Medical Device Daily Contributing Writer
PARIS — The love affair between the French and their cigarettes is over. A separation was made official in 1992 with passage of the Evin Law, but the divorce didn't happen. The French continued to live with cigarettes until earlier this month when the government finally began enforcing the law.
Caf s, bistros and brasseries have one year to prepare for a total no-smoking ban scheduled to go into effect on Jan. 1, 2008.
More remarkable than the sudden courage of the government to enforce the 14-year-old law was the calm response in Paris — no demonstrations, the country did not shut down. The only sign of the change on the streets were unusual numbers clustered around doorways to office buildings smoking cigarettes.
The association of tobacco retailers called for demonstrations back in November when the Health Minister Xavier Bertrand threatened to apply the Evin Law. Only 15,000 fuming participants marched in Paris on that "Day of Anger," so the minister confidently announced the next-day enforcement of the smoking ban for the first of February.
The business newspaper Les Echos congratulated France for arriving at the head of the class of non-smoking European nations, though a quick study reveals this to be Gallic bravado. The half-measures against public smoking enacted by France earn a place toward the back of the class — with the laggards.
European Health Commissioner Markos Kyprianou recently formally launched a review of the smoking prohibitions put in place by the 27 member states with the goal of publishing a "Green Paper" expected to proceed a EU-wide ban on public smoking. According to The Guardian (Manchester, UK), the commissioner takes a favorable view of a total prohibition similar to the measures taken in 2004 in Ireland, the first country to boldly ban public smoking. Norway followed six months later; Sweden followed suite in January 2005. And Luxembourg implemented a total ban this past September.
In these "abolitionist" countries, according to Les Echos, "the first results are positive," with tobacco sales falling almost 18% in Ireland, and only 17% of Swedes smoking compared to 32% of French.
Less-restrictive smoking bans are in force in Spain, Italy, Malta, Finland, Scotland, the Czech Republic and Belgium, which joined the non-smoking Euro zone on Jan. 1.
England's health minister announced a July 1, 2007, deadline for a partial smoking ban.
The hard cases in Europe are Germany, Austria and EU commissioner Kyprianou's native Greece.
German Chancellor Angela Merkel is an advocate of the ban, a change from her predecessor, G rard Shr der, who even took his arguments to the EU courts. But Merkel is struggling to advance even modest measures, as the federal government has no authority over smoking rules for hospitals, schools and restaurants, which will be decided by each of the 16 federated regions.
Austria is nearly pro-smoking, with 43% of the population supporting a ban. The new minister for health, Andrea Kdolsky, a physician and confirmed smoker, set off a row in Vienna recently when she said in a television interview that she opposed enforcing a ban. She later softened that position.
In Paris, the daily France Soir announced in a headline that "Resistance is Useless," predicting: "We are going to live in a perfect society, fatter, sadder and older. What joy, but Mon Dieu how boring!"
The left-leaning Liberation created a new column called "Smoking" where it suggested that as a "beau geste" of resistance, smokers should light their cigarettes in public places by the filters.
Elle magazine was upbeat, encouraging its readers to take up the UK phenomenon called "smirting," that is smoking/flirting. The magazine reported that cigarette breaks on Ireland's sidewalk have sparked romances. Elle suggested its readers should, as a conversation starter, forget to bring their lighters.
"Who would have imagined?" asked Les Echos, that the French would greet the smoking ban with a shrug of the shoulders rather than inflamed anger? The acceptance of the smoking ban is "completely incredible in this country of rebels," it said. All the more amazing is that the government dared to enforce a ban, "to which the French are not exactly indifferent," at the height of a presidential campaign.
The movement succeeded, the newspaper concluded, because the country was ripe for the change. Years of educational campaigns about passive smoking shifted attitudes from reflexive resistance to concerns for personal liberty to that strongest of forces in the French spirit, respect for others.
Some 80% of French people support the enforcement of the law. The health ministry has been conducting a 18 million pro-quitting campaign that in January doubled the calls to a special hotline and swamped a public information service website, according to INPES (L'Institut national de pr vention et d' ducation la sant ).
More than 5,000 deaths are caused by passive smoking in France at an estimated cost of 148 million for the medical system.
Yet INPES also warns that, after declining for years, the total number of smokers in France went up last year to 31.8% from 30.4% in 2003, the result of an increase in smoking among 18- to 24-year-olds.
The daily Le Monde said the government will mobilize an army of 175,000 public employees to enforce the ban. Smoking in a public space can draw a fine of 168, although the Minister of Health said a verbal warning will usually come first. A company can be fined 1750 for allowing smoking in offices.
Liberation reminded its readers that crushing out a cigarette on the sidewalk in Paris is subject to a fine, while Le Figaro cautioned business owners that the city is launching a campaign against companies that allow cigarette butts to pile up outside their doors.
Under the national health insurance plan, a smoker whose physician validates a stop-smoking effort can receive a 150 subsidy for nicotine substitutes in the form of gum, patches or medications, such as Champix, which Pfizer (New York) says will be available by Valentine's Day in France.
Supplemental health insurance plans, carried by many French to cover required co-payments, reported an additional 180-1150 per year for people trying to quit.
The weekly Nouvel Observateur reported that the anti-tobacco lobby in France finds pharmaceutical companies in its corner, even underwriting study trips for health officials to Ireland.
Agence France Presse reported the sale of nicotine substitutes shot up 27% in December ahead of the smoking ban while the sale of cigarettes fell 4.4% compared to a year earlier. Pfizer's Nicorette was selling 22% better than in December 2005, while GlaxoSmithKline (London) patches were ahead 11% for the year.
The Office for the Prevention of Tobacco Addiction (OFT; Office fran ais de pr vention du tabagisme) reports 80% of French companies were only "partially prepared" for the smoking ban. Among some 2.5 million businesses, the agency found more than 60% had not bothered to respect the rules of the 1992 Evin Law. OFT is hiring staff to keep up with the doubling of interventions required to help companies conform to the law.
The daily Le Parisien estimated a productivity loss per employee of 11,820 per year due to frequent pauses to go outside for a cigarette.
Le Figaro noted that while Bertrand may be counting on businesses, he has given little indication as to how a business can manage the frequent breaks within the restrictive French work rules. As a result, the newspapers said, the rules will need to be worked out progressively through litigation.