owners (respectively 31.8% and 25.5% in the random sample and 28.9% and 24.0% in the quota survey). The required number of calls was slightly related to the smoking status after adjustment for sociodemographic characteristics. CONCLUSION: Random sampling appears to be more effective than quota sampling, mainly by making it possible to interview hard-to-reach populations.

[Evidence-based interventions to prevent tobacco use among youth: a literature review]. / Interventions validées ou prometteuses en prévention du tabagisme chez les jeunes?: synthèse de la littérature.

This paper reviews the current knowledge of empirically validated interventions aimed at preventing tobacco use among children and adolescents. Given the increasing number of daily smokers among young people aged 17, there needs to be an emphasis on interventions aimed at promoting healthy behaviors. The study used a standard protocol to identify and review the literature and to classify the selected interventions. 22 interventions were found to have a positive impact on youth smoking. More than half of the interventions are aimed at the general population, while the other programs target vulnerable populations or young smokers. The study found that most of the interventions are aimed at adolescents, though some are aimed at children under 12 years of age. Around half of the interventions use several strategies, including actions in schools, parent involvement and/or community participation. Almost all individual-based programs are designed to promote the development of psychosocial skills. Effective mass media campaigns and national strategies to restrict access to tobacco are also presented. This study aims to contribute to the understanding of programs in other countries and to promote reflection on professional practice in France.

Evaluating the Effectiveness of France's Indoor Smoke-Free Law 1 Year and 5 Years after Implementation: Findings from the ITC France Survey.

France implemented a comprehensive smoke-free law in two phases: Phase 1 (February 2007) banned smoking in workplaces, shopping centres, airports, train stations, hospitals, and schools; Phase 2 (January 2008) banned smoking in hospitality venues (bars, restaurants, hotels, casinos, nightclubs). This paper evaluates France's smoke-free law based on the International Tobacco Control Policy Evaluation Project in France (the ITC France Project), which conducted a cohort survey of approximately 1,500 smokers and 500 non-smokers before the implementation of the laws (Wave 1) and two waves after the implementation (Waves 2 and 3). Results show that the smoke-free law led to a very significant and near-total elimination of observed smoking in key venues such as bars (from 94-97% to 4%) and restaurants (from 60-71% to 2-3%) at Wave 2, which was sustained four years later (6-8% in bars; 1-2% in restaurants). The reduction in self-reported smoking by smoking respondents was nearly identical to the effects shown in observed smoking. Observed smoking in workplaces declined significantly after the law (from 41-48% to 18-20%), which continued to decline at Wave 3 (to 14-15%). Support for the smoke-free laws increased significantly after their implementation and continued to increase at Wave 3 (p<.001 among smokers for bars and restaurants; p<.001 among smokers and p = .003 for non-smokers for workplaces). The findings demonstrate that smoke-free policies that are implemented in ways consistent with the Guidelines for Article 8 of the WHO Framework Convention on Tobacco Control (WHO FCTC) lead to substantial and sustained reductions in indoor smoking while also leading to high levels of support by the public. Moreover, contrary to arguments by opponents of smoke-free laws, smoking in the home did not increase after the law was implemented and prevalence of smoke-free homes among smokers increased from 23.2% before the law to 37.2% 5 years after the law.

Evaluation of the smoking ban in public places in France one year and five years after its implementation: Findings from the ITC France survey.

France implemented a comprehensive smoke-free policy in public places in February 2007 for workplaces, shopping centres, airports, train stations, hospitals and schools. On January 2008, it was extended to meeting places (bars, restaurants, hotels, casinos, nightclubs). This paper evaluates France's smoke-free law based on the International Tobacco Control Policy Evaluation Project in France (the ITC France Project), which conducted a cohort survey of approximately 1,500 smokers and 500 non-smokers before the implementation of the laws (Wave 1, conducted December 2006 to February 2007) and two waves after the implementation (Wave 2, conducted between September-November 2008; and Wave 3, conducted between September-December 2012). Results show that the smoke-free law led to a very significant and near total elimination of indoor smoking in key venues such as bars (from 95.9% to 3.7%) and restaurants (from 64.7% to 2.3%) at Wave 2, which was sustained four years later at Wave 3 (1.4% in restaurants; 6.6% in bars). Smoking in workplaces declined significantly after the law (from 42.6% to 19.3%), which continued to decline at Wave 3 (to 12.8%). Support for the smoke-free law increased significantly after their implementation and continued to increase at Wave 3 (among smokers for bars and restaurants; among smokers and non-smokers for workplaces). The findings demonstrate that smoke-free policies that are implemented in ways consistent with the Guidelines for Article 8 of the WHO Framework Convention on Tobacco Control (WHO FCTC) lead to substantial and sustained reductions in tobacco smoke in public places while also leading to high levels of support by the public.

Effectiveness of the European Union text-only cigarette health warnings: findings from four countries.

BACKGROUND: The European Commission requires tobacco products sold in the European Union to display standardized text health warnings. This article examines the effectiveness of the text health warnings among daily cigarette smokers in four Member States. METHODS: Data were drawn from nationally representative samples of smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), the Netherlands (2008) and the UK (2006). We examined: (i) smokers' ratings of the health warnings on warning salience, thoughts of harm and quitting and forgoing of cigarettes; (ii) impact of the warnings using a Labels Impact Index (LII), with higher scores signifying greater impact; and (iii) differences on the LII by demographic characteristics and smoking behaviour. RESULTS: Scores on the LII differed significantly across countries. Scores were highest in France, lower in the UK, and lowest in Germany and the Netherlands. Across all countries, scores were significantly higher among low-income smokers, smokers who had made a quit attempt in the past year and smokers who smoked fewer cigarettes per day. CONCLUSION: The impact of the health warnings varies greatly across countries. Impact tended to be highest in countries with more comprehensive tobacco control programmes. Because the impact of the warnings was highest among smokers with the lowest socioeconomic status (SES), this research suggests that health warnings could be more effective among smokers from lower SES groups. Differences in warning label impact by SES should be further investigated.