Most studies investigating the reasons for smoking initiation are based on adolescents or young individuals. We considered the issue in a large dataset on the general Italian population. Six population-based surveys on smoking were conducted annually from 2005 to 2010 on representative samples of Italian individuals aged 15 years or over, involving more than 3000 individuals each year. A specific question on the main reason to start smoking was asked to 7469 ever smokers. Overall, 59.9% of ever smokers started smoking before 18 years of age and 33.6% started smoking before 16 years of age. Among ever smokers, 61.1% reported having started smoking because of the influence of friends, 15.6% for enjoyment and satisfaction, 9.0% to feel mature and independent, 6.6% because of the influence of partner/family, 2.5% because of stress, 1.9% to feel more secure and 1.8% for curiosity. The finding that the majority of Italian men and women - particularly those who started smoking at a young age - started smoking because of the influence of friends suggests that antismoking campaigns should consider social influence, resistance and the dimension of self-esteem. An improvement in the legislation prohibiting the purchase of tobacco products by minors aged less than 18 years and a smoking ban in school courtyards are urgently required in Italy.

The ultimate aim is to foster PC research in Europe and to coordinate this effort with other international initiatives to reduce disease mortality.

The present meta-analysis, the first on scleroderma and cancer risk, provides definite estimates on the association between scleroderma and cancer.

The possible relation between low-calorie sweeteners (as well as sugar-sweetened beverages) and unfavourable pregnancy outcomes, in particular preterm delivery and low birth weight, has recently become of considerable interest, given the widespread use of low-calorie sweeteners, and the high frequency of preterm deliveries in high-income countries. In a study from Norway, Englund-Ogge et al. 1 considered the possible relation between low-calorie-sweetened and sugar-sweetened beverages and preterm delivery using data from 60 761 women in the Norwegian Mother and Child Study cohort. Overall, 3281 preterm deliveries (<37 weeks) were observed, corresponding to 5.4% of all deliveries. Of these, 3.9% were late preterm deliveries (34 to <37 weeks), 0.8% moderately preterm deliveries (32 to <34 weeks) and 0.7% early preterm (<32 weeks) deliveries. There was a moderate association between frequency of use of sugar-sweetened beverages during pregnancy and the risk of preterm deliveries. As compared to women who did not drink sugar-sweetened beverages, the relative risk (RR) was 1.15 for <1 serving/week, 1.15 for 1–6 servings/week, 1.25 for 1 serving/day, 1.19 for 2–3 servings/day and 1.41 for ≥4 servings/day. Allowance was made for age, education, obstetric history and tobacco but not for alcohol. Women …

This study shows no excess cancer risk among male rubber tire workers employed after 1954.

The decrease in stomach cancer mortality was not because of specific interventions, and is likely that different countries follow a similar model of variation. Here, we aimed to identify model-based patterns in the time trends of stomach cancer mortality worldwide. Stomach cancer mortality rates were retrieved for 62 countries from the WHO mortality database. Sex-specific mixed models were used to describe time trends in age-standardized rates between 1980 and 2010 (age group 35-74 years; World standard population). Three patterns, similar for men and women, were identified through model-based clustering. Pattern 1 presented the highest mortality rates in 1980 (median: men, 81.5/100 000; women, 34.4/100 000) and pattern 3 the lowest ones (median: men, 24.4/100 000; women, 12.4/100 000). The decrease in mortality rates was greater in 1980-1995 than during 1996-2010. Assuming that the patterns characterized by the highest rates precede temporally those with lower mortality, the overlap of model predictions supports a 20-year lag between adjacent patterns. We propose a model for the variation in stomach cancer mortality with three stages that develop sequentially through a period of ∼70 years. The countries with the lowest mortality had the highest proportional decrease in mortality rates.

Metformin, but not sulfonylurea, appears to reduce subsequent cancer risk. This has relevant implications in light of the exploding global epidemic of diabetes.

Underweight, overweight and obesity are associated with increased mortality from several chronic diseases, including cancer. Self body weight misperceptions affect weight control. We monitored weight perception in Italy on a total of 14 135 individuals (6834 men, 7301 women), representative of the Italian adult population with available information on body mass index (BMI) derived by self-reported height and weight. Differences in misperception of BMI categories across subpopulations were analysed using unconditional multiple logistic regression models after adjustment for a number of covariates. Overall, 66.4% of individuals accurately perceived, 21.0% underestimated and 12.6% overestimated their category of BMI. In men, 27.2% underestimated and 5.0% overestimated their BMI category the corresponding estimates for women were 15.3% and 19.6%, respectively. The large majority of underweight (64.3%) and obese individuals (93.1%) overestimated and underestimated their weight, respectively. Overall, 13.5% of Italians misperceived (8.9% underestimated and 4.6% overestimated) their BMI category by more than 2 kg/m. By multivariate analysis, we observed significant differences in terms of sex, education, geographic area, marital status, smoking and drinking habit, year of survey and BMI category. In conclusion, misperception of body weight is frequent in Italy, paralleling findings from other countries with more unfavourable overweight and obesity patterns. The fact that one out of three Italian adults misperceive their weight is of great concern and indicates that media intervention campaigns aimed at explaining measurement and correct interpretation of BMI are required.

Scant information is available on determinants of smoking prevalence in the vulnerable population of the elderly, particularly in Europe. Therefore, we analyzed smoking patterns among older adults (≥65 years old), using data from a representative survey based on 3,071 elderly, conducted in 17 European countries in 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project. Overall smoking prevalence in 17 European countries was 11.5% (15.3% in men and 8.6% in women). An inverse relation with level of education was observed among men, while no specific pattern was evident among women. Smoking prevalence was highest in eastern/central Europe for men (20.3%) and northern Europe for women (13.1%). In both sexes combined, smokers were more frequent in countries with low implementation of tobacco control activities (14.9%). Anti-tobacco campaigns and smoking cessation interventions specifically targeted to the elderly are urgently needed in Europe.