Smoking behaviour, cessation attempts and the influence of parental smoking in older adult women: a cross-sectional analysis from Italy.

OBJECTIVES: To investigate the association between parental smoking during infancy/adolescence and smoking prevalence in older adult women, and to provide a description of smoking and smoking cessation patterns in this subset of the population. STUDY DESIGN: Cross-sectional survey. METHODS: Between 1999 and 2001, trained physicians in 11 health agencies throughout the Abruzzo Region, Italy, conducted semi-structured interviews on 9708 women aged 50-70 years attending mammographic screening (overall response rate 89%). Information was collected on sociodemographic characteristics, smoking habits, parental smoking during their infancy and/or adolescence, and exposure to environmental tobacco smoke (ETS) inside or outside the family. RESULTS AND CONCLUSIONS: The overall prevalence of current smoking was 15.6% (n=1516), and that of former smoking was 13.2%. Women whose parent(s) smoked were more likely to be current smokers, especially if only the mother smoked (adjusted odds ratio 4.27; 95% confidence interval 2.24-8.12). Other factors significantly associated with current smoking in the multivariate analysis were younger age, lower body mass index, higher level of education, unmarried status, and exposure to ETS either inside or outside the family environment. Eighteen percent of all current smokers were non-inhalers, and more than 60% of ex-smokers quit smoking on their first attempt. Our findings expand the existing evidence suggesting that a strong effect of parental conduct on a daughter's smoking behaviour may persist throughout life. Although more research is needed, especially to clarify the role of genetic and environmental factors in determining the mother-child smoking association, our results suggest that intensifying smoking prevention efforts directed at women with children might considerably reduce the risk of ever smoking in future female generations.

[Appropriateness of hospitalization in the teaching hospital of Chieti using the P.R.U.O. approach]. / Valutazione dell'appropriatezza dei ricoveri con la metodica P.R.U.O. nell'ospedale clinicizzato di Chieti.

This study describes the results of a research carried out to evaluate inappropriate admissions and totally inappropriate hospitalizations (RTI) in the teaching hospital "SS. Annunziata" of Chieti using the 1999 version of the PRUO manual. A random sample of 1218 medical charts, drawn from all the medical charts of patients admitted from June to December 2000 in the units of Medicine, Surgery and Orthopaedics, was selected. The percentage of inappropriate admissions was 38.2%, while totally inappropriate hospitalizations were 18.1%. The highest percentage of inappropriate admissions was in the class of age 55-64 years. Moreover, inappropriate admissions were more frequent in the morning hours (7:00-12:59) and, within the week, on Monday. The first reason of inappropriateness of the admission, was the execution of diagnostic examinations (62.2%), followed by the execution of medical therapy (19.3%) and waiting of surgical intervention (13.4%). Short hospitalizations (2-3 days) are more frequently totally inappropriate as compared to longer hospitalizations. These findings suggest that a system for the assessment of appropriateness of hospitalizations should be established in the Abruzzo region including all accredited public and private hospitals.

[Factors related to the uptake of breast cancer screening (mammography and breast ultrasound): a retrospective survey on a sample of resident women, 50-70 years aged, from Abruzzo region]. / Fattori predittivi dell'utilizzo di metodiche preventive per il tumore del seno (mammografia ed ecografia mammaria): indagine retrospettiva su un campione di donne abruzzesi, di età compresa tra 50 e 70 anni.

Within the context of a large breast cancer screening program we conducted a retrospective survey to identify the personal, socioeconomic and behavioural characteristics associated with previous use of mammograms (Ma) and breast ultrasound examination (US). Contact was made with a sample of more than 10,000 resident women who were asked to complete three questionnaires. Achieving an answer rate of 86%, we collected data from 9,087 women, 50-70 years aged, coming from Abruzzo, a central Italian region. 61% of the participants performed Ma, while US was performed by 34%, and 67% of women attended at least one of those examinations. Multiple logistic regression results indicated that older age, low level of education, not performing diets and breast self examination were significant predictors of a lower use of both examinations. Women that were married, mothers, on menopause, with a family history of cancer, uterine fibroma, past users of oral contraceptives were more likely to having performed Ma, but not US. Age at menarche, BMI and smoking were found not to be significant in predicting attendance for both screening examinations, with the exception of ex-smokers for US. Our findings represent an important contribution to the development of the needed tailored interventions to increase breast screening participation.