Liberté, Egalité, Fumée: Smoking and
Tobacco Control in France
Constance A. Nathanson
The left-bank intellectual with a Gauloise drooping from the corner of his mouth has virtual iconic status as a symbol—if not to the French themselves, at least to the tourist soaking up culture and smoke in equal parts at every café and on every street corner. This image is, nevertheless, of relatively recent date and, in some sense, misleading.1 Not until after the Second World War did cigarettes become the dominant form of tobacco consumption in France, and it is only very recently that the prevalence of smoking has come close to that in the United States. Even more counterintuitive, perhaps, is that France was among the first countries to pass, in 1976, stringent tobacco-control legislation, including controls both on advertising and on smoking in places “open to the public.” Reflected here are multiple contradictions: not only do symbol and reality collide, but what is symbol and what is reality are often unclear. Underlying these contradictions is a story about the politics of public health, with implications— certainly for France and possibly for other countries as well—that go far beyond the limited arena of smoking and tobacco.
The story is complicated, and the chronologies overlapping. For purposes of exposition, I have divided the basic facts into three sections: (1) the history of tobacco use in France, including current data on consumption and tobacco-related mortality; (2) the relationship between tobacco and the French state, including a brief history of the French tobacco monopoly; and (3) the story of French tobacco-control legislation, a narrative that necessarily overlaps with that of the French tobacco industry. The final two sections consider the background and nature of anti-tobacco militancy in