Roberta Pacifici

Istituto Superiore di Sanità, Roma, Latium, Italy

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Publications (310)1110.87 Total impact

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    ABSTRACT: A pilot study of market surveillance in Senegal has been performed analyzing best selling drugs from an official pharmacy and a street market in two principal cities of Senegal and some traditional preparations from herbal medicine from the same market. A simple and rapid gas chromatography method with mass spectrometry detection has been applied after a liquid-liquid extraction of pharmaceutical products and traditional preparations at acidic, neutral and basic pH with chloroform-isopropanol (9:1, v/v). The assay was validated in the range from 10mg to 250mg/g powder preparations with good determination coefficients (r(2)≥0.99) for the calibration curves. At three concentrations spanning the linear dynamic ranges of the calibration curves, mean recoveries of substances under investigation were always higher than 90% and intra-assay and inter-assay precision and accuracy were always better than 15%. The four best selling drugs purchased from a Dakar local pharmacy exactly contained the amount of active principles reported in the respective labels while the best selling drugs freely purchased from Kaolack market contained an amount of active ingredients lower than that declared on the label. No pharmacological active compound, but salicylic acid was found in one of the traditional herbal preparations. This pilot study showed that whereas official drugs sold in pharmacies at prices accessible for a very few portion of the population contained the amount of active principles as reported in the labels, those from street market bought by the majority of population contained an amount of active ingredients lower than that declared on the label and finally traditional herbal preparations seldom contain pharmacological active principles. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Pharmaceutical and Biomedical Analysis 11/2014; 104C:62-66. · 2.83 Impact Factor
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    ABSTRACT: Synthetic cathinones have been markedly present in the Spanish drug market in recent years. These substances can be easily obtained in "smart shops", smoke shops, gas stations and web sites where they can be bought and received anonymously avoiding normal law controls. For the first time we present a case of a neonatal withdrawal syndrome in a baby born to a woman who was a chronic consumer of 4-methylethcathinone. The newborn presented with increased jitteriness and irritability, highpitched cry, hypertonia in the limbs and brisk tendon reflexes. 4-Methylethcathinone was identified and quantified by liquid chromatography tandem mass spectrometry in the four subsequent 3cm segments of maternal hair (4.3, 4.0, 4.0 and 3.9ng/mg hair starting from most proximal segment) accounting for maternal consumption during the whole pregnancy and before and in neonatal meconium (0.7ng/g) confirming fetal exposure during intrauterine life. Methadone and its metabolite were also measured in maternal and neonatal matrices. Counseling pregnant women and women who may become pregnant on the consequences of fetal drug exposure to new designer drugs like 4-methylethcathinone is critical to preventing poor neonatal outcomes. This case report is informative to those studying designer drugs and those clinically involved with pregnant women abusing psychoactive substances. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Forensic Science International 10/2014; 245C:e33-e35. · 2.12 Impact Factor
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    IJC Metabolic & Endocrine. 09/2014;
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    ABSTRACT: It has been known for a long time that cigarette tobacco contains naturally occurring radioactive nuclides such as Pb and Po. In this study, the concentrations of Pb and Po in the 10 most widely sold cigarette brands in Italy during the year 2010 were measured, and the effective dose to smokers has been calculated. The results of this study show that Pb concentration ranged from 11.6 to 20.0 mBq cig with an arithmetic mean of 14.6 mBq cig, while the activity concentration of Po ranged from 13.1 to 19.0 mBq cig with an arithmetic mean of 15.7 mBq cig, thus confirming previous results and showing that the radioactivity concentration was not reduced in the last few years. The annual effective dose for a typical smoker consuming 20 cigarettes per day ranged from an average of 55 μSv y to about 81 μSv y. It is finally put in evidence the need to improve the knowledge about crucial data needed for accurate dose assessment deriving from the inhalation of both radioisotopes contained in the cigarettes, namely the dose conversion coefficients, which strongly depend on several parameters such as the inhalation speed through the mouth, the real fraction of radionuclide transferred from cigarette to mainstream smoke, the lung absorption behavior of the radioisotopes inhaled with mainstream smoke, and the AMAD of particles inhaled by smokers.
    Health Physics 09/2014; 107(3):195-9. · 0.77 Impact Factor
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    ABSTRACT: A procedure based on ultra-high-pressure liquid chromatography tandem mass spectrometry has been developed for the determination of mescaline, N,N-dimethyltryptamine, psilocin, psilocybin, salvinorin A in hair of consumers of psychedelic vegetal material such peyote or trichocereus cacti, psilocybe mushrooms, Salvia divinorum or psychedelic beverage ayahuasca. After hair washing with methyl alcohol and diethyl ether and subsequent addition of mescaline-d9 and 3,4-methylenedioxypropylamphetamine as internal standards, hair samples were treated with 250μl VMA-T M3 reagent for 1h at 100°C. After cooling, 100μl M3 extract were diluted with 400μl water and a volume of 10μl was injected into chromatographic system. Chromatographic separation was achieved at ambient temperature using a reverse-phase column and a linear gradient elution with two solvents: 0.3% formic acid in acetonitrile and 5mM ammonium formate pH 3. The mass spectrometer was operated in positive ion mode, using multiple reaction monitoring via positive electrospray ionization. The method was linear from the limit of quantification (0.03-0.05ng/mg depending on analyte under investigation) to 10ng/mg hair, with an intra- and inter-assay imprecision and inaccuracy always less than 15% and an analytical recovery between 79.6% and 97.4%, depending on the considered analyte. Using the validated method, mescaline was found in concentration range of 0.08-0.13ng/mg in hair of peyote smokers, 3.2ng salvinorin A per mg hair were determined in hair from a S. divinorum smoker, 5.6ng N,N-dimethyltryptamine per mg hair from an ayahuasca user and finally 0.8ng psilocybin per ng hair of a psilocybe consumer.
    Journal of Pharmaceutical and Biomedical Analysis 08/2014; 100C:284-289. · 2.83 Impact Factor
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    ABSTRACT: Hair testing is a useful tool to investigate the prevalence of unsuspected chronic exposure to drugs of abuse in pediatric populations and it has been applied to three different cohorts of children from Barcelona, Spain along fifteen years to evaluate eventual changes in this exposure. Children were recruited from three independent studies performed at Hospital del Mar (Barcelona, Spain) and approved by the local Ethics Committee. Hair samples were collected from the first 187 children cohort (around 4 years of age) in 1998, from the second 90 children cohort (1.5-5 years of age) in 2008 and from the third 114 children cohort (5-14 years of age) in 2013. Hair samples were analysed for the presence of opiates, cocaine, amphetamines, and cannabis by validated methodologies using gas or liquid chromatography-mass spectrometry. Familiar sociodemographics and eventual consumption of drugs of abuse by parents, and caregivers were recorded. Hair samples from 24.6% children in 1998 were positive for any drug of abuse (23.0% cocaine), 25.5% in 2008 (23.3% cocaine), and 28.1% in 2013 (20.1% cocaine and 11.4% cannabis). In none of the cohorts, parental sociodemographics were associated with children exposure to drugs of abuse. The results of the three study cohorts demonstrated a significant prevalence of unsuspected pediatric exposure to drugs of abuse which mainly involved cocaine maintained along fifteen years in Barcelona, Spain. We recommend to be aware about unsuspected passive exposure to drugs of abuse in general population and to use general or selected hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions.
    International Journal of Environmental Research and Public Health 08/2014; 11(8):8267-8275. · 1.99 Impact Factor
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    ABSTRACT: Only a few studies provided information on awareness, use, and harm perception of e-cigarettes in Europe. We fill the knowledge gap in Italy.
    Nicotine & Tobacco Research 07/2014; · 2.81 Impact Factor
  • Cosmetics. 06/2014; 1(2):82-93.
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    ABSTRACT: Introduction Disclosing chronic use of cannabis has always been a difficult task due to the fact that hair testing of THC alone is not conclusive of use and hair testing of THC-COOH require specific and sensitive instrumentation and laboratory skill, not available for many analytical laboratories. We hypothesized the presence of THC-COOH glucuronide in hair as possible alternative biomarker of repeated consumption of cannabis products. Methods We developed and validated an ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method to identify and quantify THC-COOH glucuronide in hair after applying one hour digestion of 25 mg keratin matrix with M3 (Comedical Spa, Italy) reagent at 100°C, using deuterated THC-COOH glucuronide as internal standard. An amount of 10 μl was injected in the ULPC-MS/MS system. Chromatographic separation was carried out on a Acquity UPLC HSS C18 column (2,1 mm × 150 mm, 1.8 μm) using a linear gradient elution with two solvents:0.1% formic acid in acetonitrile (solvent A) and 5 mM ammonium formate pH 3 (solvent B). The flow rate was kept constant at 0.40 mL/min during the analysis. The separated analytes were detected with a triple quadrupole mass spectrometer operated in multiple reaction monitoring (MRM) mode via positive electrospray ionization (ESI). The applied ESI conditions were the following: capillary voltage 1,3 kV, desolvation temperature 600 °C, source temperature 150 °C, cone gas flow rate 20 L/h, desolvation gas flow rate 1000 L/h and collision gas flow rate 0.13 mL/min, cone voltage of 65 V. Following transitions were considered: 521.2→345.03 (Collision energy:16), 521.2 →327.07 (Collision energy: 22),521.2 → 299.09 (Collision energy: 32), with the first one used for quantification. Results Linear calibration curves were obtained for THC-CCOH glucuronide with correlation coefficients (r2) of 0.99 and a LOQ of 0.1 pg/mg hair. Analytical recovery was between 70.9 and 100.7%. Intra and inter-assay imprecision and inaccuracy were always lower than 10%. No additional peaks due to endogenous substances which could have interfered with the detection of the analytes under investigation were observed in drug-free hair samples. No psychoactive drugs other than the compounds under investigation interfered with the assay. Blank hair samples injected after the highest point of the calibration curve did not present any traces of carryover. The matrix effect in quality control samples ranged from 80 to 101%. Preliminary analysis on 9 different hair samples of consumers disclosed the presence of THC-CCOH glucuronide in the range of 0.30–1.22 pg/mg with by median value of 0.58 pg/mg hair. Conclusions Simple extraction, identification and quantification of THC-COOH glucuronide in hair by UPLC-MS/MS was developed, validated and tested for its feasibility in clinical samples and provided a good start to consider THC-CCOH glucuronide as alternative hair biomarker of repeated cannabis consumption.
    Toxicologie Analytique et Clinique. 06/2014; 26(2):S12.
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    ABSTRACT: Abstract Background: Ethyl glucuronide (EtG) measurement in neonatal meconium has emerged as a reliable marker to objectively assess prenatal exposure to maternal ethanol complementary to fatty acid ethyl ester (FAEEs) measurement. The detection of EtG in meconium is currently a lengthy, difficult and expensive process using liquid chromatography tandem mass spectrometry (LC-MS/MS) as the analytical procedure. An enzyme-linked immunosorbent assay (ELISA) for the identification of EtG in meconium was developed, validated and applied to authentic meconium specimens from newborns collected in Europe. Methods: The ELISA procedure was calibrated using 0.45, 0.9, 1.35 and 1.8 nmol/g (100, 200 300 and 400 ng/g) standards. Meconium (0.25 g) was mixed thoroughly, with extraction buffer (pH 7.3; 0.5 mL). The tube was capped, sonicated, centrifuged and the supernatant was decanted. An aliquot of the extract (50 μL) was placed in the well of the microplate followed by enzyme conjugate (150 μL). The plate was incubated for 1 h, washed with deionized water, dried and substrate (200 μL) was added. After 30 min incubation, stop solution was added and the plate was read at 450 nm and 650 nm. Samples were also analyzed for EtG and FAEEs by validated LC-MS/MS assays. Results: Using an EtG cut-off of 0.9 nmol/g for both ELISA screening test and confirmatory LC-MS/MS, immunoassay sensitivity was 100%; specificity 78%; positive-predictive value (PPV) 29% and negative-predictive value (NPV) 100%. Conclusions: The assay is proposed as a preliminary screening test for the meconium of newborns suspected of being born to mothers drinking alcohol during pregnancy.
    Clinical Chemistry and Laboratory Medicine 03/2014; · 2.96 Impact Factor
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    ABSTRACT: Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15-3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05-0.54 ng/mg hair), with four samples positive to codeine (0.1-0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child's health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions.
    International Journal of Environmental Research and Public Health 02/2014; 11(2):2288-98. · 1.99 Impact Factor
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    ABSTRACT: To validate the health and lifestyle questionnaire answered by donors to a human milk bank with respect to the presence of illegal drugs, nicotine, and caffeine levels in donor milk. A total of 400 human milk samples from 63 donors were analyzed by liquid chromatography tandem mass spectrometry for the presence of 14 illegal drugs, nicotine, and caffeine. Demographics and clinical and lifestyle data (illegal drugs, tobacco, and caffeinated beverage use) were collected from the required screening questionnaire of a human milk bank. The relationship between the 2 evaluation techniques was determined. Illegal drugs were not found in donor milk. Nicotine (46.1 ng/mL) and cotinine (138.6 ng/mL) were quantified in one milk sample from a donor who did not report tobacco use in the questionnaire (1.6% false negative). Caffeine was detected in 45.3% (181/400) of the total milk samples, with a mean concentration of 496 ± 778 ng/mL. The sensitivity and specificity of the questionnaire to detect caffeine in donor milk was 46% and 77%, respectively. The lifestyle questionnaire is reliable for the assessment of illicit drug use by donors to a human milk bank, but there are certain limitations regarding the identification of second-hand smoke exposure and the disclosure of consumption of caffeinated beverages. Data such as smoking habits of partners, type and volume of beverage or food containing caffeine, method of preparation, and time of day of consumption should be collected by the questionnaire.
    The Journal of pediatrics 12/2013; · 4.02 Impact Factor
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    ABSTRACT: Abstract Background: Drug testing in hair is a unique analysis in pharmacotoxicology for establishing a past repeated history of consumption or passive exposure to psychotropic substances. A rather lengthy sample treatment is usually required before parent drugs and eventual metabolites are amenable to quali-quantitative analysis. Methods: We evaluated a high throughput screening and confirmation analysis of drugs of abuse in hair by immunoassay and a validated ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) after applying a rapid digestion of the keratin matrix with VMA-T reagent before screening assay and M3 reagent before confirmatory analysis. Results: Samples digestion with VMA-T reagent and immunometric screening analysis of hair calibrators, controls and clinical samples for a total of 150 samples was completed in 4 h. No false-positive and -negative results were found for the control material. UPLC-MS/MS analysis confirmed all of the 31 adult hair samples positive to the screening test using internationally established cut-offs, and identified and quantified drugs of abuse in 32 pediatric hair samples, applying lower limits of quantification from 0.01 to 0.1 ng analyte per mg hair. Analytical recovery was between 70.9% and 100.7%. Intra- and inter-assay imprecision and inaccuracy were always lower than 10%. Conclusions: Rapid extraction, identification and quantification of drugs of abuse in hair by immunoassay and UPLC-MS/MS was tested for its feasibility in clinical samples and provided excellent results for rapid and effective drug testing in hair in epidemiological studies.
    Clinical Chemistry and Laboratory Medicine 11/2013; · 2.96 Impact Factor
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    ABSTRACT: There is no clear regulation on electronic cigarettes (e-cig); their health effects are not yet fully investigated and there is insufficient standardisation and quality control of the product. Moreover, the e-cig could be a gateway for young people to nicotine addiction and traditional cigarette smoking. In Italy, the Ministry of Health banned the sale of e-cig with nicotine firstly to adolescents aged <16 years, then to people <18 years. Until further scientific evidence is available, it is mandatory to regulate the production and marketing of e-cigs, to make them less attractive, to forbid their use in enclosed areas, and prevent them from being promoted. E-cigs, however, seem to be much less dangerous than traditional cigarettes, although the few studies conducted are not sufficient to demonstrate either a clear therapeutic efficacy of e-cig or their total harmlessness. If e-cig had a known content, were made according to clear rules and in certified laboratories, without toxic substances, it could be used to help heavy smokers to quit, or at least to reduce smoking habits. There is a large proportion of smokers who are unable to quit. The revision of the European Directive (the proposal is being evaluated and we are waiting for its final approval) on tobacco recommends free sale for a minority of e-cigs only, those with a nicotine content <4 mg/ml. This will be difficult, considering that the business is just the free sale of e-cig and the much more dangerous tobacco cigarettes are still sold without any restriction.
    Epidemiologia e prevenzione 10/2013; 37(4-5):303-7. · 1.46 Impact Factor
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    ABSTRACT: Successful application clinical-grade human growth hormone (hGH) immunoassays to the discovery of illegal doping cases has been rare. Indeed, the preferred biological matrix in doping control is urine, where the estimated baseline concentration of hGH falls well below the linear range and sensitivity threshold of all commercially available immunoassays, including hGH isoform differential immunoassays which can discriminate pituitary endogenous hGH from recombinant hGH. We employed hydrogel nanoparticles as a pre-processing step that concentrate urinary hGH into the linear range of isoform differential immunoassays. We explored the characteristics of immunoassays in urine spiked with both phGH or rhGH, after pre-treatment with the nanoparticles. Subsequently, pre-treatment was applied to urine obtained from 3 healthy volunteers administered during three days with daily subcutaneous injections of 0.026mg/kg/day rhGH, Genotonorm(®). Linearity between both rhGH and phGH concentrations in urine measured by a chemoluminescent assay (Immulite) and in the particle eluate was evident for differential immunoassays (R square higher than 0.999). In case of treated individuals the recombinant/pituitary concentration ratios remained above the established World Anti-Doping Agency (WADA) criterion for hGH misuse up to 24h after the last administration dose, using both assays for volunteer 1 and 2 while in case of volunteer 3 results were inconclusive. The use of nanoparticles appears to open the possibility of assessing rhGH misuse in urine.
    Journal of pharmaceutical and biomedical analysis 08/2013; 85C:194-197. · 2.45 Impact Factor
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    ABSTRACT: BACKGROUND:: The deleterious effects exerted by prenatal ethanol exposure include physical, mental, behavioral, and/or learning disabilities that are included in the term fetal alcohol spectrum disorder. The measurement of ethylglucuronide (EtG) in alternative biological matrices, including neonatal and maternal hair, neonatal meconium, and maternal nails, is receiving increasing interest for the accurate evaluation of the in utero exposure to alcohol. OBJECTIVE:: To evaluate the correlation between EtG in maternal hair and nails with EtG in neonatal meconium to further explore the suitability of these biomarkers in disclosing prenatal exposure to ethanol. METHODS:: A total of 151 maternal hair strands (0-6 cm), nail clips (2-6 mm), and corresponding neonatal meconium and nails samples were obtained from neonatal wards of 4 Mediterranean public hospitals: Rome, Florence, and Belluno in Italy and Barcelona in Spain. Hair, nails, and meconium were analyzed for the presence of EtG by validated liquid chromatography mass spectrometry assay. Meconium was also analyzed for the presence of fatty acid ethyl esters (FAEEs) as a complementary biomarker of potential in utero exposure to alcohol. RESULTS:: Eighteen newborns resulted in utero exposed to maternal alcohol consumption by FAEE testing in meconium with EtG values between 0.5 and 1.5 nmol/g. Unfortunately, none of these cases were confirmed by the presence of EtG in maternal hair and nails samples, which resulted all negative to this biomarker. DISCUSSION AND CONCLUSIONS:: The results confirm that FAEEs and EtG in meconium are the best biomarkers to assess in utero exposure to maternal alcohol. EtG in hair and nails are not good biomarkers to disclose alcohol consumption lower than on daily basis and lower than 1-2 alcoholic units per day.
    Therapeutic drug monitoring 05/2013; · 2.43 Impact Factor
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    ABSTRACT: The Nasorosso project of the Italian Youth Department and the National Institute of Health, aimed to raise awareness about drinking and driving under the influence of alcohol among club goers with a series of initiatives. Within the framework of the project, blood alcohol concentration (BAC) was measured on 106,406 individuals before and after clubbing in 66 different recreational sites from 11 Italian provinces, over 16 months. Participating individuals were interviewed regarding sociodemographic and environmental characteristics and alcohol intoxicated people were offered to be taken home. The BAC median at the club entry was 0.26 g/L with 65.3% subjects showing a BAC value under the driving legal limit of 0.5g/L. At the exit from clubs, BAC median value rose to 0.44 g/L and subjects with BAC value under the legal limit decreased to 54.9%. Being male, aged between 18 and 34 years with a diploma, being a drinker and entering the disco with a BAC already beyond the legal limit predicted a BAC value beyond 0.5 g/L at exit from the recreational place. Conversely, being a driver, being a student and exiting from the disco before 4 a.m. reduced the probability of having a BAC higher than 0.5 g/L at the end of the night. Health policies to prevent harmful use of alcohol in young people should continue to offer targeted information/ prevention; in order to steadily increase the awareness of the dangers and the damages of excessive use of alcohol.
    International Journal of Environmental Research and Public Health 05/2013; 10(5):1665-80. · 1.99 Impact Factor
  • S Nardini, R Pacifici
    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo 03/2013; 79(1):6-7.
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    ABSTRACT: OBJECTIVE: To provide updated information on smoking prevalence in Italy, with a focus on type of tobacco product, including hand-rolled (HR) cigarettes. METHOD: Two nationally representative surveys were conducted in 2011 and 2012 in Italy on a total sample of 6167 adults. Information on type of tobacco most frequently smoked was collected. RESULTS: Current smokers were 21.7% (22.7% in 2011 and 20.8% in 2012) overall, 25.3% among men and 18.4% among women. Among smokers, 94.6% most frequently consumed manufactured cigarettes, 4.6% HR cigarettes, 0.5% cigars, 0.2% cigarillos, 0.2% pipe and none smokeless tobacco. HR cigarette use was more frequent in men (6.9%) than in women (1.7%), in 2012 (5.9%) than in 2011 (3.4%), and among the young (15-24years; 9.1%). The average estimated price of one HR cigarette was 0.09€ and that of a manufactured cigarette 0.18€. CONCLUSION: In 2012 we observed the lowest reported overall smoking prevalence in Italy, though change since 2008 has been limited. The proportion of HR cigarettes on total tobacco trade has appreciably increased, particularly among young male smokers, who appear to switch to affordable cigarettes in a period of economic crisis. Fiscal policies aiming to equalise the cost of different cigarette types are needed in Italy. HIGHLIGHT: Smoking prevalence among Italian adults is decreasing and is now approaching 20% Use of hand-rolled (HR) cigarettes is increasing, particularly among the young Overall, 4.6% of current smokers most frequently consumed HR cigarettes The estimated price of one HR cigarette is half that of a manufactured one Median weight of one HR cigarette is around 0.7 grams.
    Preventive Medicine 02/2013; · 2.93 Impact Factor
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    Edited by Osservatorio Fumo Alcol e Droga, 01/2013; Istituto Superiore di Sanità, Ministero della Salute.

Publication Stats

8k Citations
1,110.87 Total Impact Points


  • 1991–2014
    • Istituto Superiore di Sanità
      • • Department of Therapeutic Research and Medicines Evaluation
      • • Clinical Biochemistry and Molecular Biology Unit
      Roma, Latium, Italy
  • 2004–2013
    • Mario Negri Institute for Pharmacological Research
      • Department of Epidemiology
      Milano, Lombardy, Italy
    • The American University of Rome
      Roma, Latium, Italy
  • 2012
    • Consorci MAR Parc de Salut de Barcelona
      Barcino, Catalonia, Spain
    • Institut Català d'Oncologia
      Barcino, Catalonia, Spain
  • 2008–2012
    • Autonomous University of Barcelona
      • Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine
      Cerdanyola del Vallès, Catalonia, Spain
    • Parc de recerca biomedica de barcelona
      Barcino, Catalonia, Spain
  • 2011
    • Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia
      Reggio nell'Emilia, Emilia-Romagna, Italy
  • 2006–2011
    • IMIM Hospital del Mar Medical Research Institute
      • Human Pharmacology and Clinical Neurosciences Group
      Barcino, Catalonia, Spain
    • Universidad Pública de Navarra
      Iruña, Navarre, Spain
  • 2010
    • University Pompeu Fabra
      • Department of Experimental and Health Sciences
      Barcino, Catalonia, Spain
  • 2009
    • The Ohio State University
      Columbus, Ohio, United States
    • University of Pavia
      Ticinum, Lombardy, Italy
  • 2005–2009
    • Parc de Salut Mar
      Barcino, Catalonia, Spain
  • 2002–2007
    • Institut Marqués, Spain, Barcelona
      Barcino, Catalonia, Spain
  • 2002–2006
    • University of Verona
      • Department of Public Health and Community Medicine
      Verona, Veneto, Italy
  • 1995–2001
    • University of Washington Seattle
      • • Department of Pathology
      • • Division of General Internal Medicine
      Seattle, WA, United States
  • 1998
    • University of Massachusetts Medical School
      Worcester, Massachusetts, United States
  • 1994–1998
    • Sapienza University of Rome
      • Department of Experimental Medicine
      Roma, Latium, Italy
  • 1985–1998
    • Washington University in St. Louis
      • • Division of Bone and Mineral Diseases
      • • Department of Biomedical Engineering
      • • Division of Endocrinology
      • • Department of Medicine
      Saint Louis, MO, United States
  • 1988–1996
    • Barnes Jewish Hospital
      San Luis, Missouri, United States
  • 1993
    • Ospedale Santo Spirito
      Roma, Latium, Italy