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Background: Prohibition of tobacco sales to minors is a provision of the World Health Organization Framework Convention on tobacco control. This measure is effective to reduce youth tobacco use, if the legislation adopted is properly implemented and enforced. Through the examples of France and Quebec, the objective of this study is to compare legislative frameworks prohibiting tobacco sales to minors, their enforcement, and possible impact on underage smoking., Methods: Identification of legislative instruments, reports from public health authorities, and articles addressing the focused question was performed trough Medline and Google., Results: Selling tobacco products to minors under 18 years of age has been banned by the law since 1998 in Quebec and 2009 in France. In 2011, in France for individuals aged 17, compliance with the law was 15%. In 2017 in France, 94% of 17-year-old daily smokers regularly bought their cigarettes in a tobacco store. Law enforcement controls and sanctions are non-existent. In 2013 in Quebec, 23% of underage smoking students usually bought their own cigarettes in a business. The compliance rate with the prohibition law rose from 37% in 2003 to 92.6% in 2017. An approach of underage "mystery shoppers" attempting to purchase tobacco products and dedicated inspectors has been implemented, and progressive sanctions are applied in case of non-compliance. In 2013, 12.2% of Quebec high school students and, in 2017, 34.1% of French 17 year olds reported using tobacco products in the last 30 days., Conclusion: Only an improved law enforcement, through the training of tobacco retailer's, inspections and effective deterrent penalties for non-compliance, leads to an effective legislative measure in terms of public health., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Smoking prevalence has reached high rates among health professionals. Our study aimed to assess smoking behavior, knowledge and attitudes towards anti-smoking regulations of nursing students., Methods: In 2013, we conducted a cross-sectional study among nursing students enrolled in private and state nursing institutions of Sousse (Tunisia)., Results: In our study, 440 students were selected. The mean age was 22 ± 2 years. The sex ratio was 0.65. The prevalence of smoking was 20.6%. It was significantly higher in men than women (50% vs 4.5%, P < 10(-3)). Strong dependency was noted in 9%. One-third of smokers stated they wanted to quit smoking. Prohibiting the sale of cigarettes to minors and smoking in enclosed public places were the two most mentioned anti-smoking regulations., Conclusion: Our rate was lower than those reported in the literature. This result should encourage policymakers to continue actions and ensure sustainability., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Electronic cigarettes are devices producing vapour containing propylene-glycol, flavourings and quickly delivered nicotine. 6.7% of the Swiss population, mainly smokers, experimented the electronic cigarette while 0.1% use it daily. Despite uncertainty due to the low level of evidence, electronic cigarettes might be effective for smoking cessation and reduction. The safety of electronic cigarettes is demonstrated at short-term but not at long-term; however its eventual toxicity is likely to be much lower than tobacco. Use of electronic cigarettes by non-smokers and youth who do not smoke is low and seems unlikely to lead them to tobacco use. Recommended public health measures include product regulation with quality control, ban in public places, prohibition of advertising and sales to minors.

Introduction: Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental smokers from never smokers in a nationally representative sample of Canadian students in grades 9 to 12., Methods: School-level data from the 2006 Canadian Census and one built environment characteristic (tobacco retailer density) were linked with data from secondary school students from the 2008-2009 Canadian Youth Smoking Survey and examined using multilevel logistic regression analyses., Results: Experimental smoking rates varied across schools (p < .001). The location (adjusted odds ratio [AOR] = 0.66, 95% CI: 0.49-0.89) of the school (urban vs. rural) was associated with the odds of a student being an experimental smoker versus a never smoker when adjusting for student characteristics. Students were more likely to be experimental smokers if they were in a lower grade, reported low school connectedness, used alcohol or marijuana, believed that smoking can help people relax, received pocket money each week and had a family member or close friend who smoked cigarettes., Conclusion: School-based tobacco prevention programs need to be grade-sensitive and comprehensive in scope; include strategies that can increase students' attachment to their school; and address multi-substance use, tobacco-related beliefs and the use of pocket money. These programs should also reach out to students who have smoking friends and family members. Schools located in rural settings may require additional resources.

WHO, for the first time in its history, asked in 2003, all Member States to sign and enforce a Framework Convention on Tobacco Control (FCTC). Ten years later, it seems important to describe the achievements made in Belgium. The main legislative measures that are taken to control the major avoidable risk factor for health, are recalled. The present status of Belgium activity in this field is described, with an emphasis on the role of health professionals to help smokers quit. The difficult challenge of curing chronic tobacco dependence disease is underlined. Regarding the fight to render tobacco products less attractive, some breakthroughs are occurring in specific countries, and some are maybe coming soon in Europe.

Background: Promoting a smoke-free hospital is a priority component for tobacco control strategies. The aim of our investigation was to study the attitudes and behaviors of the hospital staff of the F.-Hached UH of Sousse towards smoking, and to assess their knowledge about the harms of passive smoking and about tobacco regulations in the hospital., Methods: We conducted a descriptive cross-sectional study using an anonymous self-administered questionnaire. In January-February 2008, the questionnaire was submitted to hospital staff members selected at random from the care units at F.-Hached UH of Sousse, Tunisia., Results: The response rate was 92.8% (452 participants). The average age of the population was 39.7±19 years; all professional categories were represented. The prevalence of active smoking among the staff interviewed was 19% (89.5% males). About 75% of the smokers stated they smoked on the work site and 8% in the presence of patients. The majority of the smokers wished to stop smoking. Discomfort from exposure to tobacco smoke was reported by 83.4% of respondents. The large majority of staff respondents (95%) knew that tobacco smoke is dangerous and 80% were aware of the existence of a law that prohibits smoking in the hospital., Conclusion: The prevalence of smoking remains high among male hospital workers. In our hospital, the majority of the care staff favored promotion of a tobacco-free hospital. The success of this project will depend on education, implicating the entire hospital staff in the anti-smoking battle. Smoking staff members should be supported in their attempts to stop smoking., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Introduction: In France, the decree No. 2006-1386 banned smoking in public places such as hospitals. The aim of our study was to describe the impact of the legislation on the smoking status of hospital nurses., Methods: A descriptive study was undertaken in a university hospital of Marseilles, under the responsibility of the occupational medicine service. Between April and June 2008, a questionnaire was distributed to the nurses who had been working for more than one year. The following data were collected: demographic information, smoking status, behaviour and attitudes regarding smoking addiction, knowledge regarding existing preventive measures., Results: Sixty-four percent of 715 eligible subjects responded; thirty percents reported themselves as current smokers, 25 % as ex-smokers and 45 % as non-smokers. Among the smokers, 68 % said that they had decreased their tobacco consumption during their working hours and 28 % their overall daily consumption. Among ex-smokers, 20 % declared that they were in the process of quitting., Conclusions: The nurses had decreased their tobacco consumption at work and these positive results should be confirmed over a long-term perspective. The preventive role of the occupational physician could be reinforced., (Copyright 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Since 1976, France improved its anti tobacco legislation and regulation with the help of the Non-governmental organizations under the umbrella of the Alliance Against Tobacco. Since then were implemented a total ban of tobacco advertising (1991), a total ban of smoking in enclosed public and work places (2006), a high taxation of tobacco products, strong media campaigns to de normalize smoking and tobacco products, improved availability, accessibility and affordability of treatments of tobacco dependence. Since 1991, the number of cigarettes smoked per adult was halved.

Background: This report ends up with a large increase of the number of estimated deaths from passive smoking in Europe. Its conclusions have been decisive to passing laws banning smoking in public places., Results: However, analysis of this report for France reveals considerable anomalies, such as changing the usual definition of passive smoking. Among the 5863 estimated deaths, 4749 concern everyday smokers. The 1114 non-smokers include all the former smokers as well, whose remaining risk cannot be attributed to environmental smoke. Published data used for calculations come from polls, of which results are very diverse and not very reliable. The level of confidence is not discussed., Conclusion: Nevertheless, the number of estimated deaths in the field where restricting laws might be applied and efficient is so low that it makes you wonder which the real aim of this report is, and which conflicts of interests hide behind it.

This is the sixth and concluding part of a series of publications from the Swiss task force named "Smoking - Intervention in the private dental office" on the topic "tobacco use and dental medicine". The focus of this review is the effects of smoking for the development of atherosclerosis as pathohistological correlate for acute coronary syndrome (ACS), arterial occlusive disease, and cerebrovascular diseases (stroke). Additionally, a causal relationship between tobacco use and an increased rate for complications during pregnancy and child birth will be discussed. Next to causal therapy of local and systemic diseases in general, an emphasis must be given to tobacco use prevention and cessation. Finally, important public health issues concerning smoking and tobacco use will be demonstrated, and options to improve the current situation will be presented.

A majority of smokers and non-smokers mind tobacco smoke. Passive smoking causes death by sudden infant death, lung cancer and coronary heart disease. 3000 to 6000 persons are killed every year in France. The lack of implementation of the Evin's law published in 1991 explains why non-smokers are not given the protection they can expect. The trend of scientific knowledge and of French and international public opinions support a growing demand for a complete protection of non-smokers with a total ban of smoking in all public or working places.

"Cigarette smuggling: a wide scope phenomenon only there to serve the interests of big tobacco manuafacturers" uses industry officials' quotes and documents to describe how tobacco manufacturers are involved in the organisation of smuggling and how manufacturers use smuggling in two ways: on one hand, to flood markets with cheap cigarettes and defeat governements' efforts to reduce tobacco consumption by adopting one of the most efficient public health measures (ie: high taxation of tobacco products) and on the other hand, by using the false threat of increased contraband to scare politicians and prevent them from adopting strong fiscal policies. The Framework Convention on Tobacco Control (FCTC) with a protocol on smuggling and the collaboration between international agencies is a means to counter and defeat the tobacco industry attemps at sabotaging efficient public health measures.

Smoking is one most common threat of public health around the world. One of the best way to fight it is legislation. The French legislation is probably one of the more sharp and precise for the non-smokers or youths protection. Historically, the law "Veil" voted for in 1976 has defined the French basis of this sort of prevention. The law "Evin" voted for in 1991 has reinforced the non-smokers protection by the ban of smoking in public places, has decided the ban of advertising and has allowed very significant tobacco prices increases. Following European directives, new health warning appeared on cigarettes boxes in France in 2003. They are more strict, visible than they were before. It's because the law is implemented and because it's in continuous evolution that the French smoking prevalence will have the right evolution.

For decades tobacco manufacturers have attempted to trivialise the health risks associated with tobacco, reinforce and enhance its social acceptability using powerful communication and reprehensible strategies. Prevention campaigns have contributed to raise public awareness on the health risks associated with smoking. They have also allowed for an evolution of the social representation of tobacco use. From 2001, to stop tobacco consumption taking off again, media campaigns have become more offensive both in content and form. Today the communication strategy places as priority objectives the reinforcement of the socially unacceptable character of tobacco use (denormalisation) via information on health risks and cessation support for smokers to quit. In 2002, a media campaign (TV, radio, press) denounced the toxicity of tobacco smoke provoking a true remobilisation of public opinion against tobacco.

The years following the adoption of the Veil law (passed in 1977) were not characterised by substantial results in terms of a reduction in tobacco consumption. In 1991, the Evin law marked an important step in the regeneration and structuring of the fight against this substance. It is within this see-sawing context of smoking behaviour that a three-year (1997-1999) plan was supported and implemented by the French National Social Security and the French Committee for Health Education. The central theme was to help people to quit. During this same time period, the consensus conference (1997) as well as the announcement of a governmental plan (1999) came about to consolidate and magnify these directions. The observance of the change in tobacco consumption permits one to acknowledge that the Evin law and its measures for assistance had a positive impact during the early 1990s. On the other hand, this impact seems to have been on the whole "blunted" throughout the second half of the decade. The main hypothesis to explain this stagnation is that the increase in the price of tobacco was less sensitive and that the measures aimed at enforcing this law were less often applied, whereas at the very same time the commitment of the actors involved in the fight against smoking was strong. This assessment permits one to: 1) confirm the fact that in public health, health promotion actions are effective when they are jointly associated with initiatives that are coercive (the law and its application) and educational, the development of the environment and the improvement of care; and 2) remember the importance of truly applying the clauses of the Evin law and perhaps eventually adding to them.

This paper describes the trends in tobacco sales and smoking prevalence in the Tunisian population, estimates the consequences of smoking on mortality of this population, and discusses anti-tobacco actions: educational actions, legislative measures and price increases. Sales Data were collected from the Tunisia tobacco company. Smoking prevalence data from surveys, conducted by several institutes, and numbers of deaths by causes have been estimated from WHO for the year 1998. Tobacco sales increased from 4.96 g per adult per day in 1981, to 6.3 g, in 1993, then decreased widely. The proportion of smokers was 30% in 1996. 55% among men versus 5.6% among women. Among 17 to 24 years old young adults, the proportion of smokers was 29.2% in 1994 (50% among men versus 3.9%, among women). Mortality attributable to tobacco in Tunisia has been estimated to 6430 deaths in 1997 (5580 among men versus 850 among women). These deaths represent 22% of the total male deaths and 4% of the female ones. Anti-tobacco measures have been reinforced by the enactment of anti-tobacco law. Proportion of young smokers remaining elevated, it is expected that consequences of the tobacco addiction in Tunisia, in term of mortality, will be even heavier in the next two decades, if efficient anti-tobacco actions are not implemented.

Surveillance of smoking behavior and study of consequences of smoking on the health of the French population, and particularly the female population, is a public health priority. The amount of tobacco consumed can be determined from sales figures and from surveys. Globally, tobacco sales increased through 1985. According to the available surveys, the proportion of regular smokers has varied little as smoking rate has decreased in men and increased in women. The decrease occurred in all age groups for men and increased only in the 25-49 year age group for women. Smoking is the cause of 60,000 deaths per year in France, 57,000 in the male population and 3,000 in the female population. Despite reinforced legislation (The Veil and Evin laws) which is unfortunately poorly applied, tobacco consumption has not decreased greatly. Funding levels for anti-smoking campaigns are totally insignificant compared with the efforts of the tobacco industry to promote their products. However, the beneficial health effect of stopping smoking is truly great since the risk depends much more on the duration of smoking than on the number of daily cigarettes. In addition, the delay between the cause and consequence is long, the consequences of the increase in tobacco smoking among young women over the last 20 years will not become visible until 20 to 40 years from now. One could wonder why so little effort has been put into anti-smoking campaigns despite the readily available data clearly warranting their promotion.