Attitudes towards tobacco and nicotine control policies in Italy: insights from a 2024 national survey

Introduction This study assesses the Italian population's support for innovative tobacco control policies, which aims at reducing use of nicotine-containing products and exposure to secondhand smoke and aerosol. Methods A cross-sectional study was conducted in 2024 among a representative sample of 3125 Italian adults. We assessed support on banning tobacco sales to people born after a certain year (Smoke-Free Generation, SFG), raising the minimum age for purchasing tobacco to 21 years (Tobacco 21, T21), substantially increasing tobacco taxation, banning electronic cigarettes (e-cigarette) and heated tobacco products (HTP) in indoor public places and workplaces, and prohibiting tobacco and e-cigs advertising. Results Support for tobacco control policies was 67.0% for the SFG policy, 72.9% for the T21 policy, 61.5% for a tax increase, 80.8% for a ban on indoor e-cigarette and HTP use in public places and 81.7% in workplaces respectively, and 78.2% for an advertising ban for all nicotine products. Support for all policies increased with age (p-values for trend ranging from <0.001 to 0.037) and was significantly lower among current smokers (support ranging from 17.9% to 59.7%). E-cigarette users showed lower support for a SFG (32.4%) and advertising bans (41.4%), while HTP users were less supportive of all policies except the T21 policy (support ranging from 13.2% to 43.9%). Conclusion In Italy, strong public support exists for new tobacco control laws, especially among never smokers and non-users of novel products. However, also a considerable proportion of current smokers, e-cigarette and HTP users support these policies. Policymakers can confidently advance these strategies, while public campaigns should target less supportive groups.