Smoking initiation in Italian regions, 2014, and regional prevention plans

OBJECTIVES: to evaluate smoking prevalence in adolescents by Italian region from the Health Behaviour Study in School-aged Children (HBSC) of 2014 and to correlate it with the presence, in the 2014-2018 Regional Prevention Plans (PRPs), of school-based smoking prevention interventions. SETTINGS AND PARTICIPANTS: the 2014 HBSC surveillance system provided data on 48,000 adolescents aged 11, 13, and 15 years; Ministry of Health provided data for each PRP on interventions with a tobacco control component and, among them, school-based smoking prevention interventions. MAIN OUTCOME MEASURES: weekly smoking prevalence; proportion of school-based smoking prevention interventions out of prevention interventions with tobacco control measures. RESULTS: regions with the highest weekly smoking prevalence were Sardinia and Apulia for all age groups, Abruzzo for 11-and 15-year-old children, Basilicata for 15-year-old children, Bolzano for girls aged 13 years old; Liguria for females, Molise, Calabria, and Veneto for males. In the regions with the highest prevalence of smoking in 2014, in girls aged 11 and 13 years (Sardinia, Apulia, Basilicata, Liguria, Bolzano), a greater proportion of school-based smoking pre- vention interventions to be developed in the period 2014-2018 have been recorded. CONCLUSIONS: smoking prevalence in Italian adolescents is high, especially in 15-year-old children. Implementing policies recommended by the World Health Organization-Framework Convention on Tobacco Control (higher tobacco taxes, anti-tobacco mass media campaigns, plain tobacco package) could work synergistically with school-based interventions in order to decrease tobacco initiation among adolescents in Italy.