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Vatican beats Italy 1–0 in the tobacco endgame
  1. Silvano Gallus1,
  2. Maria Sofia Cattaruzza2,
  3. Giuseppe Gorini3,
  4. Fabrizio Faggiano4
  5. on behalf of the Italian Tobacco Endgame Group
    1. 1 Department of Environmental Health Sciences, IRCCS—Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
    2. 2 Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
    3. 3 Environmental and Occupational Epidemiology Section, Oncologic network, prevention and research Institute (ISPRO), Florence, Italy
    4. 4 Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
    1. Correspondence to Dr Silvano Gallus, Department of Environmental Health Sciences, IRCCS – Istituto di Ricerche Farmacologiche "Mario Negri", Milano 20156, Italy; silvano.gallus{at}


    ‘The Holy See cannot be cooperating with a practice that is clearly harming the health of people’. This is the reason behind Pope Francis banning the sale of tobacco products inside the Vatican in January 2018. Just outside the Holy See, in Italy, cigarette sales produce around €13 billion of fiscal revenues every year. In Italy, proposals to increase tobacco taxation are systematically rejected and new tobacco company plants have been officially inaugurated in recent years by representatives of State. The national branch of the Red Cross also shows ambivalent attitudes towards the tobacco industry, from which it has accepted significant funding in disregard of the recommendations of the International Federation of Red Cross. Against this backdrop, it is wishful thinking to imagine that tobacco sales and consumption in Italy will be substantially reduced in the near future. To counteract this situation, more than 30 Italian scientific associations/organisations launched a Manifesto, so far ignored by public authorities, indicating a set of measures whose gradual implementation at country level may lead to a tobacco endgame within the next few decades. Authors of this article would like to express their support for Pope Francis’ enlightened decision and plead with politicians worldwide to follow his example, thus acting more decisively against tobacco.

    • tobacco endgame
    • fiscal policies
    • red cross
    • Italy

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    • Contributors SG had the original idea. FF and SG drafted the manuscript with the contribution of GG and MSC. All authors were involved in the concept, interpretation and writing of the manuscript. All authors approved the final submitted version.

    • Funding This work was partially funded by the Italian Ministry of Health (MADES project, chapter 4100/22). The work of SG was partially supported by the Italian League Against Cancer (Milan).

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional unpublished data are available on this work.

    • Collaborators Italian Tobacco Endgame Group: Fabrizio Faggiano, Fabio Beatrice, Lalla Bodini, Maria Sofia Cattaruzza, Paolo D’Argenio, Silvano Gallus, Giuseppe Gorini, Giacomo Mangiaracina