Safeguarding palliative and serious illness care in America.

In 2019, tobacco smoking represented the primary global risk factor for premature death among men []. Although its prevalence has declined since 1990 [], smoking still accounted for 10%–20% of disability‐adjusted life years in most European countries in 2019 [], with France showing a particularly high smoking burden []. In France in 2024, 17.4% of adults aged 18–79 smoked tobacco daily, a proportion similar to that observed among those aged 18–29 (18.4%) []. Young adulthood is a critical period for establishing and reinforcing tobacco smoking as a stable, long‐term habit [, , ]. During this stage, cannabis co‐use has been identified as a major risk factor for progression to sustained and frequent tobacco smoking [, ]. Among adolescents and young adults, cannabis use has also been associated with poorer academic achievement and increased mental distress [, ]. According to the most recent surveys, 15.0% of EU residents aged 15–34 reported cannabis use in the past year []. In contrast to tobacco, the prevalence of cannabis use in Europe increased between 2010 and 2019 []. However, the burden of cannabis use disorder (CUD) has not shown a parallel rise, with age‐standardised disability‐adjusted life years rates remaining high but relatively stable in Western Europe, particularly among young adults [, ]. In 2023 in France, where cannabis possession remains illegal, past‐year prevalence exceeded 10% among adults aged 18–64, and 6.6% of those aged 18–24 reported regular use (defined as 10 or more uses in the past month) []. In 2021 in France, 80% of adults who used cannabis in the last month also smoked tobacco cigarettes daily. The prevalence of tobacco and cannabis co‐use (defined as daily cigarette smoking and at least monthly cannabis use) was 8.3% among adults aged 18–30, and adults aged 18–30 represented 46.3% of adults who co‐used [].