Trends of smoking habits in northern Italy (1986–1990)

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Abstract
The trends of age-gender specific prevalence of self-reported smoking habits are presented, observed in two population surveys, performed in 1986–87 and 1989–90 in Area Brianza, a northern Italian industrialized district where a WHO MONICA Centre is located. Methods were internationally standardized to obtain comparable data on two inde pendent random samples, each composed of 1,600 subjects, age-sex stratified and extracted from the 25–64 year old residents. A closed question interview was administered to identify smoking condition (smoker, past-smoker, occasional smoker, never smoker), number of cigarettes consumed per day and attained educational level, categorized in compulsory school and post-compulsory school. Serum thiocyanate was measured as a validation index, using a cutpoint of >100 µmol l−1 to detect false negatives. Trends in smoking prevalence are analyzed taking into account influences of education in the presence of an anti-smoking policy that was started in Italy toward the end of the eighties. Self-reported data, confirmed by serum thiocyanate, show a consistent decline of smokers among males (from 48 to 41%), more evident in younger age groups. In females, smoking prevalence is stable (23–24%), although thiocyanate levels in the whole samples indicate a slight but significant tendency to decrease. Education demonstrates positive influences against smoking, particularly in younger male classes. In females a crossover effect is observable: in the second survey youngest group, education results protective against smoking; the contrary is true in the older groups. Our data, detailing what was initially recognized in previous Italian surveys, may be useful to specify the directions of future preventive actions.