Pubblicato: 2023-10-16

Resumed action against tobacco and nicotine-based products

Internist and hematologist, former President of North Italy Transplant Program and Director of Centro Trasfusionale Ospedale Policlinico Milano, former Minister of Health.

In this late Spring 2023, the World Health Organization, after officially declaring the end of COVID-19 pandemic over, resumed its action to thwart consumption of tobacco and other nicotine-containing products. Twenty years ago (May 2003) the World Health Organization promoted the Framework Convention on Tobacco Control, which realises the binding adherence of 182 nations to prevent the tobacco industry from continuing to harm public health and hinder policies that protect it.

Since years, the tobacco industry has been applying initiatives to disinform public opinion about the peril of its products, concealing and mystifying the outcomes of independent scientific research; at the same time, by implementing pervasive lobbying initiatives that also manage to block governmental measures that may damage its interests. Italy also needs a Multi-Year Government Plan that provides for a range of initiatives to prevent tobacco use such as:

  1. Progressive reduction of the nicotine content of all tobacco products and vaping products. The Istituto Superiore di Sanità should regulate and control all products containing nicotine on the market.
  2. Prohibition of tobacco use and vaping in closed premises (in whole or in part), in crowded places, parks and public and private beaches, schools and health appliances.
  3. Prevention of initiation of tobacco and other nicotine-containing products in young people. Prohibition of use and sale of nicotine-containing products to persons under 18 years of age.
  4. Countering so-called harm reduction techniques for all nicotine-containing products, so that they do not pave the way for old and new products that are harmful to health.
  5. Conversion of tobacco crops (with incentives for farmers).
  6. Prohibition of overt and/or covert advertising of nicotine-containing products.
  7. Severe contrast of cigarette butts’ dispersion in the environment.
  8. Taxes for damage to people and things, caused by tobacco and substitutes, and at the same time to invest on and strengthen Smoking Cessation Centres and community initiatives aimed at informing and increasing social reproach against those who consume nicotine-containing products. Even the population, in addition to governments, in fact, is entitled to play an important role in curbing the intrusiveness of the profits of tobacco and other nicotine-containing products.
  9. Sanctions and responsibilities for the application of controls and sanctions.
  10. Financing of this Government Plan (not of individual Ministries) proportionate to the objectives and the time set to achieve them.

Community engagement

Each of us has the possibility and the moral duty to make those around us understand that:

  1. Smoking is an individual choice full of responsibility:
    1. towards oneself
    2. towards society
    3. towards the environment.
    In fact, it causes:
    1. damage to one’s own health and that of others (i.e., second hand-smoking)
    2. damage to health (Nations’ health cost burden)
    3. Crops
    4. damage to the environment
    5. microplastic butts
    6. damage to companies (smoke break and/or absence from work, fire insurance) and municipalities (cigarette butts’ removal).
  2. Arrogance and lack of respect for the rights of all citizens:
    1. costs (health and social) paid by everyone and not only by smokers
    2. damage to the planet (not compensable)
    3. inequalities and injustices (violation of the principle of equal rights and duties for all citizens (Charter of Nice1)
  3. Those who cause harm to others by their own choice are at fault. It must be blamed by society and society must understand the reasons for this adverse judgment.

Citizen engagement

Increasing social reproach for those who consume smoking products because it creates damage (to itself, to society, to the environmental) and inequalities (everyone pays and not just those who smoke).


1. Art. 20 of the Charter of Nice (Charter of Fundamental Rights of the European Union) proclaimed on 7.2.2000 – All persons are equal before the law (equal rights and duties) (similar to Art. 3 of the Italian Constitution).

Bibliografia di riferimento

– Lee K, Egbe CO, Bianco E, Arora M. The 20th anniversary of the WHO Framework Convention on Tobacco Control: hard won progress amid evolving challenges. Lancet 2023;S0140-6736(23)01080-2. https://doi.org/10.1016/S0140-6736(23)01080-2

– Wade S, Weber MF, Sarich P, Caruana M, Watts C, Va-neckova P, et al. Fifty-year forecasts of daily smoking preva-lence: can Australia reach 5% by 2030? Tob Control 2023:tc-2022-057624. https://doi.org/10.1136/tc-2022-057624


Girolamo Sirchia

Internist and hematologist, former President of North Italy Transplant Program and Director of Centro Trasfusionale Ospedale Policlinico Milano, former Minister of Health.


© SITAB , 2023

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