Int. J. Environ. Res. Public Health 2009, 6 4. Discussion 617 In France, among executive managers and the professional occupations, the prevalence of smoking declined significantly between 2000 and 2003, then it remained stable till 2008. Among manual workers, the decrease occurred later, was less pronounced, and after 2005 the smoking prevalence came back to its initial level. Among unemployed people, the smoking prevalence exhibited a more erratic pattern over time, and it was higher in 2008 than in 2000. These trends clearly demonstrate that since 2000 there is an increasing social differentiation of cigarette smoking in France. Regarding smoking habits, poor smokers were heavier smokers, they were more frequently tobacco-dependent, and they more frequently react to the cigarette price increase by turning to cheaper or hand-rolled cigarettes. Regarding smoking motives, poor smokers were more prone to smoke automatically, or for reducing negative feelings, and less prone to smoke to socialise or improve concentration. Finally, in- depth interview showed that poor smokers were aware of their addiction to nicotine. But they also talked about the pleasure and happiness they get from smoking, and they highlighted the essential needs satisfied by smoking: stress relief, cheap leisure, a compensation for loneliness, break-up or redundancy… They also frequently claimed that smoking is “all they got left”. Several limitations of the present study must be acknowledged before discussing our results. Firstly, repeated cross-sectional data provide smoking rates to compare one with another, but each rate mixes lifetime consumption paths observed at various stages for successive birth cohorts. A life-course perspective could have better captured the dynamics of smoking [23,24]. Secondly, changes in smoking prevalence result from changes in both smoking initiation and cessation. Nevertheless, previous analyses based on the same data showed that the social differentiation of smoking is mostly due to contrasted quitting rates [4]. Concerning poor smokers and other smokers‟ habits and motives, data were collected with a closed-ended questionnaire that prevents respondents from qualifying or justifying their responses, and we lack detailed information about non-respondents. Conversely, qualitative data provided a more comprehensive insight into poor smokers‟ perspective, but corresponding results cannot be generalised. Finally, the qualitative and the quantitative surveys did not use the same definition of poverty. In our quantitative study we opted for a subjective measure of poverty, because an objective one would have been to simplistic, unless we had much more information on respondents‟ living conditions. Nevertheless, our self-report measure was consistent with some objective indicators (occupation and monthly household income, see Table 1). We consider that it is very important to understand why people, and especially poor people, keep on smoking cigarettes despite extensive anti-tobacco policies, including cigarette price increases. Indeed, the scientific understanding of smoking behaviours is currently dominated by a biomedical model that tends to overlook smokers‟ motives, because within this model people simply smoke to reverse the symptoms of nicotine withdrawal [15,25]. Our quantitative results suggest that poor smokers are less likely to quit than wealthier smokers because they are more frequently tobacco-dependent, and because they satisfy more essential needs with cigarette smoking (the reduction of negative feelings, instead of facilitating socialisation or improving concentration). This interpretation is partially confirmed by our qualitative data, as most participants reported smoking to relief stress or to compensate for boredom or loneliness. Nevertheless, in-depth interviews with poor smokers also suggest to complete and to qualify this interpretation.