Characteristics of users of French smoking cessation services from 2004 to 2018

We investigated changes in the profile of persons who smoke (PWS) seeking assistance from smoking cessation services (SCS) in France between 2004 and 2018, aligning with national policies.

A prospective study of 131 280 adult PWS was conducted across three periods: 2004-2008 (during a 42% increase in tobacco prices), 2009-2013 (following a tobacco sales ban to minors) and 2014-2018 (marking the first national antismoking policy). Sociodemographic and medical characteristics, smoking behaviours and prescribed cessation medications were analysed cross-sectionally at the first consultation.

Between 2004-2008 and 2014-2018, the mean age of SCS attendees increased from 44 to 47 years (p<0.001). Concurrently, the proportion of PWS without a school diploma rose from 19% to 22%, and unemployed PWS from 13% to 22% (both p<0.001). Smoking-related cancer prevalence doubled from 3% to 6% (p<0.001). The proportion of PWS with no prior quit attempts increased from 31% in 2004-2008 to 35% in 2014-2018 (p<0.001). There was also a notable decline in those attending SCS on a personal initiative, dropping from 45% to 35% (p<0.001). Mean number of cigarettes smoked daily was stable at 23 between 2004 and 2018. Combination nicotine replacement therapy remained the most prescribed cessation medication, accounting for 44% of treatments during this period.

Despite tobacco control efforts between 2004 and 2018, challenges persist in reducing smoking behaviours in France. Increased SCS utilisation among older adults and individuals with lower socioeconomic status underscores the importance of enhancing SCS availability in France to support the various profiles of PWS.