Giorgia Meloni is generally considered a conservative prime minister. Yet on tobacco harm reduction, her government has sometimes adopted a comparatively progressive position by resisting policies that automatically treat vaping and heated tobacco as equivalent to smoking.
Since taking office in October 2022, the Meloni government has maintained Italy’s tobacco controls and gradually increased cigarette taxes. It has also resisted sweeping restrictions on lower-risk nicotine products and opposed European recommendations to regulate smoking, vaping and heated tobacco similarly in public spaces.
This does not mean Italy has developed a comprehensive tobacco harm reduction strategy. Important inconsistencies remain, and smoking and youth nicotine use continue to cause concern. Nevertheless, compared with governments pursuing prohibition-oriented policies, Italy has shown greater willingness to preserve alternatives for adults who cannot or do not wish to quit nicotine entirely.
Italy has had its smoke-free law in place long before Meloni took office. This legislation, introduced by former health minister Girolamo Sirchia, came into full effect in 2005 and banned smoking in enclosed workplaces and public places like bars and restaurants, with the exception of designated smoking rooms. Subsequent regulations increased the minimum age for purchasing tobacco and e-cigarettes to 18 and made it illegal to smoke in cars when children or pregnant women are on board. There are also EU regulations that dictate packaging, warning labels, ingredients, and advertising.
Meanwhile, some public-health organisations have criticised Italy for allowing heated-tobacco products in certain places where cigarette smoking is prohibited. In fact, the 2025 European Tobacco Control Scale awarded the country only 12 of 22 points for smoke-free environments, partly because heated tobacco is not regulated identically to combustible cigarettes.
From a tobacco harm reduction perspective, a lower score, of course, does not necessarily mean the policy has gotten worse. The outdated scale gives credit to countries for treating heated tobacco as traditional smoking, but it doesn’t really account for differences in combustion, emissions, or relative risk. A sensible harm reduction regulatory system would impose restrictions in a balanced way instead of applying cigarette-based standards to every nicotine product.
Meloni’s coalition pushes back against sweeping bans
In early 2023, Health Minister Orazio Schillaci suggested tough measures on heated tobacco, including extending smoking-ban protections to heated tobacco products and expanding smoke-free areas outdoors. The proposals aimed to cover parks and outside areas of bars when children or pregnant women were around.
However, this plan faced pushback within Meloni’s coalition. Deputy Prime Minister Matteo Salvini stood up for e-cigarettes as a viable alternative for smokers. Other politicians felt the measures were an excessive form of state interference. Ultimately, the proposal didn’t pass into law.
Critics might see this as the government failing to take action. But for those who understand harm reduction, halting a policy that blurs the lines between combustible and non-combustible products can be viewed as cautious and evidence-based. Regulations that ignore risk differences could actually deter smokers from making the switch by suggesting that vaping is just as risky as smoking.
Meloni has not established a formal national harm reduction programme, and her government could communicate relative risk more clearly. Still, its reluctance to impose identical restrictions suggests some openness to differentiated regulation.
Turin’s five-metre rule stirs up debate
At the same time, local authorities have occasionally taken a tougher stance. Back in April 2024, Turin updated its urban-police regulations to ban smoking or vaping outdoors within five metres of another person unless that person gives their explicit consent. However, consent doesn’t change the restrictions around children or pregnant women. Breaking this rule could result in a €100 fine. Mayor Stefano Lo Russo referred to the new measure as a way to show respect for non-smokers.
At the time, the World Vapers’ Alliance (WVA) was quick to slam the decision. Director Michael Landl argued that treating vaping and smoking as the same thing strengthens the mistaken belief that both carry similar risks, which might deter smokers from making the switch. Policy manager Alberto Gómez Hernández raised concerns about the rule’s scientific basis and practicality, calling it a poorly thought-out publicity stunt with potentially harmful effects.
Turin’s rule may be disproportionate. It places smoking and vaping under the same restriction without showing that outdoor exposure from the two products poses comparable risks. Its reliance on measuring distance and establishing consent may also make enforcement difficult.
Milan distinguishes vaping from smoking
Milan has adopted a more harm-proportionate model. Since 1 January 2025, smoking has been prohibited in public or publicly accessible outdoor areas, including streets, unless smokers stay in an isolated spot at least ten metres from others. Fines range from €40 to €240.
Significantly, the restriction does not apply to vapes. Milan targets combustion without eliminating an alternative smokers may use to reduce exposure to harmful smoke.
The measure formed the second stage of an air-quality regulation adopted years earlier. From 2021, smoking was restricted in parks, playgrounds, bus stops, cemeteries and sports facilities. The regulation had already stipulated that the prohibition would expand to all public areas in 2025.
Milan sits in the heavily polluted Po Valley, where geography, transport, industry, heating and agriculture contribute to poor air quality. Cigarettes are not the main source of the city’s pollution, but the ban may reduce close-range smoke exposure, cigarette litter and the visibility of smoking. By excluding vaping, Milan has drawn a meaningful distinction between combustible and non-combustible products. Its approach offers a better example of progressive regulation: protecting bystanders from smoke while preserving a lower-risk option for smokers.
Italy challenges the EU’s undifferentiated approach
In December 2024, the Meloni government made its position clearer when EU health ministers recommended extending smoke- and aerosol-free protection to playgrounds, restaurant terraces, beaches and transport areas. The non-binding recommendation covered cigarettes, e-cigarettes and heated-tobacco products. Italy and Romania opposed the measure, arguing that it was too broad, insufficiently supported by impact assessments and potentially intrusive.
For conventional tobacco-control organisations, Italy’s opposition was a missed opportunity. From a harm reduction standpoint, it was a welcome challenge to regulations that collapse products with very different risk profiles into one category. Applying cigarette restrictions automatically to vaping may reduce the practical advantages of switching and send misleading messages about relative harm.
Progress accompanied by unresolved problems
Meloni’s budgets have gradually raised tobacco excise duties. Higher cigarette prices can encourage cessation and switching, but tax differences between combustible and lower-risk products should be preserved when they provide smokers a financial incentive to quit smoking.
Italy nevertheless faces serious challenges. In 2024, the National Institute of Health reported that approximately 24% of adults aged 18–69 smoked. Around 30% of 14-to-17-year-olds had recently used at least one of cigarettes, heated tobacco or e-cigarettes, with increasing use of multiple products.
These figures underline the need to prevent youth uptake while helping adult smokers switch completely. They do not justify treating every nicotine product as equally harmful. A progressive response would combine strict age enforcement and targeted youth protections with accurate risk communication, proportionate taxation and continued access to safer alternatives.
Meloni’s record is therefore mixed but more open-minded than conventional rankings suggest. Her government has not yet built a coherent national harm reduction strategy, but it has resisted some one-size-fits-all restrictions and defended regulatory distinctions between smoking and lower-risk products.
The next step should not be blanket deregulation. It should be a clearer risk-based framework that focuses the strongest taxes and restrictions on combustion, protects young people and non-users, and actively encourages adult smokers to switch completely. On that test, Italy has made a promising start—but still has considerable room to progress.
