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Strategy for primary prevention of non-communicable diseases (NCD) and mitigation of climate change in Italy
  1. Paolo Vineis1,2,
  2. Jessica Beagley3,
  3. Lucia Bisceglia4,
  4. Luca Carra5,
  5. Roberto Cingolani6,
  6. Francesco Forastiere7,
  7. Francesco Musco8,
  8. Marina Romanello3,
  9. Rodolfo Saracci9
  1. 1 School of Public Health, Imperial College London, London, UK
  2. 2 Italian Institute of Technology, Genova, Liguria, Italy
  3. 3 UCL, London, UK
  4. 4 Agenzia Regionale per la Salute e il Sociale, Bari, Italy
  5. 5 Agenzia Giornalistica Zadig, Milan, Italy
  6. 6 Leonardo, Milano, Italy
  7. 7 King's College London, London, UK
  8. 8 Istituto Universitario di Architettura, Venice, Italy
  9. 9 International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
  1. Correspondence to Professor Paolo Vineis, School of Public Health, Imperial College London, London, London, UK; p.vineis{at}


This paper derives from a document commissioned in 2019 by the Italian Minister of Health, and outlines a general strategy for primary prevention of non-communicable diseases in Italy, with a special focus on cobenefits of climate change mitigation. Given that action against climate change is primarily taken via energy choices, limiting the use of fossil fuels and promoting renewable sources, an effective strategy is one in which interventions are designed to prevent diseases and jointly mitigate climate change, the so-called cobenefits. For policies capable of producing relevant co-benefits we focus on three categories of interventions, urban planning, diet and transport that are of special importance. For example, policies promoting active transport (cycling, walking) have the triple effect of mitigating greenhouse gas emissions, preventing diseases related to atmospheric pollution, and increasing physical activity, thus preventing obesity and diabetes.

In particular, we propose that for 2025 the following goals are achieved: reduce the prevalence of smokers by 30%, with particular emphasis on young people; reduce the prevalence of childhood obesity by 20%; reduce the proportion of calories obtained from ultraprocessed foods by 20%; reduce the consumption of alcohol by 10%; reduce the consumption of salt by 30%; reduce the consumption of sugary drinks by 20%; reduce the average consumption of meat by 20%; increase the weekly hours of exercise by 10%. The aim is to complement individual health promotion with structural policies (such as urban planning, taxation and incentives) which render the former more effective and result in a reduction in inequality. We strongly encourage the inclusion of primary prevention in all policies, in light of the described cobenefits. Italy’s role as the cohost of the 2020 (now 2021) UN climate negotiations (COP26) presents the opportunity for international leadership in addressing health as an integral component of the response to climate change.

  • climate change
  • prevention
  • public health policy

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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  • Contributors PV planned and designed the study. FF, RS, RC, LB and FM contributed text to different sections of the paper, JB and MR contributed text referring to Lancet Countdown. LC revised the whole manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.