Life is better and longer without tobacco

May 31, World No Tobacco Day: an important opportunity to reconsider the quality of global health and mental healthWhat is meant by mental health? According to the World Healt... More for all smokers and for those approaching this highly harmful habit, especially young people. Fondazione Patrizio Paoletti discussed this with Professor Francesco Fedele, faculty member at the University La Sapienza in Rome and president of the National Institute for Cardiovascular Research.

World No Tobacco Day: what, how, when

World No Tobacco Day was established for the first time in 1988, and since then, once a year, representatives from various institutions, along with the World Health Organization (WHO), come together under the same banner to fight tobacco use. In 2025, the global focus specifically targets the communication sector with the slogan: “Unmasking the appeal: exposing industry tactics on tobacco and nicotine products.”

The goal is to highlight the persuasive strategies used by the tobacco and nicotine industries to make their harmful products more appealing, especially to young people, promoting critical awareness and collective responsibility.

On World No Tobacco Day, the World Health Organization calls on governments, educators, and citizens to recognize and counteract these dynamics, supporting more effective policies — such as banning flavorings that increase product appeal — to protect public health and ensure a future free from addictions.

International data on tobacco consumption

Fondazione Patrizio Paoletti, which for over 20 years has studied human functioning with interdisciplinary research: neuroscientific, psychological, educational, didactic, and social, wishes to highlight — on World No Tobacco Day — community and individual risk factors related to harmful substances such as nicotine.

Tobacco victims

WHO estimates show that globally, every year, more than 8 million people die due to tobacco use. SmokingMuch more than a habit: a global health issue Smoking is oft... More represents one of the biggest public health problems worldwide and is a major risk factor for developing cancer, cardiovascular, and respiratory diseases.

Secondhand smoke also harms those exposed: 603,000 people die annually due to this pollutant, including approximately 165,000 children.

In Italy, Ministry of Health data show that between 70,000 and 83,000 deaths per year are caused by cigarette consumption (about one thousand due to passive smoking).

How many smokers?

According to data from the Italian Higher Institute of Health for 2023-24, one in four Italians (24.3% of the population) is a smoker, while ISTAT 2023 data show that 19.3% of people over 14 smoke, including 23.1% men and 15.7% women; prevalence shows a slight decrease after rising in recent years.

Among young people, there is a significant increase in nicotine use: 30.2% report using at least one of traditional cigarettes, heated tobacco, or e-cigarettes.

The phenomenon of poly-use, i.e., simultaneous use of multiple nicotine products, is particularly concerning among adolescents, with an incidence that has doubled compared to previous years. This is a clear signal that requires targeted educational responses and integrated prevention strategies.

According to 2022 estimates, in the European region over 12% of adolescents have used e-cigarettes, compared to 2% of adults.

In several countries, use among school-age children is 2–3 times higher than traditional smoking, a trend that urgently calls for attention from education, health, and public policy sectors.

Higher risk of cardiovascular damage for smokers

According to WHO, 50% of smokers worldwide die from smoking-related causes.

“Smoking is a major risk factor for cardiovascular and respiratory diseases. No one should smoke. However, it is important to consider different types of smokers, age, and motivationMotivation: a scientific perspective Motivation is a fundame... More. If a long-term smoker does not want to quit, it is beneficial for that person to try alternatives to reduce health risks; because those who don’t want to quit will not stop anyway. Absolute bans are often counterproductive,” says Professor Francesco Fedele to Fondazione Patrizio Paoletti.

The most common alternative to cigarette smoking is the electronic cigarette (often abbreviated as e-cig). It is a device that allows inhalation of vapor, usually flavored, containing variable amounts of nicotine (typically 6–20 mg), in a mixture of water, propylene glycol, glycerol, and other substances, including flavorings.

 

 

E-cigarettes are also harmful to physical and mental health

20% of Italian adults smoke only traditional cigarettes, while 4.5% alternate with one of the new electronic products (e-cigarettes or heated tobacco).

For both types of consumers, the health risk is the same as smoking tobacco: addiction, cancer, cardiovascular, and respiratory diseases (causing an average loss of ten years of life per smoker), financial impact on households, reduced productivity.

For smokers, the act of inhaling from the cigarette-shaped cylinder, termed “vaping,” provides not only the nicotine the body craves but also a tactile, olfactory, and gustatory experience reminiscent of a cigarette.

According to SCHEER – Scientific Committee on Health, Environmental and Emerging Risks – there is little evidence supporting the effectiveness of e-cigarettes in helping smokers quit, and data on smoking reduction are considered weak to moderate.

Moderate risks exist for local respiratory irritation and moderate, but increasing, evidence indicates that e-cigarettes have harmful effects on health, especially but not only on the cardiovascular system.

Heated tobacco devices have not yet shown clear evidence of causing less harm than burned tobacco cigarettes (WHO data). Independent studies on products like IQOS have shown mixed results.

The key point is that all types of tobacco products seriously harm health. Tobacco is responsible for 20% of deaths from coronary diseases. Overall, the link between cigarettes and cardiovascular and pulmonary risks also extends to mental health risks.

Prolonged nicotine use creates addictionDrug addictions are not simply personal “vices,” but gen... More similar to drugs and reduces the effect of some mental health medications. According to WHO, those with mental disorders are more likely to smoke. Conversely, tobacco increases symptoms of mental illness, such as depressionDepression is a disorder characterized by persistent sadness... More, anxietyAnxiety is an emotional response characterized by feelings o... More, and stressWhat is stress? From a clinical perspective, stress is a phy... More.

Educating self-care through prevention

“It is true that today, unfortunately, more and more young people try e-cigarettes,” explains Fedele. “Smoking is harmful in all its forms; therefore, it is essential to continue informing about health risks, especially for new generations. Those who try vaping at 14/15 years often do so out of emulation or emotional fragility. We, as the National Institute for Cardiovascular Research, continue to run awareness campaigns on all heart health risks.” They participate in events promoting periodic check-ups like electrocardiograms or provide free cardiovascular screenings “to remind that the human body needs regular maintenance like cars.”

Information and prevention can make a difference. Any type of tobacco use is harmful and addictive. Worldwide, at least 38 million youths aged 13–15 use tobacco products, and Italy has the highest percentage of adolescent smokers in Europe (30%).

Different flavors used by the tobacco industry to make products more appealing are a key factor attracting young people to e-cigarettes.

Youth, distress, and smoking

According to WHO, the reasons young people smoke stem from a complex multifactorial process originating from:

• environmental risk factors (e.g., easy access to the product);
• family distress and social acceptance of tobacco;
• low socioeconomic status and education;
• low self-esteemThe term self-esteem literally refers to the evaluation of o... More and self-efficacyWhen facing the daily challenges we must confront, sometimes... More.

To combat this increasingly widespread phenomenon, the scientific community recommends environmental (community) and individual prevention programs.

Overall, prevention interventions aim to counter substance use among youth and communities by reducing risk factors and promoting personal skills and life competencies, enhancing protective factors through programs like Prefigurare il Futuro by Fondazione Patrizio Paoletti.

It is essential to support not only self-efficacy and resilienceWhat is meant by resilience? According to the American Psych... More but also the family and social support network, ensuring that young people can rely on at least one trusted person within their social context.