Background Tobacco smoking is currently the predominant health burden in developed countries. In the European Community smoking is responsible annually of 520,000 deaths. Though the health consequences are well known, millions of people keep on smoking, and annually millions of adolescents start smoking cigarettes. Smoking prevalence, attributable morbidity and mortality have to be carefully monitored in order for the policy makers to plan prevention and cessation campaigns. Methods Data on smoking prevalence were collected through standard surveys administered to a representative sample of the Italian population (>14 years old) every three-five years between 1980 and 2005 by the Italian National Institute of Statistics (ISTAT). Data were stratified by sex and adjusted by age to allow comparisons among years. The proportion of deaths due to tobacco smoking (attributable mortality) was estimated applying Relative Risks of smoking related deaths obtained from the literature to prevalence data with a 15-year latency, and transferring the algorithm obtained to mortality data 1996-2003. Results The prevalence of tobacco smoking in Italy was 36% in 1980 and 23.2% in 2005. The reduction is observed among men only, particularly the elders and those with high education level. The proportion of smokers among females is stable around 18%. In the year before the 2005 interview, 29.8% of smokers tried to quit but only 9.6% of them were successful. Most of the attempts were done without help (90.5%), though an higher proportion of cessations was obtained when a doctor was consulted. In 2003, 12.0% of deaths among people over 35 years old were related to tobacco smoking, with a decrease among men (-11.8% compared to 1996) and an increase among women (+26.5%), with cancer of trachea, bronchus or lungs as the main cause, followed by hearth attack. When considering people 35-74 years old the attributable proportion rises to 17.7%. Conclusions In Italy about 69.000 deaths are attributable annually to tobacco smoking. These deaths could be prevented if the smoking habit were avoided. Policies for prevention and cessation of smoking habit should be implemented; their effectiveness can be evaluated monitoring the annual statistics.
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