title: Are smokers less likely to seek preventive healthcare measures in Italy?
abstract: Smoking cessation is the key cancer and cardiovascular disease (CVD) prevention action for smokers; however, smokers can still benefit from earlier diagnosis. This study aims to investigate behaviours towards cancer and CVD prevention by smoking habits in Italy. The study relies on data from a large Italian population-based survey carried out in 2013 on a sample of 119 073 individuals. We studied the relationship between smoking habits and the participation in cancer (cervical, breast and colorectal) screening programmes, or CVD prevention (performing cholesterol, blood pressure and glycaemia exams) using a multilevel logistic regression model. Only 11.4, 40.1 and 8.0% of the subsamples attended cervical, breast and colorectal cancer screening, respectively, whereas CVD prevention registered higher attendance: 83.3, 66.4 and 58.1%, respectively, for cholesterol, blood pressure and glycaemia. Smokers were less likely to undergo Pap smear compared with nonsmokers [odds ratio (OR): 0.70; 95% confidence interval (CI): 0.57-0.87], whereas former smokers showed a higher attendance for breast and colorectal cancer screening (OR: 1.25; 95% CI: 1.14-1.37 for breast, OR: 1.21; 95% CI: 1.07-1.38 for colorectal cancer). Former smokers were also more likely to perform CVD prevention. Moreover, CVD prevention was inversely related to smoking (OR: 0.84; 95% CI: 0.74-0.96 for cholesterol; OR: 0.86; 95% CI: 0.79-0.93 for blood pressure; OR: 0.61; 95% CI: 0.54-0.69 for glycaemia). Particular attention should be paid to involve smokers in prevention checks. Research aimed at understanding smokers' pessimistic attitudes, which may determine smokers' prevention avoidance, and at improving smokers' engagement with prevention is needed and may help increase the reach of supported smoking-cessation programmes.
authors.affiliation: Occupational and Environmental Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carreras
authors.affiliation: Health and Health Services, National Institute of Statistics (ISTAT), Rome.
authors.forename: Laura
authors.initials: L
authors.lastname: Iannucci
authors.affiliation: Department of Clinical and Biological Sciences, Turin University, Turin, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.affiliation: Occupational and Environmental Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Chellini
authors.affiliation: Occupational and Environmental Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gorini
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data; D000074285:Smokers / Q000523:psychology / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data