Two years ago, Emmanuel Macron said he wanted the advent of “the first tobacco-free generation in recent history” in 2030. The government’s plan, at the end of last August, to increase the price of a pack of cigarettes therefore seemed coherent . This was to increase to 12 euros from 2024 against a maximum of 11.50 euros currently, after an initial increase in May. But on Sunday, Prime Minister Elisabeth Borne, while saying she was “very vigilant” on smoking, said on RTL that the government “does not plan to increase the price of tobacco next year”.

A new anti-smoking plan is to be announced “soon”, added the Matignon tenant, who also wants to ban “puff” disposable electronic cigarettes “which give young people bad habits”.

Professor Amine Benyamina, president of the French Federation of Addictology and head of the psychiatry and addictology department at the Paul-Brousse hospital, protests against this volte-face. He insists on the essential role of taxation in reducing the number of smokers and especially new consumers.

Le Point: Do you regret the government’s decision not to increase tobacco taxes?

Amine Benyamina: Yes, I regret it very much. The government may have wanted to save money for the most precarious. But tobacco taxation is not just a way to raise revenue for the state. It is above all a public health tool which aims to reduce the number of smokers. In addition, the savings would be much greater for smokers if they stopped smoking. They would even be so for all taxpayers. The direct and indirect cost of tobacco for France was 156 billion euros in 2019, according to a report published this summer by the French Observatory of Drugs and Addictive Trends. For alcohol, this cost was 102 billion euros.

What is the impact of an increase in tobacco taxation on consumption?

The increase in the price of tobacco through taxation has an almost arithmetic effect on the number of new consumers, especially among young people. It also deters those who are likely to start smoking. It is one of the rare levers, if not the only one, to have such a marked effect. A 20% increase in the price of tobacco is a 10% drop in the number of consumers. The effect on long-time smokers is less marked, but it also exists.

What is the mechanism at work?

There are two mechanisms. An income effect: the price becomes too expensive and therefore I can no longer afford to buy a pack of cigarettes. Also, a psychological effect: a high price signals to me the uniqueness of this product, and the will of the government to divert me from it. But there are two conditions for these mechanisms to work: the price increase must be very significant, and it must be repeated year after year. Otherwise, people stop smoking temporarily, then eventually get used to the higher price and go back to tobacco. The price has to go up every year to keep those who quit smoking out of it, and get new people out of it.

Should we fear an increase in consumption in the coming years?

We have witnessed a significant decline in tobacco consumption in France for several years. Then it started to rise again since the health crisis, in part because we did not put in place a sufficient increase in taxes. Partly also because the current prevention policy does not reach the most disadvantaged strata. If we do not put in place a real policy of increasing taxation, an effective prevention strategy and harmonization of prices on a European scale, we will not be able to stop it.

You bring up the subject of prevention. How to make the speech carry more?

Scary pictures on packages are not enough. We need to get more tobacco addicts to see a doctor. We cannot decide on an anti-tobacco plan without having integrated this aspect into it.

Is it inconsistent to ban “puffs” and at the same time announce that tobacco taxes will not increase?

It is not impossible that this leads to the classic cigarette of people who used to “puff”. Contrary to popular belief, the “puff” selects new consumers. So it’s obviously good news that the government wants to ban it. But it is unfortunate that this is done without also increasing tobacco taxes.