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HEALTH

Covid halted France’s efforts to cut smoking levels

France may no longer be 'the chimney of Europe', but years of falling smoking rates have been halted by the pandemic and lockdowns, causing concern to public health experts.

Covid halted France's efforts to cut smoking levels
A cigarette smoker is pictured on March 1, 2018, in Lille, northern France (Photo by PHILIPPE HUGUEN / AFP)

French smoking habits are often among the first things to strike foreigners arriving in L’Hexagon, with the waft of cigarette smoke from a café terrace one of the defining smells of the country. Though France had been making progress on discouraging smoking in the last decade, recently the country has stagnated in its efforts to cut back on les clopes.

As of 2020, about 31.8 percent of adults (ages 18-75) in France smoke and 24 percent percent are daily smokers – by contrast Americans and Brits’ national smoking habits have fallen below 15 percent.

READ MORE: The French and smoking: Is France really ‘Europe’s chimney

However, in comparison to its European counterparts, France is certainly not the ‘chimney of Europe,’ as shown in the graph below that outlines daily cigarette consumption in the EU.

In terms of trends, French cigarette consumption declined every year from 2014 to 2019.

For Viêt Nguyen Thanh, head of the Addictions Unit for the ‘Prevention and Health Promotion Directorate’ at Santé publique France, this is evidence that the national program to prevent tobacco consumption, which went into effect in 2014, was effective.

“It was the first time there was a nationwide, coordinated attempt to decrease tobacco usage,” said Nguyen Thanh. “It is thanks to this that we saw a very important drop in tobacco usage between 2014 and 2019.”

Over the years, the French government has taken several steps to combat tobacco usage. One of the most important was the “Loi Evin,” a 1991 law that placed restrictions on cigarette advertising. Smoking is also prohibited in all enclosed public places, including cafés and restaurants, as well as on public transport, in schools, and in the workplace.

Since smoking is relegated to the outdoors, it generally now takes place on café terraces – even if some of these ‘terraces’ have three walls and a roof. This whiff of cigarette smoke is still a very common experience when walking down a French street.

In 2017, France also took the step of requiring “plain packaging” on cigarette containers. The French government has also dissuaded many would-be smokers with heavy taxes on cigarettes. The size of the tax is progressive, and right now a single packet of cigarettes is about €10.

According to the French health ministry, higher tobacco taxes discouraged at least one million daily smokers between 2016-2017. 

Since the Covid pandemic, which culminated in strict lockdowns and curfews throughout France, smoking habits have actually stopped going down and in fact have stabilised. Quarantine periods were particularly challenging, with nearly 4 out of 10 French people reporting that they had difficulty controlling their tobacco consumption during periods of confinement.

Another survey by Santé Publique France found that 27 percent of smokers saw their tobacco consumption increase during the confinement. This increase was most noticeable among 25-34 year olds (41 percent) and people working at home (37 percent).

Smoking habits in France are also particularly pronounced when looking at gender and social class.

Between 2019 and 2020, daily tobacco consumption increased by three points for working class people, specifically the third of the French population with the lowest income. This mirrors trends in other countries, like the United States. According to the CDC, “blue-collar workers are more likely to start smoking cigarettes at a younger age and to smoke more heavily than white-collar workers.”

READ MORE: MAP: The places in France where people smoke the most

When it comes to gender, French men are both more likely to be smokers – 36.2 percent of men versus 27.7 percent of women – and more likely to suffer health consequences from smoking. 

Ultimately, despite tobacco usage being significantly lower than it was 10 years ago, experts still see cause a need for further efforts. Viêt Nguyen Thanh still considers French smoking levels to be “very high.”

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HEALTH

How to get help in France with dementia and memory loss

It’s not something anyone wants to consider, but older people especially are susceptible to suffering some form of mental decline including dementia - and there is help and support out there in France.

How to get help in France with dementia and memory loss

If you are concerned that a loved one or friend may be showing signs of mental decline, here’s an overview of the system in France and where you might go to get help.

What to do if you think a loved one has dementia

First things first, dementia is not an illness. It is, more accurately, a catch-all term used to describe a group of symptoms that affect memory, thinking and social abilities, linked to one of a number of medical conditions of the brain, including Alzheimer’s, or by traumatic brain injuries. Symptoms vary according to the part of the brain that is damaged.

Dementia can occur at any age, but mainly affects older people. It is the cause of more than half of referrals to long-stay centres.

Britain’s NHS website lists early dementia signs to be aware of. If you are concerned that a loved one is displaying one or more of these signs, then you should seek out a formal diagnosis. Such signs do not prove the presence of a neurocognitive disorder, but if they do, early detection will make things much easier.

The first step – as always – is to arrange a consultation with your GP, who may refer the patient to a specialist.

READ ALSO How to make a doctor’s appointment in France

What happens in the specialist consultation

A referral will generally see the patient go to a local Consultation mémoire de proximité (CMP) in a Centre mémoire de ressources et de recherche (CMRR), where a specialist medical team can diagnose dementia and memory disorders.

The diagnosis will follow a series of cognitive assessment tests as well as, perhaps, brain scans and physical tests, depending on the outcome of the cognitive testing. The specialists will give you all the information you need at the time.

If a form of dementia is diagnosed, it’s understandable that you’ll be concerned about what could and should happen if your loved one can no longer take care of themselves.

As with early detection of a degenerative brain condition itself, it’s important not to leave discussions about the future too long. Do it before it’s too late is the best advice, even though it’s a conversation (or a series of them) that you will not want to have.

Financial and legal affairs

France has several administrative options for legal arrangements similar to power of attorney or guardianship – known by the umbrella term of mesures de protection judiciaires (judicial protection measures) – as well as less formal steps for those who are unable to make decisions in their daily life.

READ ALSO GUIDE: Guardianship or power of attorney options in France for elderly or vulnerable people

It is worthwhile noting, for example, that power of attorney in France can be separated into different individual areas – banking, administration, documents and management related to assets/inheritance, and voting – or granted for all sections.

It is also a good idea to check any life and health insurance policies. France insurance companies offer something known as Assurance dépendance, which pays out when holders are unable to care for themselves.

READ ALSO Health insurance in France: What you need to know about a mutuelle

Most policies insure against partial and/or total loss of autonomy. The exact sums – paid either as a lump sum or monthly – depend on the terms of the policy and degree of incapacity and can cover adaptations to a home to allow for the care of a dependent person, home help, specialised transport – even funeral expenses.

Meanwhile, families caring for a family member with dementia may also be eligible for means-tested Allocation personnalisée d’autonomie

READ ALSO French government’s seven-step plan to improve end-of-life care

Help and support

It is worthwhile getting in touch with agencies and associations, France Alzheimer for example, once you have a diagnosis. 

They will be best placed to help you navigate the French system for care and assistance – and even just provide emotional support when you need it.

They can also guide you through the CAF benefits that you may be eligible for, or help you apply for visits from a home help or aide domicile.

If the time comes when the person can no longer live at home and residential care is required, here’s a look at how the French care home system works, and the financial situation for people who have never worked in France.

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