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Ipsen notes n this period, as well into the late 1900s, the Italian state was profiting handsomely from its monopoly, while knowing Italians were dying from smoking

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A 1952 Readers Digest article titled Cancer by the Carton was a groundbreaking study that further enlightened consumers about the health effects of smoking, and caused cigarettes sales to decline for the first time in over two decades.[7] In an attempt to protect future profitability, and to ensure that consumers continue buying their products, cigarette manufacturers introduced narratives, images, and slogans in new advertisement campaigns that marketed cigarettes as healthy products that were even consumed by physicians

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