The law n. 3 of 16 January 2003 which, with article 51, established for the first time in Italy the ban on smoking in enclosed spaces open to the public, a law that at its inception met strong resistance but which then changed the customs of the country and partly also the social etiquette. Proposed and strongly supported by the then Minister of Health Jerome Sirchia, the law, which came fully into force on 10 January 2005, has contributed in two decades to significantly reduce the number of smokers in Italy.
However, this trend has recently reversed: if between 2003 and 2020 the share of smokers in the population over 15 had fallen from 33% to 22%, between 2020 and 2022 there was a leap forward which brought the share to 24.2%. In absolute terms, this is 800,000 smokers more than the 11.6 million of two years ago.
“Law 3/2003 was a great battle, which the citizens understood, so much so that over the years they have defended the provision from the continuous attacks by the multinationals of smoking more than politics”, the former minister comments to ANSA Sirchia. “People – he adds – have understood that it is a measure that does not look at someone’s specific interests, as often happens, but at those of the population, their health and their lives”.
For Sirchia, however, an extra effort would be needed today by the institutions to “carry forward the anti-smoking agenda”. Also in the light of a further challenge that has emerged in recent years: that of the products that “multinationals have invented to differentiate themselves and re-conquer the market, such as electronic cigarettes and heated tobacco products”.
According to data released by the Istituto Superiore di Sanità (ISS) in May 2022, on the occasion of World Tobacco Day, the share of Italians who smoke cigarettes with heated tobacco has grown from 1.1% in 2019 to 3.3 % in 2022, with more than one in three people (36.6%) considering them less harmful than traditional cigarettes. E-cig users have also increased in recent years, going from 1.7% in 2019 to the current 2.4%.
For the former health minister, one of the first signs that politics should give to confirm its commitment to the fight against smoking could be precisely that of “extending the rules on the ban on smoking in closed places to include these new products as well as exteriors of the premises that are declared ‘outdoors’ but which, between canopies and awnings, have very little open air”.
It is estimated (Ministry of Health data May 2022) that in Italy over 93,000 deaths per year are attributable to smoking (20.6% of the total of all deaths among men and 7.9% of the total of all deaths among women) with direct and indirect costs of over 26 billion euro.
Among the benefits of law 3/2003, the ISS underlines the reduction of acute coronary events recorded in Italy between 2004 and the years following the introduction of the law, “with values ranging from -4% to -13% of hospitalizations for heart attack among people of working age”. The balance of the experts of the Italian Society of Allergology, Asmology and Clinical Immunology (SIAAIC) was also positive. After the entry into force of the law, visits to the emergency room and hospitalizations of asthmatic patients, even among the youngest, have decreased by 10/15%.