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Italy’s ban on smoking in public places has led to 8% drop in consumption

Abergavenny Roger Dobson

The restriction of smoking in public places in Italy has led to an 8% drop in cigarette consumption, a new study says. And the ban on smoking in indoor public places has been almost universally accepted and does not seem to have had an adverse effect on business, say the authors of the study, which was published online ahead of print publication on 7 November in the Annals of Oncology (http://annonc.oxfordjournals.org/, doi: 10.1093/annonc/mdj070).

"The results of our study on the first extensive smoking ban in a large country show the advantages of smoke-free legislation, which may have major public health implications," wrote the authors, who come from a number of centres and organisations in Milan and Rome, including the Istituto di Ricerche Farmacologiche, the Istituto Superiore di Sanita, the Istituto DOXA, and Gallup International.

On 10 January this year the Italian government banned smoking in all indoor public places, including cafes, restaurants (except for a few with separate and regulated smoking areas), airports, and railway stations, as well as in all public and private workplaces.

After the ban came into force the authors conducted a survey on a representative sample of Italian adults to collect information on attitudes to smoking regulation. The sample comprised 3114 men and women over the age of 15 who were representative of the adult Italian population in terms of age, sex, geographical area, habitat, education, and working status.

The authors also compared smoking consumption data from nationally representative, population based surveys and from official sales figures over time to try to calculate the effect on tobacco consumption of the smoking ban.

Data from official legal sales data show that 28.3 million kg of cigarettes were sold in Italy in the period January to April 2005. In the same period last year 31.1 million kg were sold.

"This corresponds to a decline in cigarette sales by 8.9%. This compares well with a 7.6% fall in consumption revealed by the comparison between results from the 2005 survey and those from a companion survey conducted in March–April 2004," the authors wrote.

The fall in consumption from 2004 to 2005 seemed to be greater among young people (a fall of 23% for the 15-24 year age group) and among women (a fall of 10.5%), although the authors caution that the estimate for young people is based on a small sample.

The study shows that support for the ban grew after it came into force. The percentage of people in favour of a smoking ban in public places was 83.3% in 2001 but was more than 90% after the ban came into force.

The results also indicate that businesses have not been adversely affected. Just under 10% of men and women said they went more often to cafes and restaurants after the ban was introduced, while 7.4% said they went less often.

"The study quantified the fall in cigarette sales since the ban came into force in Italy at around 8%," wrote the authors. "These results suggest that smoke-free legislations do not unfavourably affect the business of restaurants or cafes."