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Background In 2018, smoking rate among French adults was 32.0%. This rate has been slowly decreasing over the past years but remains high compared to other European countries. In addition, smoking habits have changed over time and for instance roll-your-own tobacco (RYO) is both cheaper and seen as less dangerous. It is crucial to keep an eye on these changes in order for public health actors to adapt their actions in the fight against smoking. Methods Data come from the Santé publique France health Barometer, a national representative phone survey. In the 2005, 2010, 2014, 2017 and 2018 editions, respectively 28,224, 25,034, 15,186, 25,319 and 9,074 adults where asked about their smoking habits. Results In 2018, three quarters of smokers smoked cigarettes, over a third smoked RYO and about ten percent smoked hookahs. The proportion of smokers using exclusively RYO tobacco has more than doubled in recent years (from 8.1% in 2010 to 20.5% in 2018). Since 2010, RYO tobacco is taking shares over traditional cigarettes especially among the poorest smokers. In 2018, RYO tobacco users were more often young men or deprived individuals. Conclusions The share of cigarette smokers switching to RYO has increased over the past years. It seems to be both a result of changes in trends and a way for deprived smoker to cope with higher prices for cigarettes. Key messages Public health actions need to take into account the recent increase of popularity of RYO tobacco in France. taxes need to be adjusted in order to level up RYO tobacco prices compared to traditional cigarettes.

Recent changes in smoking habits in France