Context: Italy implemented a law in January 2005 banning smoking in all enclosed public spaces.
Objectives: To document perceived obstacles and effects of the law and observed client smoking behaviours in bars and restaurants.
Design: Four surveys were conducted between December 2004 and February 2006. Protocols and questionnaires were posted on a public health website to solicit participation among local health units (LHUs). Participating LHUs randomly selected 50 bars and restaurants using the electronic Yellow Pages. Self-administered questionnaires were delivered to owners or managers of selected locales; all of them were revisited during peak hours to collect questionnaires and observe client smoking.
Results: Before the ban, smokers were observed in 31% of locales; 24% of owners predicted major financial losses. One year later, no smokers were observed and only 7% reported major financial losses. Only 30% had received law enforcement visits. Most owners/managers (88%) reported positive attitudes about the law and 79% reported such attitudes among clients.
Conclusions: The Italian smoking law has drastically reduced smoking in bars and restaurants despite minimal enforcement visits. Perceived negative effects on profits appear limited, and the owners and managers and their clients are satisfied.