Four Italian cancer prevention organizations are calling on the government and Parliament to ban the use of e-cigarettes and heated tobacco products in indoor public spaces. They are seeking an outright prohibition, similar to the smoking ban introduced in Italy in 2005 under the Sirchia Law, which currently applies only to traditional cigarettes, cigars and pipes. At the time, vaping products did not yet exist.

The organizations — the Italian Association of Medical Oncology (AIOM), the AIRC Foundation for Cancer Research, the Umberto Veronesi Foundation and the AIOM Foundation — say the ban must be comprehensive and explicitly cover all devices that produce inhalable emissions. These include e-cigarettes, with or without nicotine, which entered the Italian market in 2009, and heated tobacco products, introduced in 2014.

They also want vaping prohibited in schoolyards, hospital entrances and corridors, parks, beaches and outdoor dining areas.

The four organizations are also calling for a ban on advertising, whether through traditional direct marketing or indirect promotion on digital platforms, social media, influencer channels, events and retail outlets. They also want to counter the misleading impression that e-cigarettes and other devices are less dangerous simply because they contain lower concentrations of nicotine.

The appeal is set out in the Manifesto for the Protection of Nonsmokers' Rights, presented in Rome on Nov. 12 at a conference held ahead of the 28th National Congress of the Italian Association of Medical Oncology.

Smoking remains widespread among Italian teenagers. Among those ages 14 to 17, 37% smoke with some degree of regularity. Of these, 22% use heated tobacco products and 30% use e-cigarettes. The categories may overlap. Nearly 40% of underage smokers also purchase traditional cigarettes, e-cigarettes and heated tobacco products themselves.

In January 2026, AIOM, the AIRC Foundation for Cancer Research, the Umberto Veronesi Foundation and the AIOM Foundation had already introduced a citizens' initiative bill proposing a €5 increase in the price of all smoking products and nicotine inhalation devices.

“In the meantime, we are calling on public institutions to take urgent national legislative action because people's health must not be put at risk by exposure to products used by others. Tobacco use, in all its forms, is extremely dangerous. In Italy alone, smoking is estimated to cause more than 93,000 deaths a year, including 35,000 from lung cancer, a disease linked to tobacco use in nine out of 10 cases. Exposure to secondhand smoke is also a major global health hazard, causing 1.6 million deaths every year worldwide,” the organizations say.

“Claiming that e-cigarettes are harmless is a major deception,” Massimo Di Maio, President of AIOM, an Oncologist and Professor of Medical Oncology at the University of Turin who specializes in lung cancer, told SAE Salute.

“Everything in the messaging — which is clearly in the interests of those selling these products — is designed to make them appear harmless or, at the very least, less harmful than traditional cigarettes. Even if we accept that they are less harmful, they still cause damage.”

There is also a paradox, Di Maio says. “As we have pointed out in recent months, and I want to reiterate today, these devices are promoted as a way to help people quit traditional smoking. In reality, they are becoming potential gateways to nicotine use.

“Many people are first introduced to nicotine and smoking through these products. Research has shown that some young people who have never smoked before are taking up these devices, which still deliver nicotine, and becoming dual users — meaning they also start smoking traditional cigarettes. It is a paradoxical situation: even in small amounts, nicotine is addictive.”

For anyone who assumes that less exposure means greater safety, Di Maio has a clear answer: “There is no safe amount.”

Nor should the fact that there is not yet as much scientific literature on the health effects of e-cigarettes as there is on traditional smoking be used as an excuse for complacency.

“We have to bear in mind that there is a latency period between exposure to a risk and the development of cancer,” Di Maio explains. “Naturally, we have far less data on these newer devices than we do on traditional cigarettes. Conventional cigarettes have been around for decades, and we have an extremely solid body of scientific evidence linking them to cancer. But there is already published research documenting an increased risk of lung cancer associated with e-cigarettes and other devices as well. And people who use both traditional cigarettes and e-cigarettes face an even higher risk.”

The manifesto has received broad support from Italy's medical and scientific community. In addition to the organizations behind the €5 anti-smoking legislative initiative (5eurocontroilfumo.it), it has been endorsed by the presidents of the Italian Society of Gynecology and Obstetrics, the Italian Society of Tobacco Studies, the Italian Society of Oncological Urology, the Italian Society of Cardiology, the Italian Association of Hospital Pulmonologists and the Italian Federation of Family Pediatricians.