Smoking is blamed for 60,000 deaths a year in France
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A regional health authority in western France is suing four tobacco companies for the cost of treating thousands of cancer patients.
In the first case of its kind in France, the national health insurance fund (CPAM) in the city of Saint-Nazaire is demanding 18.6m euros from BAT-Rothmans, Philip Morris, JTI-Reynolds and Altadis.
The CPAM says this is the amount it has spent on more than 1,000 people suffering from smoking-related diseases.
The court will adjourn to consider the evidence in the case and is expected to reach a verdict in a few months.
We want the justice system to recognise the responsibility of cigarette manufacturers in causing cancer
Guy Couillaud CPAM chief executive
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"BAT-France is awaiting the decision of the court and has full confidence in French justice," BAT spokeswoman Ann Tradigo told BBC News Online.
Another of the four companies, Philip Morris, declined to comment.
Free treatment sought
The case was originally brought in 1999 but has been delayed by procedural objections from the four companies.
"We want the justice system to recognise the responsibility of cigarette manufacturers in causing cancer and get back the money which we have had to spend on illnesses linked to tobacco," the CPAM chief executive in Saint-Nazaire, Guy Couillaud, told AFP news agency.
The fund will also ask for 3.6m euros annually from the manufacturers to cover expenses for future treatment.
It wants them to provide clearer labelling about health risks, pay for cancer detection facilities and offer free treatment for those trying to give up.
CPAM lawyer Francis Caballero told the agency that nearly 7bn euros are spent each year in France on smoking-related diseases, from which about 60,000 people die.
In recent years the tobacco industry has been hit by numerous multi-billion-dollar awards in cases brought by ill smokers.