When Cancer Doesn’t Stop People From Smoking

According to Santé Publique France, tobacco killed around 68,000 people in France in 2024, nearly 186 deaths per day. Worldwide, it is responsible for more than 8 million deaths each year, according to the World Health Organization. Despite the scientific consensus on its harms, and decades of prevention measures such as awareness campaigns, plain packaging, graphic warning labels, and price increases, nearly a quarter of French adults still smoke. Why is it so difficult to encourage a change in behaviour?

Beyond public health messaging, lived experience, such as a loved one falling ill or a parent diagnosed with a smoking-related cancer, might be expected to act as a wake-up call and permanently change behaviour. But is that really the case? Researchers Sylvie Blasco, Eva Moreno Galbis, and Jeremy Tanguy examine the impact of a “family shock,” such as a relative’s diagnosis, on behaviour. Their study offers important insights for public health policy.

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Dialogues économiques is a digital journal published by the Aix-Marseille School of Economics (AMU, CNRS, EHESS, Centrale Méditerranée). A gateway between academic research and society, Dialogues économiques provides all citizens with the keys to economic reasoning. Articles are published every two weeks.

The researchers drew on data from the Constances cohort, a large-scale public health program tracking more than 220,000 adults in France over several years. Participants report their lifestyle habits annually, including tobacco use, along with medical check-ups and family health histories. This allows researchers to reconstruct individual smoking trajectories over time.

Mixed findings in earlier research

The study fits into a broader body of work in health economics on risk behaviours following a parent’s diagnosis. Earlier research has produced mixed results. Some studies¹ have found that health shocks can shift individual preferences. For example, American economists Michael Darden and Donna B. Gilleskie² observed a slight decline in smoking, mainly among daughters, after a father experienced a cardiovascular event. Other research on the intergenerational transmission of behaviour points to strong continuity and generally concludes that the effects are weak or even non-existent.

Thanks to the richness of the Constances cohort, the researchers were able to examine whether a diagnosis of lung cancer or another smoking-related cancer in parents affects their children’s smoking behaviour. They also explored how the impact varies depending on the child’s age at the time of the diagnosis.