Recent research on morality policy has focused on policy change, morality framing and the presence of favourable cultural opportunity structures (COSs). The resulting literature describing various aspects of morality policy has failed to discuss the impact of multilevel dynamic in this field. This contribution examines gambling policy in Italy, applying a multilevel approach to detect the presence of favourable COSs, and whether policymakers frame policies morally. Italy offers a particularly fertile field for the study of morality policy, featuring a liberal national approach versus local restrictive policy. By applying a methodology based on semistructured interviews and secondary sources, we examine the national and local political spheres, demonstrating that morality framing, when detected, is more likely to be found at the local level where the influence of experts and interest groups on legislators may result in the transformation of a health policy based on paternalistic considerations.

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The goal of this paper is to determine the prevalent governance model in regional social and health systems, in the Italian setting. At the end of a long period of institutional reforms, it appears indeed that a model of regulation is emerging based on networks and on the participation of the citizens. However, in analysing standard procedures, one observes the persistence of ordered hierarchies and bureaucracies, in which public institutions are at the centre of decision-making processes, whether on the local level or centralized. This is particularly visible if one analyses the management of financial resources that are meant to support policies.

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