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A damage/benefit evaluation of addictive product use


  • Funding: Inserm/University Paris SUD funded the regular salaries of all investigators.

Michel Reynaud, Department of Psychiatry and Addictology, University Paris SUD, Paul Brousse Hospital, 12/14 Avenue Paul Vaillant Couturier, F-94804 Villejuif, France. E-mail:


Aims  To obtain damage/benefit assessments of eight commonly used addictive products and one addictive behaviour from French addiction experts and link these to overall evaluations.

Design and setting  Criteria-based evaluation by experts in addiction. Specific statistical modelling to estimate the relative contribution of various criteria to formulating expert general opinion on products.

Participants  Forty-eight French experts in addiction.

Measurements  Twelve criteria covering the whole spectrum of damages and benefits to users and to society evaluated using visual analogue scales (VAS). Direct measure of expert overall subjective opinions on products from user and from social perspectives.

Findings  Damage scoring identified alcohol (damage score = 48.1), heroin (damage score = 44.9) and cocaine (damage score = 38.5) as the most harmful products to users and to society; gambling was considered the least harmful (score = 22.5), replicating previous results. Damage scoring correlated poorly with legal status or with overall subjective expert opinions of products. Benefit perception scores indicated alcohol as a clear outlier (benefit score = 45.5) followed by tobacco (benefit score = 34.3) and cannabis (benefit score = 31.1). Statistical modelling suggested that experts attributed 10 times more importance to benefit perception than to damages when making their subjective opinion from a user perspective and two times more importance to benefit perception than to damages in formulating their opinion from a social perspective.

Conclusions  The perceived benefits of addictive products appear to have a major impact on the opinion of those products expressed by a number of French addiction experts.