Smoking cessation in cancer patients in France
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Secretary General in French alliance against tobacco and vice president of Respadd, France
Publication date: 2019-03-26
Tob. Prev. Cessation 2019;5(Supplement):A143
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Fifty years ago, no action was taken in France against smoking in the context of cancer. In 1987 with Pr Tubiana, oncologist, who will also later found the French Alliance against tobacco, President Mitterrand with the European Commission launched the first program ( 1987-1989) Europe against cancer. Article 1 and 2 of the European Code Against Cancer ask to don’t smoke and promote smoke-free home. This program widely developed in France only involved the prevention of cancer. In 1999 France create its national network of tobacco cessation centers (1 / 100,000 inhabitants), but without specific program for cancer patients. In 2002 president Jacques Chirac, "declares the war on tobacco" by launching the first Cancer plan. Alongside taxes increases, this plan also clearly included smoking cessation. In 2006 the decree Bertrand put an end to passive smoking with the French ban. In 2013 the National Cancer Institute (INCA) has developed a series of tools for the management patients with cancer who smoke. A literature review showing the benefit of stopping smoking for cancer patients in terms of survival time, quality of life, the results of surgery, certain radiotherapy and chemotherapy and wished that the cessation of tobacco be included in the standard care Theoretically each patient supported in one of the 700 cancer centers licensed for cancer surgery, chemotherapy and radiotherapy was questioned about his smoking and nicotine replacement is proposed to all smoker without delay. The management of smoking is planned as other care need for cancer. All guideline from HAS incorporate smoking cessation as an essential treatment of cancer. All the drugs and medicals fees for smoking cessation are free of charge (for > 98% of the French population). INCA is the France health agency that has the most open attitude towards the e-cigarette. But in 2019 it is possible to perceive ambulance drivers or other medical personnel smoking in white coats in certain outdoor spaces of a cancer center and oncologist not enough proactive to treat tobacco dependence of cancer patients. Good rule is not enough, France need also good daily practice.
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