31 May 2023: World No Tobacco Day Report| Tabaccologia

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On the occasion of the World No Tobacco Day 2023, on May 31^st 2023, the National Center for Addiction and Doping of the Istituto Superiore di Sanità (ISS) organized the annual conference “Smoking and the National Health Service”, with the patronage of the Italian Society of Tobaccology (SITAB) and the Mario Negri Pharmacological Research Institute - IRCSS. During the day there were numerous interventions on the topic of the fight against smoking and the National Report on Smoking and the new Guideline for the treatment of tobacco and nicotine addiction were presented. The “Smettodifumare.iss.it” platform and the Toll Free Telephone against Smoking (800 554088), tools that the center provides to help smokers quit, were promoted.

As usual, the initiative has its roots in the theme chosen every year for this day by the World Health Organization (WHO): for this year the topic was “Grow food, not tobacco”, a message aimed at encouraging the replacement of tobacco crops with sustainable crops, in order to contain the component linked to smoking which affects the global food crisis. In fact, around 3.5 million hectares of land around the world are converted to tobacco cultivation every year, an activity which contributes, among other things, to the deforestation of 200 thousand hectares per year. The 2023 campaign therefore invites governments to commit to developing policies and strategies that allow tobacco farmers to convert their crops into food crops, so as to guarantee a better life for their families too.

The day opened with the speech of the President of the ISS Dr. Brusaferro, who underlined the importance of addressing the issue of smoking from a One Health perspective, considering not only the health aspects linked to smoking-related diseases, but all the health risks (even the indirect ones) linked to climate change, in which tobacco production plays a non-negligible role.

The institutional greetings continued with the speeches of Prof. Garattini and Prof. Cattaruzza, respectively representing the Mario Negri Institute and SITAB. Both reiterated the importance of paying attention to the climate and humanitarian impact of tobacco cultivation, underlining the importance of intercepting and investing in youth advocacy with the aim of contributing to the fight against smoking.

During the first session of the day, moderated by Dr. Sirchia and Dr. Pichini (ISS), there were interventions by Dr. Mastrobattista (ISS) who presented the National Report on Smoking 2023; by Dr. Galeone (Italian Ministry of Health) who illustrated the perspectives and critical issues of the current prevention and control techniques for smoking, concluding with the speech by Dr. Pacifici (ISS) who illustrated the latest updates carried out by the ISS team on the treatment guidelines for tobacco and nicotine addiction. At the end of this first session, a lively debate was held on the interventions heard, with the participation of the audience present in the room who actively participated in the discussion with the speakers about the current critical issues of the fight against smoking.

The second session of the event, moderated by Dr. Mangiacavallo and Dr. Zagà, began with the speech of Dr. Agrimi (ISS) on the topic of Food security and the unsustainability of tobacco cultivation. The report presented the latest evidence on the topic, released by the WHO on the occasion of World No Tobacco Day 2023, underlining in particular how to date Italy still remains the leading European tobacco producer (28.6% of the EU market), with agreements between tobacco associations farmers (Coldiretti) and tobacco industry. Following the presentation entitled “Tobacco control in Italy”, during which Dr. Gallus (Mario Negri Institute) illustrated to the public the evaluation of the Tobacco Control Scale (TCS) 2021, relating to the adoption of the most important policies of tobacco control in the main European countries. The TCS evaluates the degree of adoption of the six policies identified by the World Health Organization and the World Bank as the most effective in terms of Tobacco Control:

1. price increases through tax increases;
2. smoking bans in public and private places;
3. financing of public information campaigns;
4. ban on advertising;
5. health warnings on cigarette packages;
6. access to smoking cessation treatments.

In the ranking, compared to other European countries, Italy has gradually lost positions in the adoption of effective policies, going from eighth place (out of 30 countries) in the 2006 TCS to eighteenth place (out of 37 countries) in 2021.

In the following speech, Dr. Spizzichino (Italian Ministry of Health) focused on some of the international activities implemented in various European countries in the fight against smoking, illustrating the paradigmatic example of Italy in which the comparison between the Ministry of Health, The Ministry of Economy and Finance and the Italian Customs and Monopolies Agency often encounter difficulties in implementing common policies to combat smoking due to the complexity of the legislative processes and ministerial discussions on such a delicate topic as Tobacco Control.

The second session comes to an end with the speech of Dr. Gorini (Institute for Oncological Study and Prevention, Florence) who presented the results of surveys conducted in Italy among adolescents, according to standardized international protocols (GYTS, ESPAD®Italia), about the spread of poly-use (traditional cigarettes smoked together with other novel tobacco products). From the investigations it appears clear that we are witnessing a process of partial replacement of the traditional cigarette with other products, among which electronic cigarettes (e-cigs), probably due to their lower price, appear as preferred sources of smoking among adolescents, surpassing heated tobacco products (HTPs) and traditional cigarettes. Dr. Gorini then addressed the controversial topic of the use of e-cigs as a smoking cessation tool, explaining how in e-cig trials more than 80% of vapers continue to vape at the end of treatment, exposing smokers to a double risk of relapse towards traditional cigarettes.

The conference ends with a warning not to lower our guard on new tobacco products and to invest in wide-ranging Tobacco Control policies that include the involvement of young people and the development of campaigns aimed at all smokers encouraging them to stop smoking regardless of the product they use, through the use of all the means at our disposal, including the use of social networks and artificial intelligence, already implemented in other European countries with considerable success.