Introduction - Lung cancer mortality is the most specific indicator of the health effects of tobacco. We present its trends in France since the 1950s and discuss the results in light of trends in tobacco consumption. Methods - Lung cancer mortality data were obtained from death certificates. Sales data and results from self-reported surveys on tobacco use were used to estimate average consumption by sex and age. Average consumption by sex was estimated by adjusting self-reported data with sales data. This consumption by sex was then adjusted for age, based on the proportions of regular smokers by sex and age obtained through linear interpolation. Results - A recent decline in lung cancer mortality has been observed among men, a consequence of the significant reduction in male smoking in France, and a very sharp increase in the risk of death from lung cancer among women who began smoking much more recently. The most dramatic changes are observed in the 35–44 age group: mortality among men has been halved over 10 years, while mortality among women has quadrupled over 15 years. Conclusion - Policy measures over the past decades have had an undeniable beneficial effect, but we can expect the epidemic to continue among women as the generations with a high proportion of regular smokers age. We can also expect the decline among men to level off, given that tobacco sales have remained constant since 2004. [author’s abstract]