Trends in tobacco-attributable mortality in France

Background: In 2010, the prevalence of tobacco use in France was 33% and reached 39% in the population aged 18-44. The purpose of this article is to describe the trends in tobacco-attributable mortality in France between 1980 and 2010. Methods: Using data from the national mortality statistics and relative risks of death, we estimated the tobacco-attributable fractions (AF) by sex and age using the method developed by Peto et al. and used recently by the World Health Organization with improved relative risk estimates. The tobacco-attributable mortality by age and sex is obtained by multiplying the AFs by the number of deaths. They are estimated in 5-year intervals from 1980 to 2010. Results: In 2010, a total of 78 000 deaths were attributable to tobacco use in France. The number of deaths attributable to tobacco use among men decreased from 66 000 deaths in 1985 to 59 000 deaths in 2010, and the tobacco-AF decreased from 23% in 1985 to 21% in 2010. The number of deaths attributable to tobacco use among women increased from 2700 in 1980 (1% of all deaths) to 19 000 in 2010 (7% of all deaths). In the population aged 35-69, one in three deaths among men and one in seven deaths among women are attributable to tobacco use. Conclusion: While tobacco-attributable mortality among men has been declining during the past three decades, it has increased dramatically among women. Thus, effective preventive measures are urgently needed to stem the tobacco epidemic.