Int. J. Environ. Res. Public Health 2009, 6, 608-621; doi:10.3390/ijerph6020608 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdpi.com/journal/ijerph Article “It’s All We Got Left”. Why Poor Smokers are Less Sensitive to Cigarette Price Increases Patrick Peretti-Watel 1,2,3,* and Jean Constance 1 1 INSERM, U912 (SE4S), IPC, 232 Bd Sainte-Marguerite, 13273 Marseille Cedex 09, France; E- Mail: jean.constance@free.fr (J. C.) 2 UniversitéAix Marseille, IRD, UMR-S912, 58 Bd Charles Livon, 13284 Marseille Cedex 07, France 3 ORS PACA, Observatoire Régional de la SantéProvence Alpes Côte d'Azur, 23 rue Stanislas Torrents, 13006 Marseille, France * Author to whom correspondence should be addressed; E-Mail: Patrick.peretti-watel@inserm.fr; Tel.: +33-491-598-907; Fax: +33-491-598-918 Received: 29 December 2008 / Accepted: 6 February 2009 / Published: 10 February 2009 Abstract: In France, between 2000 and 2008, concurrently to the increase in cigarette price, we observed an increasing social differentiation of cigarette smoking: smoking prevalence decreased among executive managers and professional occupations, it remained stable among manual workers, and it increased among the unemployed. Poor smokers were heavier smokers, they were more frequently tobacco-dependent, and they were more prone to smoke automatically or to reduce “negative feelings”. In-depth interviews provided a more comprehensive insight into poor smokers‟ motivations: they were aware of their addiction, but they also talked about the pleasure they get from smoking, and they highlighted the essential needs satisfied by smoking: stress relief, cheap leisure, compensation for loneliness, break-up or redundancy… Acknowledging the functional aspects of smoking experienced by poor smokers helps to understand why increasing the cigarette price is unlikely to deter many poor smokers from smoking. Keywords: Cigarette smoking; poverty, smoking motives.