Cigarette smoking remains a major public health issue, contributing to numerous oncological, cardiovascular, and neurological diseases. Despite extensive scientific evidence demonstrating the harmful effects of tobacco use and increasing regulatory restrictions at local and national levels, smoking prevalence remains high.
This study describes the actions implemented by a large healthcare organization in Northern Italy to reduce smoking among employees and the general public. Over two years, a multidisciplinary working group introduced various training, awareness, and enforcement, including public campaigns, social media initiatives, health promotion events, and smoking cessation support. A key innovation was the integration of smoking bans and enforcement strategies not only within hospitals but across all healthcare facilities, such as vaccination centers and diagnostic units. Additionally, standardized smoking cessation messages were incorporated into hospital discharge summaries and outpatient reports, and enforcement officers were trained to apply sanctions to individuals violating smoking regulations. These interventions have led to increased awareness, broad public engagement, and reported reductions in smoking from 34 to 20% in our province. Although primary prevention outcomes are difficult to measure, a comprehensive approach involving healthcare professionals, patients, and the community may contribute to long-term behavioral change and a healthier environment.

Impact statement
Cigarette smoking remains a major public health problem. The Local Health Authority of Reggio Emilia has launched a massive campaign to reduce smoking habits among its employees.