Hardcore smoking among Italian men and women.

Hardcore smokers are described as heavy smokers who have not attempted to quit and have no future intentions to quit. The objectives of this study were to characterize hardcore and nonhardcore smokers in Italy. The data for this analysis were collected from 3057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the population. Hardcore smoking, defined as consuming 15 or more cigarettes per day with no earlier quit attempts and no future intention to quit, was examined in individuals who were aged 26 years and older. Hardcore smokers were compared with their nonhardcore counterparts with respect to sociodemographic and smoking characteristics, perceived stress, and attitudes and beliefs about smoking. The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females). An estimated 7.8% of individuals were hardcore smokers (9.7% among males and 6% among females), which translates into 33.1% of all smokers in Italy. Age at smoking initiation, occupation (among males), home smoking rules, and perceived stress (among females) distinguished hardcore from nonhardcore smokers. This is the highest prevalence of hardcore smoking that has been reported in the literature to date. This reflects the general attitude toward smoking cessation in Italy. Although the indoor smoking ban has helped to reduce the rate of smoking, it is clearly not enough. Stronger tobacco control measures are warranted.