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Background: In view of experts' warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population.Methods: This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD.Results: Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7-19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts.Conclusions: These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management. [ABSTRACT FROM AUTHOR]

Background: In March 2020, as the coronavirus disease 2019 (COVID- 19) pandemic was spreading across the globe, many countries have implemented unprecedented lockdown measures. But how populations did react to these measures? We examined the case of France. Our aims were threefold: assessing some aspects of their impact on French's daily living conditions; investigating their attitudes toward the lockdown; investigating the factors associated with these attitudes.Methods: A cross-sectional online survey was carried out 10 days after the nationwide lockdown (from March 27th to March 29th 2020), among a representative sample of the mainland French population aged 18 and over. A quota sampling method was applied to achieve a sample of 1012 respondents. We used a cluster analysis to obtain contrasted attitudinal profiles, and logistic regressions to investigated which factors were associated to these profiles.Results: After 10 days of lockdown, there were already significant consequences regarding respondents' living conditions and mental health. Most respondents supported the current lockdown. However, it appeared as a stopgap measure due to a lack of alternatives, and a large majority acknowledged its heavy drawbacks. We found three contrasted attitudinal profiles: full support (38%), strong but critical support (31%), limited support (31%). Regarding respondents' SES, low-income and low-education respondents were more likely to display critical or limited support to the lockdown, as well as those who reported deteriorated living conditions or psychological distress.Conclusions: In France, the large public support to the lockdown was fragile. First, it was a critical consensus anchored in current controversies and recent social struggles. Second, it was weaker among people with a lows SES, especially since the lockdown have exacerbated preexisting social inequalities. [ABSTRACT FROM AUTHOR]

During the last decade, public health research has emphasised the growing public disaffection with vaccination. This contemporary vaccine hesitation (VH) refers to a delay in acceptance or refusal of vaccines, as well as agreement despite doubt and reluctance. We investigated VH among French parents of young children, with an emphasis on two key features of VH: trust towards physicians and commitment to vaccination issues. We targeted two populations with contrasting socioeconomic profiles, using in‐depth interviews (n = 25). Most parents exhibited some kind of VH, with differentiated attitudes across vaccines, including acceptance despite enduring doubts, especially for vaccines already provided to older siblings ('vaccine inertia'). Despite the rise of the Internet and social media, our participants still strongly relied on face‐to‐face interactions with peers and significant others. Most participants trusted their own physician but this was the result of a selection process: they had engaged resources to find a physician they could trust. Participants with contrasted socioeconomic profiles struggled with the same dilemmas, and they committed themselves to the same quest to find the 'right' physician. Nevertheless, parents with a higher socioeconomic status were able to engage more resources and use a wider repertoire of actions, and they also displayed greater health literacy. [ABSTRACT FROM AUTHOR]

Because the effectiveness of a coronavirus disease lockdown in curbing coronavirus disease spread depends on public support, acquiring real-time information about the way populations reacted to the lockdown is crucial. In France, such public support remained fragile among low-income persons, probably because the lockdown exacerbated preexisting social inequalities and conflicts. [ABSTRACT FROM AUTHOR]

The internet is playing an increasingly important part in fueling vaccine related controversies and in generating vaccine hesitant behaviors. English language Antivaccination websites have been thoroughly analyzed, however, little is known of the arguments presented in other languages on the internet. This study presents three types of results: (1) Authors apply a time tested content analysis methodology to describe the information diffused by French language vaccine critical websites in comparison with English speaking websites. The contents of French language vaccine critical websites are very similar to those of English language websites except for the relative absence of moral and religious arguments. (2) Authors evaluate the likelihood that internet users will find those websites through vaccine-related queries on a variety of French-language versions of google. Queries on controversial vaccines generated many more vaccine critical websites than queries on vaccination in general. (3) Authors propose a typology of vaccine critical websites. Authors distinguish between (a) websites that criticize all vaccines (“antivaccine” websites) and websites that criticize only some vaccines (“vaccine-selective” websites), and between (b) websites that focus on vaccines (“vaccine-focused” websites) and those for which vaccines were only a secondary topic of interest (“generalist” websites). The differences in stances by groups and websites affect the likelihood that they will be believed and by whom. This study therefore helps understand the different information landscapes that may contribute to the variety of forms of vaccine hesitancy. Public authorities should have better awareness and understanding of these stances to bring appropriate answers to the different controversies about vaccination. [ABSTRACT FROM AUTHOR]

Abstract: Background: In many countries, the decline in smoking prevalence has coincided with a growing concentration of smoking among people with lower socioeconomic status (SES). This concentration may reflect the social differentiation of risk perceptions. We investigated the factors associated with risk perception and fear of cancer, paying particular attention to SES indicators and health information seeking. Methodology: A cross-sectional telephone survey conducted in France in 2010 (including 826 current smokers aged 18–75) assessing how smokers perceive the risk of smoking-related cancer in terms of daily consumption and duration thresholds. Results: Among current smokers, 38% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 22% stated that tobacco-related cancer risk only becomes high for a longer smoking duration than their personal one. Predictors of such risk perceptions included low SES, material deprivation and mentioning either the internet or their relatives as one's main source of information on cancer. The same characteristics were also predictive of personal fear of tobacco-related cancer. Conclusion: Our results illustrate the challenges faced by prevention campaigns in the internet society, as information found on the web may fuel smokers' risk denial. Anti-tobacco policies should tailor interventions to people with low SES, who may be especially impervious to standard prevention campaigns because of material deprivation, and they should also address and challenge smokers' risk denial beliefs. [Copyright &y& Elsevier]

Abstract: In 2009–2010, the H1N1 episode occurred in a general context of decreasing public confidence in vaccination. We assumed opposition to vaccination in general to be an ‘unfounded fear’, reflecting ignorance and perceived vulnerability among low-socioeconomic status (SES) people, and opposition to the H1N1 vaccine a ‘legitimate concern’ reflecting the elite's commitment to ‘risk culture’ in a ‘risk society’. We indirectly tested these assumptions by investigating the socioeconomic profiles associated with opposition to vaccination in general and opposition to the H1N1 vaccine specifically. Our second aim was to determine whether or not opposition to the H1N1 vaccine fuelled opposition to vaccination in general. We used data from a telephone survey conducted in 2009–2010 among a random sample of French people aged 15–79 (N = 9480). Attitudes toward vaccination in general and toward the H1N1 vaccine specifically varied significantly between October 2009 and June 2010 with strong correlation being observed between these attitudes throughout the whole period. In multivariable analysis attitudes toward vaccination in general remained a significant predictor of attitudes to the H1N1 vaccine and vice versa, for distinct profiles as follows: males, older people, low-SES people for opposition to vaccination in general, versus females, people aged 35–49 and those with an intermediate SES for opposition to the H1N1 vaccine. Results also differed regarding indicators of social vulnerability, proximity to preventive medicine and vaccination history. The first profile supported the “unfounded fears expressed by low-SES people” hypothesis, while the second echoed previous work related to middle-classes’ “healthism”. Opposition to vaccination should not be reduced to irrational reactions reflecting ignorance or misinformation and further research is needed to acquire a greater understanding of the motives of opponents. [Copyright &y& Elsevier]

Abstract: Background: There is growing evidence that cigarette smoking has become a stigmatized behaviour, at least in western countries, and there is ongoing debate among experts about whether or not such stigma should be an instrument of anti-tobacco policy. Methods: We investigated French non-smokers attitudes toward cigarette smokers, using data from a telephone survey carried out in 2010 among a representative random sample of non-smokers aged 15–75 (N =3091). We carried out a cluster analysis to build contrasted attitudinal profiles and we also computed a score of stigmatization. Results: We found evidence for the existence of stigma associated with cigarette smoking in France: a majority of French non-smokers would not date a smoker, nor hire one to take care of their children. The cluster analysis identified four contrasting profiles, corresponding to different levels of stigmatization, including one cluster whose respondents demonstrated strong levels of moral condemnation and social rejection of smokers. Older people, those with a lower educational level and those reporting financial difficulties were more prone to stigmatize smokers, while those who reported that somebody smoked in their home were less likely to do so. Those who had never smoked and those who abstained from alcohol were more prone to stigmatize smokers. Obese people were also more likely to do so (in bivariate analysis only). Conclusion: The process of tobacco stigmatization seems well-advanced in France, despite a cultural context that may be less permeable to this process. Further research is needed as our results raise some questions regarding its efficiency as a policy tool. First, people who are familiar with smokers are less prone to stigmatize them. More generally, simultaneously stigmatizing several categories of people may provide each of these same categories with stereotyped ‘others’ onto whom they can deflect their stigma. [Copyright &y& Elsevier]

Background: Tobacco control policies have succeeded in reducing tobacco use, but the negative correlation between smoking prevalence and socioeconomic status (SES) has increased. This study focused on the relationships between time preferences, SES, and smoking behaviour, attitudes and risk awareness. Methods: A cross-sectional telephone survey was conducted in France in 2008 on a representative national sample of people aged 18–75 (N = 2000, including 621 smokers) years. Two scales measuring planning horizon and impulsivity and various indicators of SES were introduced into the logistic regressions performed on smoking status and smokers’ attitudes to anti-smoking campaigns, quitting attempts, attempts to quit or smoke less, fear of smoking-related cancer and risk perception. Results: Indicators of lower SES and smoking status were correlated with present time orientation and impulsivity. On modelling smoking status, time orientation and lower SES were found to be significant predictors. Among smokers, lower SES and present time orientation were predictive of smoking-related outcomes: little personal concern with anti-tobacco campaigns, not reporting recent behavioural changes, not expressing personal fear of smoking-related cancer and low risk awareness. When time-related preferences were introduced into the analysis, the effects of several lower SES indicators (especially a low educational level) became non-significant. Conclusion: The relationship between SES and smoking behaviour, attitudes and beliefs may be partly mediated by time preferences. Time preference is strongly correlated with smoking status, risk perceptions and attitudes towards anti-smoking campaigns. Tobacco control policies should include messages targeting present time-oriented smokers and/or interventions designed to enhance more future-oriented attitudes among smokers. [ABSTRACT FROM AUTHOR]

Thanks to data from the French Environmental Barometer EDF-R&D 2004 (national representative sample of French aged over 15), this paper investigated lay risk perceptions related to exposure to electromagnetic fields (from an electric power-line, a TV, a cellular phone or micro-wave oven). Answers to an opened-ended question suggested that many people worry about such exposure: it may interfere with natural electricity circulating in the human body, disturb the nervous system and cause cancer. These answers revealed a conception of human body, health and disease, and participants referred to various kinds of arguments, from expert knowledge to personal intuition. Statistical analyses showed that risk perceptions related to these four devices were strongly correlated with each other and shared common predictors. These results suggest that these risk perceptions are built within the same perceptive frame. One should not consider them as "false beliefs": they are based on consistent conceptions of the body, health and disease, they are fuelled by the contemporary levelling of knowledge, and they reflect the difficulties experienced by many people living in a changing world. [ABSTRACT FROM AUTHOR]

In-depth interviews were conducted with French breast cancer survivors 24 month after cancer diagnosis (N=21 women). We documented their experience of chronic pain, compared their pain narratives with their answers to the WHOQOL-BREF questionnaire, and studied both the meaning they gave to their pain and how they dealt with it in their daily lives. Half of participants reported are suffering from iatrogenic chronic pain. Most of the time, this pain was not captured by the WHOQOL questionnaire and was not medically treated. Patients "normalized" their pain in various ways: they considered it either as a necessary step on the road to recovery, as the proof of treatment efficacy, or as a permanent condition one must learn to live with. They learned to deal with pain by taking precautions, giving up certain activities, and changing the way they performed others. Participants were also prone to compare themselves with other patients suffering worse pain. Breast cancer survivors should be better informed about chronic pain and how to alleviate it. Physicians should contribute to fighting pain-related beliefs which lead patients to conceal their pain. Techniques used by patients to cope with chronic pain in their daily lives should also be promoted. [ABSTRACT FROM AUTHOR]

Aims: We present the results of a cross-sectional survey that investigates young smokers’ reactions to an increase in cigarette prices in France, and the factors associated with these reactions. Methods: This survey was carried out in 2005–2006, in South-Eastern France, among first-year university students (response rate: 71%, N = 1723). Findings: Among the 427 current daily smokers, 32% did not react to the increase, 33% reduced the cost of smoking (they purchased cigarettes in foreign countries or smuggled cigarettes, turned to a cheaper brand or to hand-rolled cigarettes) and 35% reduced their consumption or tried to quit. Daily smokers with low-educated parents were less likely to react to the price increase, as well as those with psychological distress. Students with financial difficulties were more prone to diminish the cost of smoking, while students who suffered from being apart from family were less likely to reduce their consumption. Conclusions: Further research is needed to better understand the diversity and heterogeneity of young smokers’ reaction to cigarette price increase, in relation to their socio-economic background and their motivations for smoking. [ABSTRACT FROM AUTHOR]

Aims This paper aimed to assess whether the increase of social differentiation of smoking is observed in France. Design and setting Five cross-sectional telephone surveys conducted in France between 2000 and 2007. Participants The surveys were conducted among national representative samples of French subjects aged 18–75 years ( n = 12 256, n = 2906, n = 27 499, n = 2887, n = 6007 in 2000, 2003, 2005, 2006 and 2007, respectively). We focused on three groups: executives, manual workers and the unemployed. Measurements Time trends of smoking prevalence were assessed, and socio-economic factors (especially occupation and job status) associated with smoking were identified and compared in 2000 and 2005. We also computed respondents' equivalized household consumption (EHI) and their cigarette budget to assess the financial burden of smoking. Findings Between 2000 and 2007, smoking prevalence decreased by 22% among executive managers and professionals and by 11% among manual workers, and did not decrease among the unemployed. Indicators of an underprivileged social situation were associated more markedly with smoking in 2005 than in 2000. In addition, the falling-off of smoking initiation occurred later and was less marked among manual workers than it was among executive managers and professionals. Finally, in 2005 15% of French smokers devoted at least 20% of their EHI to the purchase of cigarettes, versus only 5% in 2000, and smoking weighted increasingly heavily on the poorest smokers' budgets. Conclusions While these results point out an increased social differentiation in tobacco use, they underline the need to design and implement other forms of action to encourage people to quit, in particular targeting individuals belonging to underprivileged groups. [ABSTRACT FROM AUTHOR]

Abstract: Encouraging seropositive people to voluntarily disclose their serostatus has been promoted as a key component of HIV prevention. Among other reasons, HIV disclosure to one''s main partner is believed to be an incentive for serodiscordant couples to practice safe sex. The present article investigated this issue by conducting a cross-sectional survey of a large sample of HIV-infected women attending HIV care centers in Cameroon (N =1014). Overall, 86.3% of these women had disclosed their serostatus to their main partner. With respect to sexual activity with their main partner during the previous three months, 35.0% had practiced abstinence and 47.4% only safe sex, whereas 17.6% had engaged in unsafe sex at least once. HIV disclosure to one''s main partner was related to safe sexual practices in multivariate analysis. Some of the factors associated with disclosure and safe sex were illustrative of the positive roles of improved access to care and women''s empowerment. On the contrary, beliefs overestimating the effectiveness of antiretroviral therapies were quite widespread among respondents and predictive of both concealment of HIV status and unsafe sex. [Copyright &y& Elsevier]

Individuals with certain personal, family and job characteristics are at elevated risk of poor mental health. Yet, the respective role of obesity, smoking, alcohol abuse, low education, income, living and family conditions, and socio-occupational category in fatigue/insomnia (FI), nervousness (N) and frequent drug use for those disorders (DFI and DN) among men and women and in gender disparities are not well known. We studied gender differences in FI, N, DFI, DN, and in their correlated, and whether the gender differences were mediated by individual and lifestyle factors among 3,450 active subjects aged 18–64, randomly selected from North-eastern France. Subjects completed a post-mailed questionnaire. Data were analyzed via adjusted odds ratio (ORa) computed with the logistic regression model. Women were more affected than men for FI (21.3 vs. 13.1%, OR adjusted for age ORa 1.80, 95% CI 1.50–2.16), DFI (11.6 vs. 7.1%, ORa 1.74, 1.38–2.21), N (14.7 vs. 9.9%, ORa 1.58, 1.28–1.94), and for DN (12.1 vs. 5.7%, ORa 2.29, 1.79–2.94). These differences were not mediated by the individual characteristics studied. Multivariate analysis showed that the risk patterns varied between the two sexes. Smoking was related to N in men as well as in women; alcohol abuse to DFI in men only; lack of family support to all outcome variables in men and women; low educational level to DFI in men only; low income to FI, N and DN in men and to FI and DN in women; being unmarried to DN in men; being divorced/separated to N and DN in women; being a manual worker to FI and being a farmer to DFI in men; and being a manual worker to DN and being an employee to FI in women (1.50 ≤ ORa ≤ 2.95). Women suffered more from fatigue/insomnia and nervousness and used more drug for those disorders than men. Socio-demographic and lifestyle factors played significant roles among men and women but they did not explain the gender disparities. [ABSTRACT FROM AUTHOR]

Abstract: Background: The relationship between smoking and poverty is a public health issue in many countries, and several studies have shown a link between living in deprived neighbourhoods and smoking. In France the prevalence of smoking has decreased since the year 2000s. We examined whether reduced smoking rates differed by socio-economic status, anticipating reductions to be smaller amongst lower socio-economic groups. We also investigated whether poor housing conditions and/or living in a deprived neighbourhood were significantly associated with smoking. Methods: Data were collected by telephone surveys conducted between 2000 and 2007 with representative samples of the French population aged 18–75. The data from the last of these surveys (2007, N =6007) were also used to carry out a cluster analysis on various indicators relating to housing conditions and neighbourhood. Results: Between 2000 and 2007 the social differential in smoking rates increased sharply in France. Specific types of neighbourhood and poor housing conditions (described as cramped housing in a noisy and stressful environment or deprived neighbourhood), which were closely correlated with socio-economic status, were found to be significantly correlated with smoking, even after adjusting for potential key confounders and especially for individual markers of social disadvantage. Conclusion: Interventions which do not specifically target smoking but which contribute to improving poor smokers’ living conditions, are necessary to promote smoking cessation. [Copyright &y& Elsevier]

The article presents a study which investigates the relationships between working conditions, job satisfaction and smoking behaviors among clerks and manual workers in the U.S. The researchers used data from the French Health Barometer which is a cross-sectional telephone survey conducted among a national random sample. It was concluded that poor working conditions have the potential to contribute health inequalities since they are likely to fuel stress and unhealthy behaviors which combine to increase in morbidity and mortality.

Background: Past studies on smokers' risk perception have produced mixed results. We endorsed a new approach to assess smokers' perceptions of risk by asking them to estimate threshold values for the cancer risk associated with daily consumption of tobacco and number of smoking years. We expected that many smokers would endorse a "risk denial" attitude, with threshold estimates higher than their own smoking consumption and duration. Methodology: A French national telephone survey (n=3820; 979 current smokers) included several questions about smoking behaviours and related beliefs. Results: Among current smokers, 44% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 20% considered that the cancer risk becomes high only for a smoking duration higher than their own. Most smokers also agreed with other "risk denial" statements ("smoking is not more dangerous than air pollution," "some people smoke their whole life but never get sick"). Those who considered they smoked too few cigarettes to be at risk were less likely to report personal fear of smoking related cancer. Conclusion: Risk denial is quite widespread among smokers and does not simply reflect a lack of information about health risks related to tobacco. Fully informing smokers about their risks may necessitate changing the way they process information to produce beliefs and limiting their capacity to generate self exempting beliefs. [ABSTRACT FROM AUTHOR]

This paper aims to illustrate the relevance of Howard S. Becker's sociological model of deviance for a better understanding of contemporary adult smoking. From this perspective, one crucial aspect of smoking is smokers' ability to develop and entertain convincing rationalizations that help them to deny smoking hazards and challenge anti-tobacco messages. Several hypotheses are derived from this model and most of them are successfully tested with quantitative data from a cross-sectional survey conducted in the Paris Ile-de-France Region. As expected, most smokers agreed that smoking damages health and considered being well-informed about smoking hazards, even those who denied these hazards for themselves. Moreover, smokers' rationalizations were closely correlated to cigarette consumption and duration since smoking initiation. Paradoxically, risk denial was also stronger among smokers who have some characteristics usually considered as protective factors against smoking (especially future-orientation and importance attached to one's health). More generally, our sociological perspective leads to consider smokers' risk denial as the result of acquired cognitive skills instead of the consequences of lack of information or psychological bias. We believe it provides a promising avenue for further research. [ABSTRACT FROM AUTHOR]

This study examines attitudes to smoking among adolescents. Data for the study is derived from a large quantitative French cross-sectional survey of school students. Attitudes toward smoking were found to be associated with regularity and quantity of consumption, and the type of school attended. These associations are explained according to Becker's concept of a 'moral career', for attitudes differ among occasional, regular and heavy smokers. The association with school type indicates advanced formal schooling enables students to offer sophisticated rationalisations for smoking, combining an acknowledgement of health-related risks of smoking, emphasis on personal benefits derived from smoking, and claims that smoking is a private matter. [ABSTRACT FROM AUTHOR]

Abstract: In most developed countries, a significant part of the population is still smoking despite comprehensive tobacco control policies. Among other reasons, many smokers may endorse self-exempting beliefs that help them to deny the smoking hazards for themselves. We investigated the relationship between smokers'' risk denial and their readiness to quit making use of a French cross-sectional survey conducted in the Paris Ile-de-France Region (N =939 smokers). Self-exempting beliefs were quite widespread among participants and two of them were significant predictors of a low readiness to quit: considering that one''s cigarette consumption is too low to be harmful and believing that one''s way of smoking can protect from smoking-related diseases. Future tobacco control messages and interventions should specifically address these self-exempting beliefs that reduce smokers'' cognitive dissonance and then inhibit their willingness to quit. [Copyright &y& Elsevier]

Abstract: This paper integrates insights from both sociology and psychology into the economic approach of drug use. Within this theoretical framework, the utility provided by cannabis use depends on the ability to deny its riskiness, and this ability is a kind of human capital accumulated through earlier consumption. This assumption is tested with a dataset of French adolescents. A simultaneous equation model is estimated, with one equation for cannabis use, and one for risk denial. The results provide some empirical evidence in favour of the tested assumption, and they also cast doubt on the efficiency of preventive information at school. [Copyright &y& Elsevier]

Using the data from the French Environment Barometer EDF-R&D 2004 (national representative sample of French citizens aged over 15) and surveys by ADEME between 2000 and 2005, the paper investigates lay perceptions of the causes and consequences of the greenhouse effect, which may be considered as archetypal of contemporary environmental risks. Beyond lay lack of knowledge, the greenhouse effect gives rise to coherent and meaningful cognitions, including causal explanations, shaped by the pre-existing cognitive framework. This cognitive work, based on analogic rather than scientific thought, strings together the greenhouse effect, ozone depletion, air pollution and even nuclear power. The cognitive process is also fed by the individuals' general conceptions of Nature and of the rights and duties of humankind towards Nature. People are not greatly worried about the unseen and controversial consequences of the greenhouse effect: such worry could be one of those "elite fears" mentioned by Beck. Finally, while the efficiency of public policies to counter the greenhouse effect requires extensive societal involvement, low confidence towards both political and scientific authorities may prevent the population from becoming aware of the environmental stakes tied to the greenhouse effect. [ABSTRACT FROM AUTHOR]

Abstract: This paper argues that the sociology of deviance can be used to improve our understanding of some difficulties and unintended effects of health-promotion interventions designed to change risk behaviours, especially drug-taking. Firstly, many people engaged in ‘risk behaviours’ tend to deny the ‘risky’ label just as delinquents neutralise the ‘deviant’ label, and preventive information itself may be used by individuals in shaping risk denial. Secondly, deliberate risk-taking may be an ‘innovative deviance’,which is related to difficulties of conforming to the dominant ‘risk culture’. Health promotion is likely to be quite ineffective if it remains wedded to the dominant risk culture and de facto contributes to the spread of it. [Copyright &y& Elsevier]

The management of technological and health risks has been the source of many sociological studies in recent years. The purpose of this article is to draw on some of them to show how both the successes and the failures of technology and health risk management can contribute to ideas and discussions on terrorism prevention. The author examines three main questions: (1) Is terrorism a risk, or can it be treated as one through the application of conventional risk prevention tools? (2) What is, or should be, the role of the general public in preventing terrorist acts? (3) What is the primary goal of prevention? To prevent attacks or to prevent terror? Recent incidents show that managing one risk may intensify risks elsewhere and that there is a need to take into account not only the expectations and working conditions of those actually implementing the preventive measures but also public reaction. User empowerment and accountability is unlikely to be a contributing factor in terrorism prevention. On the other hand, some prevention efforts must be aimed at the general public, if only to forewarn people of the potential for terror and its devastating effects. [ABSTRACT FROM AUTHOR]

This study investigated attitudes toward buprenorphine maintenance treatment (BMT) among general practitioners (GPs) and their maintained patients' propensity to turn to several prescribers (doctor shopping), among a sample of 345 GPs prescribing BMT in South-East-em France. Survey data were anonymously matched to administrative data that provided information about GPs' patients. A simultaneous equation model suggests that GPs' attitude influenced doctor shopping, not the reverse. Doctor shopping was lower among GPs who reported inducting BMT with 8 mg of buprenorphine per day or more, and was higher for GPs endorsing a stringent attitude toward patients. Thus doctor shopping should not be understood exclusively as a deviant behaviour. It is partially physician-driven, and further research is needed to assess whether it reflects patients' dissatisfaction toward inappropriate care supply and the difficulty to establish a good therapeutic relationship between an opiate-dependent patient and a general practitioner. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Despite a large public health interest in substance use among athletes, only a few works have addressed illicit drug use in relation with sport practice. We have studied cannabis use to enhance both sportive and non-sportive performance among French sport university students. Methods: An anonymous self-reported questionnaire was administered to a sample of students from six Sport Science Universities from Southern France. Information on sport practice and cannabis use (frequency, quantity, motives) was collected. Results: Males were more prone to have already used cannabis to enhance non-sportive performance as well as sportive performance. The simultaneous equation model indicated that both kinds of enhancing-substance use were endogenous: cannabis use to enhance sportive performance leads to cannabis use to enhance non-sportive performance and reciprocally. Moreover, the relaxing properties of cannabis may be frequently used to enhance performance. Cannabis use to enhance sportive performance was positively related to the competitive level and to sliding sports. Conclusions: The present study helps to improve understanding on an empirical paradox about the relationship between doping agents use and so-called ‘recreational’ drug use among athletes. Indeed, people who use doping agents may also use ‘recreational’ drugs for a ‘non-recreational’ purpose. [Copyright &y& Elsevier]

This article aims to investigate the effect of French mass media national prevention campaigns on attitudes and behaviours of people living with HIV/AIDS (PLWHAs), with a special emphasis on HIV-related sexual risk behaviours. In 2001, a face-to-face survey was conducted in 32 hospital departments delivering HIV care randomly selected in two French regions (Paris metropolitan area and South-Eastern France). Eligible respondents were HIV-infected outpatients aged 18 or older, and diagnosed for at least 1 year. Overall, 1386 patients were asked to participate and 900 agreed to answer the questionnaire (response rate: 64.9%). Most respondents supported national AIDS information media campaigns; some have found support from these campaigns to talk to relatives or friends about AIDS (19.7%), or to manage their sexual life (24.5%). In multivariate analysis, PLWHAs who declared that these media campaigns have helped them to manage their sexual life were more likely to report condom use in the prior 6 months (“sometimes” vs. “never”: OR?=?2.77 [95% CI?=?1.15?–?6.71]; “always” vs. “never”: 2.46 [1.14?–?5.29]). So mass media general information campaigns can play an efficient role for secondary prevention among PLWHAs and may need to be redesigned to include this goal more explicitly. [ABSTRACT FROM AUTHOR]

In France as in other developed countries, cigarette smoking has been acknowledged as the most preventable cause of death and disability. Tobacco control has become a priority for the French government, which decided a 20% rise of the cigarette price at the end of 2003 and plans further rise in 2004. This study adopted a life-course perspective with retrospective data extracted from a national telephone survey for assessing the impact of pricing policy and some other predictors on smoking behaviours in France during the period 1965–1999. Our findings suggest that during a period marked by cultural trends favouring more frequent and earlier initiation of cigarette smoking, pricing policy has been a poor deterrent to youth smoking. Such findings highlight the necessity to implement simultaneously other preventive strategies, including restrictions on tobacco advertising, youth access and smoking in public places, as well as mass media campaigns and school-based educational interventions. [Copyright &y& Elsevier]

In France, since 1996, any general practitioner (GP) can prescribe high-dosage buprenorphine maintenance treatment (BMT) for opioid-dependent patients. The health authorities initially provided mandatory specific training, but since 1998, such training is only delivered by specialized networks and the pharmaceutical industry. Among a random sample of GPs from southeastern France (N=345), we found that many untrained GPs, as well as a significant minority of trained GPs, were likely to prescribe an ineffective dosage of buprenorphine or a potentially dangerous treatment (BMT+a short half-life benzodiazepine). These results highlight the necessity to edit clear guidelines, especially concerning situations of polyaddiction and psychiatric comorbidity, and to extend and improve BMT training in France with a renewed involvement of health authorities for quality control of such training. They even suggest that GPs'' participation to specialized training sessions should become a mandatory prerequisite for prescribing BMT. [Copyright &y& Elsevier]

Since the end of the 1980s, `youth risky behaviours' have become a major issue for public health. The relationship between these behaviours and sporting activity is well-documented but still controversial. This article examines some sociological hypotheses related to this relationship, with data from a pilot survey conducted on a sample of 458 elite-student-athletes (ESAs) aged 16-24, gathered and trained in specialized public centres. We found a significant relationship between motives to do sport and `risky behaviours': ESAs who considered sport as a convivial leisure were more prone to use cannabis, while ESAs who mingled sporting and extra-sporting achievements together were more likely to engage in risky behaviours on the road, possibly because they transposed values from the sporting field (speed, competition) into the `real world'. Moreover, sporting activity may provide opportunities for drug use with peers as well as incentives to use drugs in order to cope with the anxiety induced by high-level competition. Thus `recreational' drugs may be used as `integrative' drugs. [ABSTRACT FROM AUTHOR]

Purpose: To study the relationship between cannabis use, sports practice and other leisure activities during adolescence, as a test for the sociological theory of deviant opportunities. Methods: A sample of 12,512 French adolescents aged 18 responded to an anonymous self-reported questionnaire in March 2001. Three logistic models (for occasional, recent and regular cannabis use) were estimated for girls and boys separately. Results: Outings and other peer-oriented activities were strongly correlated with cannabis use but this relationship depended on which levels of use were considered. Occasional use was more common among respondents who participated in many different outdoor activities. Regular use was associated with a more selective lifestyle, focusing on music-oriented outings and time spent at a friend’s home in the evening. Conclusions: Our results provided empirical support for the theory of deviant opportunities. Changing patterns of lifestyle associated with transition from initiation to higher levels of use may reveal a shift from opportunities of cannabis use provided by a wide range of activities to specific activities chosen for their convenience to cannabis use. Further research will need to investigate how drug use is shaped by lifestyle, and conversely, how drug use reshapes lifestyle. [Copyright &y& Elsevier]

ABSTRACT Aims To study the relationship between sporting activity and alcohol, cigarette and cannabis use among adolescents and young adults, by focusing on elite student athletes (ESAs). Design, setting, subjects Cross-sectional survey (Spring 2002), in a sample of 460 ESAs (ages 16–24 years) recruited at 40 public centres gathering the young sporting elite from 30 different sports in South-Eastern France, comparison with samples of the general population of adolescents in South-Eastern France. Measures Respondents were asked confidentially by a self-administered questionnaire about their use of licit and illicit drugs, their sporting activity and other aspects of their life-style. Findings Prevalences of cigarette, alcohol and cannabis use were markedly lower for ESAs than for other adolescents (generally twice or three times as low). Among ESAs, when compared with the practice of an individual sport, the practice of a team sport was correlated positively with alcohol use (OR = 2.7 for girls, OR = 1.8 for boys), and the practice of a sliding sport was correlated positively with cannabis use (for girls: OR = 2.3) and with alcohol use (for boys: 4.3). Girls who entered competition at international level were more prone to smoke cigarettes and cannabis (OR = 6.1 and 2.4, respectively). Conclusions As a whole, practising sports as an elite student-athlete can be considered as correlated negatively with cigarette, alcohol and cannabis use. Nevertheless, this relationship depends on the kind of sport practised as well as the level of competition, and further research is needed to understand specific elite athletes’ motives for use. [ABSTRACT FROM AUTHOR]

A national telephone survey was conducted to investigate public opinions and attitudes toward drugs issues in France (N=2009). This article aims to study: (a) how French people perceive heroin users and (b) how this perception shapes opinions toward risk reduction policy, alcohol and tobacco. Overall, 73% of respondents considered that heroin users are a danger to their friends and relatives, 59% thought that they try to lead young people to use heroin, 22% labelled them as ‘hangers-on’. A cluster analysis led to distinguish a significant minority who endorsed a stereotyped perception of heroin users, described as ‘dope fiends’. These respondents were more likely to disagree with risk reduction policy and less prone to label alcohol and tobacco as drugs, as well as to consider that cigarette smoking and alcohol abuse cause more problems in society than illegal substance use. Factors associated with these opinions and implications for public health policy are discussed. [Copyright &y& Elsevier]

In contemporary societies, risk culture and risk profiling lead to the stigmatization of unhealthy behaviours as ‘risky’. Risk denial theory refers to a cognitive way to deal with risky behaviours and can be considered as an updated variant of Sykes and Matza's neutralization theory. People neutralize the ‘risky’ label using specific techniques that must be added to those previously enlisted by Sykes and Matza. This paper introduces and discusses three techniques of risk denial: scapegoating, self-confidence and comparison between risks. As it is usually defined and studied as a ‘risky behaviour’, cannabis use provides a relevant example to illustrate these types of risk denial, thanks to various ethnographic studies (including Becker's seminal work on marijuana smokers) and quantitative French data from the 1999 European School Survey on Alcohol and Other Drugs (ESPAD). In order to deny the ‘risky’ label, cannabis users scapegoat ‘hard drugs’ users, they emphasize their own ability to control their consumption personally, or they compare cannabis and alcohol risks. The paper concludes with suggestions for further analyses of risk denial. [ABSTRACT FROM AUTHOR]

This article aims to assess the hypothesis of Charlton & Bates about a negative correlation between cigarette smoking and mobile phone ownership among adolescents. This hypothesis is discussed and tested by using data from a national survey conducted in France in 2000 (n = 8414; age 17). The results show that, in France, owning a mobile phone is positively correlated with smoking, and this relationship remains significant once confounding factors are controlled. Thus, cigarette smoking and mobile phone ownership could turn out to be complementary rather than substitutable goods or could be considered as two characteristics of the same lifestyle. [ABSTRACT FROM AUTHOR]

Aims This study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice. Design, setting, subjects The study was a national school survey (n = 10807; ages 14–19 years) conducted in France in 1999. Measures Respondents were asked confidentially by self‐administered questionnaire (pen and paper) about their use of licit and illicit drugs and life‐style (including sporting activities outside school: hours per week, registration in a club, type of sport). Findings The U‐shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account. Conclusion The results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport. [ABSTRACT FROM AUTHOR]

Objective: The measures put in place to contain the coronavirus epidemic in France have led to fears of a massive increase in the consumption of alcohol, tobacco, and other drugs. Method: Taking advantage of an ongoing weekly Internet survey monitoring living conditions of the French population during the containment, we introduced questions on alcohol and tobacco use 1 month after the start of the first containment. Analyses were conducted with multivariate Poisson regressions. Results: Tobacco consumption remained almost unchanged. By contrast, more than a third of French people did change their weekly alcohol intake: 13% increased it, whereas 21% decreased it, indicating that the containment measures were often taken as an opportunity to reduce alcohol consumption, especially among those who drank less than 4 days per week before. Men were more likely to decrease their alcohol intake and less likely to increase it than women, probably because of a differential impact of the reduction of social activities on gendered social roles. The people most affected were smokers and those living in a dwelling in which someone had been infected, including themselves. Conclusions: The crisis tended to polarize alcohol consumption toward extremes. If the new drinking habits were to continue, the consequences could be beneficial for occasional drinkers but harmful for heavier drinkers. [ABSTRACT FROM AUTHOR]

Objectives: To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. 'Patients' voice is an excellent means to capture data on primary care pathways. We aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences, and to test whether these clusters were associated with a higher risk of poor clinical outcomes. Design: Cross-sectional online survey using life-event calendars. Setting: All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in France. Participants: 312 patients responded to the survey. Main outcome measures: From the day of symptom onset to the day of hospitalisation, we defined a symptom sequence as the time-ordered vector of the successive symptom grades (grade 1, grade 2, grade 3). State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom sequences. Multivariate logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit (ICU) and COVID-19 sequelae after hospitalisation. Results: Three clusters of symptom sequences were identified among 312 complete prehospital pathways. A specific group of patients (29%) experienced extended symptoms of severe COVID-19, persisting for an average duration of 7.5 days before hospitalisation. This group had a significantly higher probability of being admitted to ICU (adjusted OR 2.01). They were less likely to know a loved one who was a healthcare worker, and more likely to have a lower level of education. Similarly, this group of patients, who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time, may have been inclined to postpone reassessment when their health worsened. Their relatives played a decisive role in their hospitalisation. [ABSTRACT FROM AUTHOR]

Introduction: With France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17–May 10). This study explored the perception of the adult population about the need for—and access to—psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown. Material and method: This online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7–10, 2020). Results: One in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35–64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019. Conclusion: The perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary. [ABSTRACT FROM AUTHOR]

Objectives: To estimate geographical variations of child immunisation at the regional level in Senegal, to identify individual and contextual factors that could explain these regional discrepancies, and to measure their effects.Methods: Data come from the 2015, 2016 and 2017 Senegalese Demographic and Health Survey, a national survey targeting women aged 15-49, with a questionnaire focusing on health and reproductive issues including their children's immunisation status. We restricted the analysis to children aged 12-23 months (n = 4955) and conducted a multilevel logistic regression to assess individual and contextual factors associated with complete immunisation coverage.Results: The complete immunisation coverage rate of children was estimated at 68% and ranged from 41% in the region of Kedougou to 83% in the region of Dakar. The inter-regional variance was significantly different from zero (P = 0.006) in the empty multilevel model. It decreased by more than half (57 %) after adjusting for individual factors but remained significantly different from zero (P = 0.010). Regional variations of complete immunisation rates drastically decreased and were no longer statistically significant (P = 0.343) after adjusting for the following regional factors: population density, density of hospitals, literacy rate and proportion of health facilities with an antenatal care service.Conclusions: Regarding health policies designed to improve childhood immunisation and to reduce related inequalities, our results highlight the need to take into account both individual and contextual factors, with a focus on rural and deprived areas where children are at higher risk of incomplete immunisation. [ABSTRACT FROM AUTHOR]

Background: Long‐term medico‐social follow‐up of cancer survivors is a challenge because of frequent subsequent troubles. In particular survivors with lower health literacy (HL) have poorer health and might more often use primary care services. However, the impact of HL on cancer survivors' medico‐social follow‐up visits is not known. Our aim was to study medico‐social follow‐up and its associated determinants with a focus on HL 5 years after diagnosis. Methods: VICAN is a national survey of French adult cancer survivors 5 years after a primary cancer. The Single‐Item Literacy Screener was used to define functional HL in this sample. We also asked patients to report the frequency of follow‐up visits with a general practitioner (GP) and/or social worker (SW) regarding their cancer disease. Results: The 4045 participants were 57.4 ± 12.9 years old at diagnosis (range 20‐82) and 1495 (37%) were classified as having inadequate HL. Most cancer survivors (66.7%) were followed up by a GP regarding their cancer while only 14.5% had contact with a SW. After adjustment for sociodemographic, medical, and psychosocial characteristics, medico‐social follow‐ups (GP and SW visits) were more frequent among survivors with low HL. Furthermore, low income, unemployment, impaired mental health, treatment by chemotherapy, and perception of sequelae and fatigue were also associated with more frequent medico‐social follow‐up. Cancer localization association with medico‐social follow‐up was heterogeneous. Conclusion: French cancer survivors with limited HL, lower socioeconomic status, and more severe cancer were more likely to use GP care and social services. Raising awareness and training GPs and SWs on medico‐social follow‐up for patients with limited HL seem necessary to support these vulnerable survivors. [ABSTRACT FROM AUTHOR]

Worldwide, around 18 million people receive a cancer diagnosis each year, most of whom survive long enough to face additional cancer-related costs. In France, most costs directly related to cancer are covered by the National Health Insurance Fund, and cancer patients can receive treatments without paying advance fees. In this context, the costs faced by cancer survivors are mostly social costs. Drawing on fundamental cause theory, this study aimed to explore the socially-differentiated evolution of cancer survivor’s income five years after diagnosis. Our study draws on the findings of VICAN5, a French national survey that was conducted in 2015/2016 in a representative sample of 4,174 cancer survivors to obtain information on living conditions five years after diagnosis, and that was restricted to 12 tumour sites accounting for 88% of global cancer incidence in France. We used the multiple imputation method and the Heckman selection model to identify the factors associated with a decrease in household income per consumption unit (HICU), while accounting for missing data. Among survivors still working five years after diagnosis, 17.6% reported lower income at survey than at diagnosis. After adjustment for socio-demographic and medical characteristics, the decrease in HICU was more frequent in women, singles, low educated survivors, and survivors with reduced working time. Finally, subjective measures of income variation and economic well-being were a useful complement to objective measures since 31.6% of cancer survivors still working five years after diagnosis reported a perceived decrease in household income. In conclusion, inequalities in economic well-being persist long after diagnosis in France, and this despite the fact that most cancer-related costs are covered by the French National Health Insurance Fund. Consequently, more attention should be paid to cancer patients with low socio-economic status to help reduce inequalities in post-diagnosis living conditions. [ABSTRACT FROM AUTHOR]

The author reflects on the role participation in sports plays in the prevention of drug and alcohol abuse during adolescence. He suggests that research into the role that sports participation plays in the prevention of drug abuse has not yielded any definitive results. He argues that hypotheses should be developed and tested which can help determine whether there is a link between sports participation and drug abuse.

Background: The human papillomavirus (HPV) vaccine reduces the burden of cervical and other cancers. In numerous countries, a slow uptakeof this vaccine persists, calling for a better understanding of the structural factors leading to vaccine acceptation. We aimed to assess the attitudes toward HPV vaccination among its intended public to explore its specific characteristics. Methods: A random cross-sectional telephone survey of the French general population provided data from a sample of 2426 respondents of the target public: the parents of young women and the young women aged 15-25 themselves. We applied cluster analysis to identify contrasting attitudinal profiles, and logistic regressions with a model averaging method to investigate and rank the factors associated with these profiles. Results: A third of the respondents had never heard of HPV. However, most of the respondents who had heard of it agreed that it is a severe (93.8%) and frequent (65.1%) infection. Overall, 72.3% of them considered the HPV vaccine to be effective, but 54% had concerns about its side effects. We identified four contrasting profiles based on their perceptions of this vaccine: informed supporters, objectors, uninformed supporters, and those who were uncertain. In multivariate analysis, these attitudinal clusters were the strongest predictors of HPV vaccine uptake, followed by attitudes toward vaccination in general. Conclusions: Tailored information campaigns and programs should address the specific and contrasted concerns about HPV vaccination of both young women and of their parents. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To study the relationship between drug use and adherence to highly active antiretroviral therapy (HAART) among HIV-positive people, with two alternative measures of drug use: a set of drug uses considered independent and patterns capturing combinations of drug uses. Methods: A cross-sectional survey conducted among a nationally representative sample of 4963 HIV-positive people randomly recruited in 102 French hospital departments delivering HIV care. The researchers modelled non-adherence to HAART with a set of binary indicators of drug use (model I) or comprehensive patterns obtained with a cluster analysis (model II). Results: In model 1, heroin use, injection drug use, and cocaine/amphetamine/ecstasy use were not significant predictors of poor adherence in contrast with nicotine dependence, cannabis use, and amyl nitrate use. In model II, non-adherence to HAART was more prevalent among profiles characterised by alcohol abuse and multiple addictions, including nicotine dependence and use of various illicit drugs. Conclusions: Nicotine dependence, cannabis use, and amyl nitrate use are associated with non-adherence only if they are embedded in drug use patterns characterised by alcohol abuse or heroin use. The results also illustrate the interest in investigating the effects of drug use patterns on behavioural outcomes, rather than measuring independent effects of various drug use indicators that are highly correlated. [Copyright &y& Elsevier]

Reaching the last pockets of unvaccinated people is challenging, and has led to the consideration of mandatory vaccination for coronavirus disease 2019 (COVID-19). Our aim was to assess attitudes toward mandatory COVID-19 vaccination in France before the announcement of—and factors associated with opposition to—this type of policy. Between the 10th and 23rd May 2021, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over, and a specific sample of the French senior population aged over 65. Among 3056 respondents, 1314 (43.0%) were in favour of mandatory COVID-19 vaccination, 1281 (41.9%) were opposed to such a policy, and 461 (15.1%) were undecided. Among opponents to mandatory COVID-19 vaccination for the general population, 385 (30.05%) were in favour of mandatory COVID-19 vaccination for healthcare workers (HCWs). In multivariate analysis, the age groups 18–24 and 25–34 years were significantly more opposed than the reference group (>75 years old) with respective adjusted odds ratio (aOR) and 95% confidence interval (95%CI) 4.67 (1.73–12.61) and 3.74 (1.57–8.93). Having no intention of getting COVID-19 vaccination was strongly associated with opposition to mandatory vaccination (aOR 10.67, 95%CI 6.41–17.76). In comparison with partisans of the centre, partisans of the far left and green parties were more likely to be opposed to mandatory COVID-19 vaccine, with respective aORs (95%CI) of 1.89 (1.06–3.38) and 2.08 (1.14–3.81). Attitudes toward mandatory COVID-19 vaccination are split in the French general population, and the debate might become politicized. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the Covid-19 pandemic and the accompanying lockdown measures have had a major impact on societies around the world, leading to sleep problems for a large part of the population. In order to assess the sustainability of sleeping troubles related to the sanitary crisis, it was crucial to measure its prevalence after the end of the Covid-19 confinement.Methods: As part of an epidemiological survey on Covid and Confinement (COCONEL), we enquired on sleep disorders using two items in 4 repetitive cross-sectional surveys. The first took place during the first week of the French confinement (March 31 to April 2; N = 1005 participants). The second took place in the middle of this period (April 15-17; N = 1005). The two last surveys were held at the end of the confinement (May 7-10; N = 2003) and one month after the end (June 10-12; N = 1736). Using a random constant, the mixed model took into account the longitudinal character of the last two waves (intra-individual correlations for individuals surveyed in waves 3 and 4).Results: The prevalence of sleep problems significantly decreased during the last weeks of the confinement, and this trend was confirmed one month after the end of confinement. One quarter of the population reported that their sleep was better one month after the end of the confinement. Sleep improvement was reported more often by women and people aged less than 65. Such improvement was less frequent among those who were still highly exposed to the pandemic's media coverage after the end of the confinement.Conclusion: The possibility of recovering a good sleep largely depends on the type of sleep disorder. The decrease in sleep problems occurred mainly among people with mild sleep problems during the confinement. Further research is needed to assess the long-term effects of the Covid-19 pandemic and its confinement period on sleep quality in the general population. [ABSTRACT FROM AUTHOR]

The Covid‐19 pandemic has disrupted the habits of billions of people around the world. Lockdown at home is mandatory, forcing many families, each member with their own sleep–wake habits, to spend 24 hr a day together, continuously. Sleep is crucial for maintaining immune systems and contributes deeply to physical and psychological health. To assess sleep problems and use of sleeping pills, we conducted a cross‐sectional study of a representative sample of the general population in France. The self‐reported sleep complaint items, which covered the previous 8 days, have been used in the 2017 French Health Barometer Survey, a cross‐sectional survey on various public health issues. After 2 weeks of confinement, 74% of the participants (1,005 subjects) reported trouble sleeping compared with a prevalence rate of 49% in the last general population survey. Women reported more sleeping problems than men, with greater frequency or severity: 31% vs. 16%. Unusually, young people (aged 18–34 years) reported sleep problems slightly more frequently than elderly people (79% vs. 72% among those aged 35 or older), with 60% of the younger group reporting that these problems increased with confinement (vs. 51% of their elders). Finally, 16% of participants reported they had taken sleeping pills during the last 12 months, and 41% of them reported using these drugs since the lockdown started. These results suggest that the COVID crisis is associated with severe sleep disorders among the French population, especially young people. [ABSTRACT FROM AUTHOR]