|The headline "In Italy, smoking curbs face an uphill battle; health minister sets out to change a culture" describes the tobacco situation in Italy (18).
Italy is between the developed and the developing world regarding its smoking culture.
- Smoking prevalence of over 15 years: men 38% (1994), women 26% (1994)
- Consumption per capita over 15 years (in pieces): 1804.37
- Consumption per smoker (in pieces): 3101.45 (1995) (38)
Despite efforts on banning cigarette advertisements since 1962, requiring health warning labels since 1992 and administering restrictions on selling cigarettes to individuals under 16 years, national anti-tobacco campaigns have not been developed (38). However, the National Cancer Institute of Genoa and the Italian League Against Cancer of Genoa started an ongoing campaign since 1981.
- Italian male smokers: 33%
- American male smokers: 24%
- Third World male smokers: 51% (1999) (19)
The health-professional program conducts surveys to assess the smoking habits of doctors and their attitudes and practices towards counseling patients against smoking. Marked differences in smoking habits appear in the cities under study. The women-targeted program addresses women of various ages to educate about tobacco risks plus effects regarding pregnancy, oral contraception, etc. This initiative is the first of its kind in Italy to develop a correlation between smoking behavior and age, educational achievement and occupation among Italian women (4).
- Targets schoolchildren, teachers, military personnel, doctors, nurses and women.
- Involves 10,000 students ages four to 18 and their teachers.
- Has experts give meetings to groups of 20-40 students and leaflets, posters and other material are distributed.
- Addresses teachers of primary and secondary schools in Genoa to train personnel to implement prevention programs.
- Trains doctors and nurses, lectures to recruits and distributes informative material.
- Is updated annually (since 1983).
In contrast to Genoa's initiatives, a survey carried out by E Boccoli, A Federici, GL Trianni and AS Melani, showed an increase in smoking of students from the School of Nursing in Florence from 1991-1994.
Another survey was done in hospitals in Faenza, Forli and Rimini (Emilia-Romagna region, Northern Italy) by F Zanetti, A Gambi, A Bergamaschi, F Gentilini, G De Luca, C Monti and S Stampi in 1998. Health staff (n=2453) was questioned about smoking habits and exposure to passive smoking. 53% were professional nurses, 16% doctors, 15% maintenance staff, 10% ancillary staff, 1% non-medical graduates, 2% administrators and 3% others. 39% were smokers, 19% ex-smokers and 42% non-smokers.
- The average number of cigarettes smoked per day increased.
- The degree of dependence to nicotine increased.
- The knowledge of the dangers of tobacco remained generic (7).
Despite minimal efforts in anti-tobacco campaigning, consequences of using tobacco receive coverage in the newspapers, especially in the advent of the new health minister in April 2000, Umberto Veronesi (20). An article taken from the Italy Daily section (in accordance with the Corriere della Sera) of the International Herald Tribune from June 5, 2000 reports that smoking 20 cigarettes a day has the same effect as undergoing 300 chest X-rays in a year, according to consumer watchdog Codacons. As part of no-smoking day, the research was presented in Rome claiming that cigarettes contain radioactive substances (23).
- Women (41%) smoked more than men (37%).
- Men are heavier smokers smoking stronger cigarettes.
- Ancillary staff (48%) smoked most compared to nurses (41%) and doctors (31%).
- 87% of hospital employees smoked at work especially in areas reserved for staff.
- 87% said they were exposed to passive smoking inside the hospital especially in cooking areas, information desks and corridors.
- 56% of smokers, 65% of ex-smokers and 72% of non-smokers were willing to participate in future campaigns to limit smoking in hospitals (44).
The rate of smoking in Italy is increasing:
- The percent growth of smokers over 15 years old from 1980-1995: -0.23
- The percent growth of smokers over 15 years old from 1990-1995: -0.11
And the mortality rate has decreased minimally:
The Swiss magazine "Smoker", first published in May 2000 in Italy by Marmedia Sagl, is the first Italian-language publication for smokers. The cover reads:
- Mortality from smoking (ages 35-69, all cancers): 34% 1985, 33% 1995
- Mortality from smoking (ages 35-69, lung cancer): 89% 1985, 88% 1995 (38)
"Smoking is life's ultimate pleasure" (21)