Background. In March 2014 the EU revised Tobacco Products Directive on limiting their appeal. The purpose of the current study was primarily to compare the differences in reactions to different types of cigarette packaging in Italy. The different reactions were measured asking if the look of the packaging help to quitting, reduction of consumption and to not start smoking. Methods. A multicentric cross-sectional study was performed during 2013. All participants were asked to complete a face-to-face interview. An image with 3 different types of cigarette packaging was shown to the participants (classic Italian package, CP, plain package with text warnings, PP, plain package with pictorial warnings, PWs). Three questions, considered as outcomes, were asked to measure the most effective in convincing to not start, to quit, and to reduce the tobacco consumption. The sample was shared in smoker, nonsmoker and ex-smoker. To evaluate possible differences 2 test was used and p 0.001. Conclusions. The study shows that the PWs result more effective for all individuals independently to the smoking habits. Smokers believes more in PWs effectiveness and less in PP impact than other individuals. An encouraging result concerning PP is that although the majority of smokers declare would have started smoking even with PP, the 12% would not have started. The results indicate that a shift from branded to plain cigarette packaging and even more to pictorial warnings could lead to a reduction of the number of who starts to smoke. Key messages. The findings of this study support that graphic warning labels are more salient and potentially more effective than plain package. Additionally it???s important to underline that the PP represents however an additional intervention to reduce the tobacco consumption.