The prevention of smoking‐related diseases has entered a new phase. Smokers and non‐smokers alike have become overwhelmingly in favour of smoking bans at work and in public places (recent polls in France showed that around 80% of the population is in favour of the ban). Many countries, including France, have ratified the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) which came into effect on 27 February 2005. Countries signing up to the agreement committed themselves to introducing new governance that would enable them to implement various actions in the most effective way. The European Union (EU) is also proposing to reinforce national policies on tobacco control.
At the same time, politicians at the highest level have taken this objective on board and schemes such as the “Plan Cancer” were launched by the French President in 2003. Unfortunately, the tobacco industry has systematically attempted to confuse the issue and through large scale lobbying activities has managed to scare members of the HORECA (hotel, restaurants and bars) sector.
Quite early on, France embraced several courageous decisions such as the Veil Law (1976) and the Evin Law (1991), followed by the “Plan Cancer” and energetic measures relating to tobacco taxes. Unfortunately, the measures that have been implemented have barely lived up to expectation in a country that professed itself committed to a “guerre au tabac” (war against tobacco) and having placed precautionary measures at the constitutional level. In all, barely 20 people from central government, government agencies and associated bodies and NGOs are actively working to control smoking. In Ireland, by contrast, the Office of Tobacco Control (OTC) has 17 full‐time staff (population ratio would mean France having 250 staff) and 18 staff engaged as law enforcement officers.
Article 5.2a of the WHO FCTC recommends each signatory country to “establish or reinforce and finance a national coordinating mechanism or focal points for tobacco control”. In France, such a “national mechanism” is sadly lacking as the document prepared by the Comité National Contre le Tabagisme (National Committee Against Tobacco Smoking) and the Ligue Nationale Contre le Cancer (French Cancer League), testifies (the document is available in French and English at: http://cnct.org/site/article.php3?id_article = 395). Analyses by the LNCC and the CNCT reflect those of the United Kingdom's Royal College of Physicians, which has recommended adding a renewed and firm impetus to the national tobacco policy with the creation of a Tobacco and Nicotine Regulatory Authority for the UK.
This new coordinated, comprehensive, resolved and goal oriented policy implies the mobilisation of the necessary resources and the coherent and responsive organisation of public health measures to be adopted or strengthened. The CNCT and the LNCC agree that France needs real coordination of its organisations and resources, which can be achieved by setting up a body dedicated to that purpose, an Autorité Nationale de Régulation du Tabac et de la Nicotine (National Tobacco and Nicotine Regulatory Authority). This regulatory body would work with other national organisations across Europe, which are either in the process of being set up or already established as in Ireland and Norway. The authority would work in direct contact with the government, the territorial administrations and other local public services. It would be responsible for formulating decisions about how tobacco and nicotine products will be regulated and overall responsibility for tobacco control. In this endeavour, it would also be expected to rely heavily on the work of NGOs and scientific bodies that come under the umbrella of the Alliance Contre le Tabac (Alliance Against Tobacco) to which it could delegate some of its competencies. The authority would have full and direct control in areas not covered by these bodies.
Lung and cancer specialists have been able to do relatively little to mitigate the devastating effects caused by asbestos. This is a product that for more than 50 years we knew, and taught, was a hazard to health (cancer and other diseases) when inhaled and yet not enough was done in time to prevent its effects. We know even more about the damage to health caused by smoking and we know there are effective ways to prevent them. In such a context, doing nothing is not an option, it is simply unethical. We have to assume our responsibilities and work together for an effective and cohesive tobacco control policy.