Waste management is an important issue all over the world and it will become even more urgent in the near future due to the increase of global volumes of waste. Waste prevention is at the top of the European waste hierarchy, followed by reuse, recycling, other recovery (including energy recovery), and safe disposal. In Italy, municipalities are the authorities that concretely choose the prevention actions to be applied in their territory and therefore they are crucial in promoting a decrease in waste amounts. In our research we investigated costs and benefits of prevention actions in three small municipalities in the north of Italy. We found that the "Pay as You Throw" (PAYT) scheme is an effective action in preventing waste production, with many instances, on analyzing the collection data. The specific effect of the other actions (such as the awareness raising campaigns) is difficult to isolate, even if we found positive impacts. We analyzed some external drivers, such as the migration effect, in order to understand the real effectiveness of the implemented actions. One of the objectives of the study was to comprehend the consequences of political choices at a bigger scale than the individual municipality. Analyzing the results obtained in three typical small Italian municipalities, this study suggests that local authorities, with their choices, can greatly affect the efficacy of selected waste collection and waste prevention.