Hardcore smoking among Italian men and women

Hardcore smokers are described as heavy smokers who have not attempted to quit and have no future intentions to quit. The objectives of this study were to characterize hardcore and nonhardcore smokers in Italy. The data for this analysis were collected from 3057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the population. Hardcore smoking, defined as consuming 15 or more cigarettes per day with no earlier quit attempts and no future intention to quit, was examined in individuals who were aged 26 years and older. Hardcore smokers were compared with their nonhardcore counterparts with respect to sociodemographic and smoking characteristics, perceived stress, and attitudes and beliefs about smoking. The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females). An estimated 7.8% of individuals were hardcore smokers (9.7% among males and 6% among females), which translates into 33.1 % of all smokers in Italy. Age at smoking initiation, occupation (among males), home smoking rules, and perceived stress (among females) distinguished hardcore from nonhardcore smokers. This is the highest prevalence of hardcore smoking that has been reported in the literature to date. This reflects the general attitude toward smoking cessation in Italy. Although the indoor smoking ban has helped to reduce the rate of smoking, it is clearly not enough. Stronger tobacco control measures are warranted

Smoking in Italy 2007, with a focus on the young

AIMS AND BACKGROUND: Although smoking has been on the decline in Italy, its prevalence is still high among younger individuals. We analyzed data from the 2007 tobacco survey and present the findings on smoking prevalence by selected characteristics, with a particular focus on the young. METHODS: The data were collected from 3,057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the general Italian population. The prevalence of self-reported current smoking was estimated overall and by age group, education, geographic region, and gender. Additionally, intentions to quit and trends in smoking in the total population and among individuals aged 15-24 years were estimated. RESULTS: The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females), with higher estimates among adults living in central regions and among men with a lower educational level. Among individuals aged 15-24 years, since 2001 the male prevalence has fluctuated between 30% and 35% and the female prevalence between 20% and 25%. Overall, the prevalence decreased by approximately 40% in this age group. A small percentage (3.3%) reported having intention to quit smoking in the next 6 months. CONCLUSIONS: The smoking prevalence is the lowest estimate reported since 1957, and the gap between men and women has diminished. Compared to earlier birth cohorts, the lower current estimate among younger adults suggests that the rates will decrease in the future

Smoking in Italy 2007, with a focus on the young

Aims and background. Although smoking has been on the decline in Italy, its prevalence is still high among younger individuals. We analyzed data from the 2007 tobacco survey and present the findings on smoking prevalence by selected characteristics, with a particular focus on the Young. Methods. The data were collected from 3,057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the general Italian population. The prevalence of self-reported current smoking was estimated overall and by age group, education, geographic region, and gender. Additionally, intentions to quit and trends in smoking in the total Population and among individuals aged 15-24 years were estimated. Results. The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females), with higher estimates among adults living in central regions and among men with a lower educational level. Among individuals aged 15-24 years, since 2001 the male prevalence has fluctuated between 30% and 35% and the female prevalence between 20% and 25%. Overall, the prevalence decreased by approximately 40% in this age group. A small percentage (3.3%) reported having intention to quit smoking in the next 6 months. Conclusions. The smoking prevalence is the lowest estimate reported since 1957, and the gap between men and women has diminished. Compared to earlier birth cohorts, the lower current estimate among younger adults Suggests that the rates will decrease in the future

Factors influencing smokeless tobacco use in rural Ohio Appalachia

The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Fifteen focus groups and 23 individual qualitative interviews were conducted with adult (n = 63) and adolescent (n = 53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to (1) shift the perception of cultural norms regarding ST use and (2) address male social networks as vehicles in ST initiation

Factors influencing smokeless tobacco use in rural Ohio Appalachia

The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Fifteen focus groups and 23 individual qualitative interviews were conducted with adult (n = 63) and adolescent (n = 53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to (1) shift the perception of cultural norms regarding ST use and (2) address male social networks as vehicles in ST initiation

Smokeless tobacco marketing and sales practices in Appalachian Ohio following federal regulations

Introduction: Smokeless tobacco (ST) use is increasingly prevalent among poor and vulnerable groups, especially rural males. Access to tobacco products, as well as marketing messages, is associated with tobacco usage. In June 2010, the Tobacco Control Act (TCA) marked the beginning of federal regulation of the sale and marketing of tobacco products — including ST. The goal of this study was to describe marketing practices over time and to provide early assessment of the federal regulation in rural tobacco-licensed retail outlets. Methods: Observational data were collected from a sample of retail outlets within three Ohio Appalachian counties. From an estimated 300 retail establishments, a stratifi ed random sample was drawn ( n = 86). Trained observers surveyed the sales and marketing of tobacco products. Baseline surveys were conducted between November 2009 and May 2010 before the TCA; follow-up surveys were repeated in August 2010. Results: Follow-up surveys were completed for 79 tobaccolicensed retail outlets. The majority of retail outlets were gas stations or convenience stores. Compared with baseline, there was a signifi cant reduction in the frequency of exterior and interior advertisements observed after the TCA ( p < .01). Despite the lack of change in the proportion of stores advertising ST, the number of ST brands being advertised doubled between baseline and follow-up. Conclusion: Initial compliance with certain elements of the federal restrictions appears to be high in Appalachian Ohio. The signifi cant increase in ST brands advertised suggests that advertising remains a clear presence in retail outlets in Appalachian Ohio

Physician-delivered advice to quit smoking among Italian smokers

OBJECTIVE: A clinical practice guideline for smoking cessation was released in Italy in 2002, but to date little is known about the implementation of these recommendations among primary care physicians. The objectives of this study were to estimate the prevalence of receiving physician-delivered advice to quit smoking and to determine what factors were related to the receipt of advice among adult Italian smokers. METHODS: The data were collected as part of the Italian 2004-2006 adult tobacco surveys (analyzed in 2007), conducted by DOXA, the Italian branch of the Gallup International Association, and representative of the population aged>or=18 years. Each year smokers were asked whether they had received advice to quit smoking from their family physician during the previous year. Demographic, socioeconomic, tobacco-related, and physician-related variables were examined for their association with the receipt of advice. A logistic regression model was then fit to the data to determine which variables were related to receiving advice to quit smoking. RESULTS: Overall, 22% of smokers reported receiving advice to quit smoking from their physician in the previous year. Less likely to receive advice to quit were smokers who: were single (compared to divorced, widowed, or separated); lived in the South; had a higher level of education; were lighter smokers; had no previous quit attempts; and had physicians who likely smoked. CONCLUSIONS: The data suggest that Italian physicians are not advising smokers to quit at a high rate. Future research should focus on methods that encourage physicians to counsel smokers to quit during a patient-provider encounter

Use of pharmacotherapy while attempting cessation among Italian smokers

The objective of this study was to examine the use of pharmacotherapy while attempting smoking cessation among current smokers and also the prevalence of use among former smokers in Italy. The data for this study were collected as part of six Italian tobacco surveys conducted between the years 2002 and 2007 on a total of 19 459 Italians aged 15 years and older. These surveys were designed to be representative of the Italian population with respect to age and sex. The current smoker analysis involved estimating the prevalence and the 95% confidence interval of use of pharmacotherapy among smokers in any previous quit attempt. Age-adjusted and sex-adjusted odds ratios and 95% confidence intervals were also estimated. The former smoker analysis involved estimating the prevalence of use of pharmacotherapy to assist in cessation for smokers who quit between 1995 and 2006 in an attempt to determine if it was being used with increasing frequency over time. Among 1854 smokers who had made at least one quit attempt in the past, 9.4% reported using pharmacotherapy during at least one attempt. Use of pharmacotherapy was related to smoking intensity, education level, and age. Among former smokers, pharmacotherapy use for cessation ranged between 0 and 4.9%. Methods to increase the use of pharmacotherapy for smoking cessation need to be enhanced in Italy because these products are not reaching a large majority of smokers. One possible solution is to add pharmacotherapy to the list of medications covered by the National Health Service