Dear Mme Minister,

I am writing to you in response to the intention of the French government to introduce standardised packaging for cigarettes in France. On behalf of the European Public Health Alliance (EPHA), I would like to take this opportunity to congratulate France for its willingness to take this bold step forward in the fight against the tobacco epidemic.

Based on the latest evidence about tobacco packaging as well as the WHO Framework Convention on Tobacco Control guidelines [1], the European public health community strongly recommends the introduction of plain standardised packaging and urges the French government to follow through on its commitment.

Like many European countries, France is greatly affected by the deadly burden of tobacco consumption. As President Hollande highlighted by launching the 3rd National Cancer Plan (2014-2019) earlier this year, cancer is the most important preventable cause of death in France. Tobacco has a proven strong link to cancer, yet 33% of the population of France still smokes. We believe strongly that introducing standardised packaging is essential if France is to achieve its goal of cutting smoking prevalence to 20% [2] and subsequently cutting cancer rates. Today, 44 000 deaths from cancer in France each year are linked to tobacco consumption. [3]

Beyond cancer, tobacco is a leading risk factor in a number of deaths and diseases in France today. Evidence suggests that deaths from cardiovascular disease (CVD), and incidences of heart attack stroke and chronic obstructive pulmonary disease (COPD) can be prevented and or reduced by not smoking.

By cutting down on tobacco consumption through the introduction of standardised tobacco packaging, one of the main risk factors of these diseases will be reduced.

A systematic review of the evidence shows that health warnings on tobacco packs are effective in discouraging young people from taking up smoking and in motivating smokers to quit. In 2010, Uruguay implemented health warnings covering 80% of both front and back of tobacco packages. Since then, cigarette consumption decreased by an average 4.3% per year, while in its neighbouring country, Argentina, it decreased by 0.6%. Similarly, the prevalence of tobacco use in Uruguay has decreased by 3.3% a year; more than twice as much as Argentina [4]. Other countries, like Canada [5] and Australia [6] with comprehensive tobacco control strategies in place, including large pictorial health warnings have seen significant annual decreases in youth smoking [7]. In contrast, Europe’s youth has the highest smoking rates in the world, with higher rates among lower socio-economic groups and rising rates in the young female population [8].

France will be setting a shining example for public health by being among the first countries in Europe to introduce plain packaging. This form of leadership in Europe is crucial in light of the recently adopted Tobacco Products Directive (TPD) which aims at strengthening European tobacco control policy [9]. As you know, article 24.2 of the TPD recognises the right of Member States to maintain and introduce further requirements applicable to all products placed on its market in relation to standardisation of packaging of tobacco products, where it is justified on grounds of public health, taking into account the high level of protection achieved through this Directive [10].

Evidence shows that standardised packaging protects young people and future generations from addiction to tobacco products by reducing the take-up of smoking among children and encouraging current smokers to quit. On behalf of the European Public Health Alliance I would like to congratulate you for this announcement and offer our full support for the implementation of the standardised packaging proposal.

Yours sincerely,

Peggy Maguire

EPHA President

- (French) [Lettre ouverte d’EPHA] Soutient de la communauté européenne de la santé publique à la mise en place de paquets de cigarettes neutres (pdf)

- (English) [EPHA Open letter] Support from the European Public Health Community for the plans on Plain Packaging for cigarettes in France (pdf) Photo: Marisol Touraine, French Minister for Health

EPHA related articles


[1] Parties should consider adopting plain packaging requirements to eliminate the effects of advertising and promotion on packaging”. (GL Article 13)



[4] Tobacco control campaign in Uruguay:a population-based trend analysis,Abascal W et al.,Lancet 2012 Nov, 380(9853):1575-82

[5] HealthCanada.Canadian Tobacco Use Monitoring Survey (CTUMS) 2011. Accessed 3 March 2013.

[6] White, V. Bariola, E. Australian secondary school students’ use of tobacco, alcohol, and over-the counter and illicit substances in 2011. Report prepared for: Drug Strategy Branch Australian Government Department of Health and Ageing. December 2012. Accessed 15 March 2013

[7] Smoke Free Partnership Mythbusting Briefing -

[8] Kaiser S, Gommer AM. 2007. Smoking Summary. EUPHIX.

[9] The new TPD, Directive 2014/40/EC, entered into force on 19 May 2014.


Last modified on June 14 2014.