Aims and background: To analyze and update smoking prevalence and trends in Italy to 2001.
Methods and study design: Population-based household survey conducted by the DOXA (The Italian Branch of the Gallup International Association) in 2001 on a total of 3,296 individuals aged 15 or over, representative of the whole Italian population.
Results: Overall, 28.9% of the Italian population (34.8% of males, 23.6% of females) were current cigarette smokers, and a further 0.2% (0.4% of males) were cigar or pipe smokers; 14.6% (19.9% of males, 8.7% of females) smoked 15 or more cigarettes per day. Ex-smokers were 16.6% (25.5% of males, 8.4% of females). In males the smoking prevalence steadily declined, from 65.0% in 1957 to 34.8% in 2001, but the fall was comparatively limited during the last decade. In females, the smoking prevalence was below 10% in the 1950s and 1960s, peaked at 25.9% in 1990, and declined to 23.6% in 2001. The mean number of cigarettes smoked per day, however, tended to increase, reaching 16.4 in 2001 (18.8 for males, 12.2 for females). Moreover, compared with legal sales data these figures appear underestimated by 25% to 35%. The difference in smoking prevalence between males and females tended to increase with age. Among males the smoking prevalence was lower in the North, while it was similar among females in various areas of the country.
Conclusion: For the first time since the 1950s the overall smoking prevalence in Italian adults fell below 30%, but the figure is now higher than in most Western countries. Also for females the smoking prevalence in Italy is now higher than in the USA. This reflects the absence of any comprehensive policy and legislation against smoking in Italy.