At any age, quitting smoking is the prevention step with the biggest payoff: one year after quitting, the risk of heart attack is halved; quitting at 50 gains back about four years of life expectancy (French National Health Insurance, Assurance Maladie). Nicotine replacement covered at 65%, the free 39 89 helpline, Mois sans tabac: the prevention check-up helps you choose your moment and your method.
Why is quitting smoking still the number one prevention step?
Because tobacco remains the leading cause of preventable death in France: more than 68,000 premature deaths in 2023, or 11% of all deaths, according to Santé publique France, the French public health agency. On average, one in two regular smokers dies from the consequences of smoking. And there is no threshold below which smoking carries no risk: the only effective way to reduce that risk is to quit.
In our consultations, we see the three main families of disease that tobacco drives. Cancers first: one cancer in three is linked to tobacco, and 80 to 90% of lung cancers are caused by active smoking, not to mention cancers of the throat, mouth, pancreas, kidney and bladder. Cardiovascular diseases next: heart attack, stroke, peripheral artery disease of the legs. And finally chronic obstructive pulmonary disease (COPD), a respiratory disease that gradually leaves you short of breath and is mainly caused by smoking. Tobacco also weighs, more quietly, on diabetes, cholesterol, teeth and eyesight.
The good news is that quitting pays off at any age. French National Health Insurance notes that quitting at 40 gains back about 7 years of life expectancy, at 50 about 4 years, and at 60 about 3 years. The benefits start quickly: twenty minutes after the last cigarette, blood pressure and pulse return to normal; after 24 hours, carbon monoxide has been cleared from the body; after one year, the risk of heart attack has been cut in half. That is why smoking is the first variable to act on when we estimate 10-year cardiovascular risk: smoking status feeds directly into the SCORE2 calculation.
Where does France stand? In 2024, 18% of people aged 18 to 75 smoked every day, compared with 25% ten years earlier: four million fewer daily smokers since the first national tobacco reduction program, launched in 2014. But 55% of daily smokers say they want to quit, and only 17.3% made an attempt lasting at least a week during the year. That gap between wanting to quit and actually doing it is exactly where prevention can help.
What does the prevention check-up change for a smoker?
The prevention check-up is a 30- to 45-minute consultation, fully covered (100%) by French National Health Insurance, offered at four stages of life: ages 18–25, 45–50, 60–65 and 70–75. Tobacco is one of its official topics, and the self-assessment questionnaire completed before the appointment asks about it directly. What the check-up changes is not the patient’s willpower: it is the setting.
First, time. In a visit for a sore throat, the advice to quit fits into one sentence. Since 2014, the French National Authority for Health (HAS) has recommended that every primary care professional bring up tobacco with every patient who smokes, whatever the reason for the visit, and offer support. For once, the prevention check-up provides the time to do this properly: where are you with it, what is holding you back, what went wrong last time?
Next, priorities. The check-up leads to a Personalized Prevention Plan that sets only one or two goals. For a smoker, quitting is almost always the goal we suggest first, because no other measure has a comparable effect on the heart, the lungs and cancer risk. But the patient decides: a quit date you have chosen is worth more than a goal imposed on you.
Finally, practical referral. The plan names the aids: a nicotine replacement prescription from your regular doctor (médecin traitant), a call to 39 89, signing up for Mois sans tabac, a tobacco cessation consultation. The document is sent to your regular doctor, unless you object, and your doctor takes it from there. Between 45 and 50, smoking often goes hand in hand with rising blood pressure or cholesterol: our page on the prevention check-up at ages 45–50 shows how these factors are considered together. Between 18 and 25, the challenge is different: keeping social smoking from becoming a daily habit, as we explain in the prevention check-up at ages 18–25.
Which quit-smoking aids are covered in 2026?
Since January 1, 2019, the vast majority of nicotine replacement products have been covered at 65% by French National Health Insurance, on prescription, with no annual cap; the remainder is usually covered by your supplementary health insurer (mutuelle). Varenicline, a drug prescribed when nicotine replacement has not worked, is also covered. Phone support from the 39 89 helpline is free.
| Aid | What it is | Coverage in 2026 | Who prescribes or refers |
|---|---|---|---|
| Nicotine replacement (patches, gums, lozenges) | Nicotine without smoke to relieve cravings; usually a 3- to 6-month treatment | Covered at 65% by French National Health Insurance on prescription, no annual cap | Doctor (including occupational physician), midwife, nurse, dentist, physiotherapist |
| Nicotine sprays and inhalers | Fast-acting forms | Unregulated prices, not covered | Advice from a pharmacist or doctor |
| Varenicline | Prescription drug when other approaches have failed; not before age 18 or during pregnancy | Covered as part of smoking cessation | Doctor |
| Bupropion | Prescription drug | Not covered | Doctor |
| 39 89 (Tabac Info Service) | Phone line, personalized follow-up by the same tobacco cessation specialist, callbacks at the time you choose | Free, Monday to Saturday from 8 a.m. to 8 p.m. | Direct access |
| Tobacco cessation consultation | Specialized consultation, in the hospital, at an addiction center or in private practice | Depends on the facility | Regular doctor, Tabac Info Service directory |
| Tabac Info Service app | Personalized e-coaching, progress tracking | Free | Direct access |
What studies show, as summarized by Santé publique France: nicotine replacement increases the chances of success by 50 to 70%, and motivational interviewing increases the likelihood of quitting compared with minimal advice. The World Health Organization puts it another way: counseling and medication combined can more than double the chances that a quit attempt succeeds. In practice, combining treatment with human support is the strategy that works best; it is also the easiest to set up, since the prescription and the 39 89 helpline are available the same week as the check-up.
What about e-cigarettes? Santé publique France states that they can be considered a quitting aid for smokers who want to stop, while stressing that evidence on their long-term effectiveness remains limited. Our position as doctors: if you vape so you no longer smoke, it is the lesser evil; the goal is still to stop depending on nicotine. Hypnosis and acupuncture, on the other hand, have no proven effectiveness.
How does Mois sans tabac work?
Mois sans tabac (“Tobacco-Free Month”) is a collective challenge organized every November by Santé publique France: quit smoking for 30 days, together. It rests on a simple fact: quitting for 30 days makes you five times more likely to quit for good, because the most difficult withdrawal symptoms are behind you.
Sign-up is free and gives access to a quit kit with a 40-day program, the app, the 39 89 helpline and a community of participants. The 2025 edition brought together 117,568 participants. In our experience, what works is the group effect: at work, at home, among friends, it is easier to hold on when you are not the only one counting the days.
If your prevention check-up falls in September or October, the timing is ideal: the Personalized Prevention Plan can set signing up for Mois sans tabac as the first dated action, and the appointment with your regular doctor for a nicotine replacement prescription within the following two weeks. The overall framework of the program is described on our reference page about the prevention check-up.
How can you quit smoking without gaining weight or giving in?
The two fears we hear most often in consultations are weight gain and irritability. They are real, but manageable, and that is exactly what nicotine replacement and support are for.
On weight: nicotine suppresses appetite and slightly increases energy expenditure; after quitting, gaining a few kilograms is common. Three levers limit it: properly dosed nicotine replacement (too low a dose drives you to compensate by snacking), taking up physical activity at the same time as quitting, even just thirty minutes of walking a day, and paying attention to dietary guidelines without a restrictive diet. The month you quit is not the right time to lose weight: stop smoking first, then deal with the rest.
On cravings: intense urges last a few minutes. Having a plan for those minutes (nicotine gum or lozenge, a glass of water, a few steps outside, a call to a loved one) makes all the difference. The 39 89 helpline lets you set up regular phone appointments with the same tobacco cessation specialist, who calls you back at the agreed time; 87% of its users say this follow-up helped them quit.
On alcohol and coffee: these are two common relapse triggers in the first weeks. We discuss them openly at the check-up, and our page on alcohol guidelines explains why the two topics are linked.
What if I have already tried and relapsed?
A relapse is not a final failure: it is a common step, and the HAS devotes a specific tool to preventing it in its 2014 recommendation. Every attempt teaches you something: the moment you gave in, what was missing (a nicotine replacement dose that was too low, no follow-up, a setting that was too tempting).
What we do at the prevention check-up after a relapse: go back over the history of your attempts, without judgment; identify what worked, even briefly; suggest a different strategy (combination treatment with a patch and an oral form, phone support, Mois sans tabac, or varenicline through your regular doctor if nicotine replacement has failed several times); and set a new date, chosen by the patient.
Key takeaways
- Tobacco causes more than 68,000 premature deaths a year in France (2023); one in two regular smokers dies from it, and there is no risk-free threshold.
- Quitting pays off at any age: about 7 years of life expectancy regained at 40, 4 years at 50, 3 years at 60; the risk of heart attack is halved after one year.
- Nicotine replacement has been covered at 65% on prescription since 2019, with no cap; the 39 89 helpline is free Monday to Saturday from 8 a.m. to 8 p.m.
- Mois sans tabac, every November: after 30 days, you are five times more likely to quit for good.
- The prevention check-up gives you time to talk about it, sets priorities and schedules a first dated action, shared with your regular doctor.
What Sokrate lets you do
Sokrate lets you prepare your prevention check-up online: an adaptive questionnaire covering nine dimensions of health, including tobacco, alcohol, physical activity and cardiovascular risk, followed by a Personalized Prevention Plan written and signed by a doctor and sent to your regular doctor unless you object. A coordinating nurse provides long-term follow-up, including in the weeks after a quit date. The check-up remains fully covered (100%) by French National Health Insurance when carried out by an authorized professional. To be notified when the service opens in your area, join the waitlist.