Abstract
BACKGROUND: Despite past progress, smoking and secondhand smoke (SHS) remain major public health concerns in Italy. The absence of recent regulations and the spread of novel products highlight the need for continued monitoring. METHODS: We conducted a nationally representative survey in Italy in 2024 using face-to-face interviews on 3125 participants aged 15 years and older. Smoking prevalence, daily SHS exposure in indoor settings and their relationship with sociodemographic and behavioural factors were analysed using unconditional multiple logistic regression models. RESULTS: In 2024, 26.6% of Italian adults reported to be current conventional cigarette smokers (31.1% in men and 22.3% in women), 11.7% former smokers, and 61.7% never smokers. Compared to never, current smoking was more common among middle age groups (adjusted odds ratio; aOR=2.0; 95% confidence intervals; CI: 1.5-2.7 for individuals aged 25-64 compared with <25 years) and was related to higher levels of education (p for trend=0.008). Current smoking was also more frequent among users of electronic cigarettes (e-cigs; aOR=25.5; 95% CI: 10.8-60.2) and heated tobacco products (HTP; aOR=100.3; 95% CI: 35.4-284.2). Among nonsmokers, 16.3% reported daily indoor exposure to SHS, mainly at work (6.4%) and in other indoor places (7.1%). Daily SHS exposure at home and in private and public transport was 4.3%, 4.3% and 1.4%, respectively. Being exposed to SHS decreased significantly with age (p for trend<0.001). CONCLUSION: This study highlights that smoking prevalence remains high and that SHS exposure continues to represent a significant public health concern in Italy. The results underline the need to update and enforce evidence-based tobacco control measures.