title: Demographic characteristics, nicotine dependence, and motivation to quit as possible determinants of smoking behaviors and acceptability of shocking warnings in Italy.
abstract: BACKGROUND
  This paper presents the final results of a cross-sectional study started in 2010. It compares the perceived efficacy of different types of tobacco health warning (texts versus shocking pictures) to quit or reduce tobacco use.
  
  
  METHODS
  The study conducted between 2010 and 2012 in Italy enrolled adults smokers. Administering a questionnaire demographic data, smokers behaviors were collected. Showing text and graphic warnings (the corpse of a smoker, diseased lungs, etc.) the most perceived efficacy to reduce tobacco consumption or to encourage was quit.
  
  
  RESULTS
  666 subjects were interviewed; 6% of responders referred that they stopped smoking at least one month due to the textual warnings. The 81% of the smokers perceived that the warnings with shocking pictures are more effective in reducing/quitting tobacco consumption than text-only warnings. The younger group (<45 years), who are more motivated to quit (Mondor's score ≥ 12), and females showed a higher effectiveness of shocking warnings to reduce tobacco consumption of, 76%, 78%, and 43%, respectively with P < 0.05.
  
  
  CONCLUSIONS
  This study suggests that pictorial warnings on cigarette packages are more likely to be noticed and rated as effective by Italian smokers. Female and younger smokers appear to be more involved by shock images. The jarring warnings also appear to be supporting those who want to quit smoking. This type of supportive information in Italy may become increasingly important for helping smokers to change their behavior.
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Mannocci
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Colamesta
authors.affiliation: Respiratory Diseases Unit and ALS Respiratory and Critical Care Unit, Policlinico Umberto I-Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Conti
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Maria Sofia
authors.initials: MS
authors.lastname: Cattaruzza
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, San Camillo-Forlanini Hospital, Sapienza University of Rome, 00149 Rome, Italy.
authors.forename: Gregorino
authors.initials: G
authors.lastname: Paone
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cafolla
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Rosella
authors.initials: R
authors.lastname: Saulle
authors.affiliation: Gynaecology Obstetric Department, Casilino Hospital, 00169 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bulzomì
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Antici
authors.affiliation: Clinic Center, 80126 Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Cuccurullo
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Boccia
authors.affiliation: Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy ; Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.affiliation: Respiratory Diseases Unit and ALS Respiratory and Critical Care Unit, Policlinico Umberto I-Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Terzano
mesh_terms: D003430:Cross-Sectional Studies; D003710:Demography / Q000379:methods; D005260:Female; D006293:Health Promotion; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D009538:Nicotine / Q000009:adverse effects*; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology*
chemical_list: D009538:Nicotine