Abstract

In Italy, smoking is still widespread among a relatively high percentage of young people. This study aimed to develop and validate a questionnaire to assess smoking habits, passive smoke exposure, electronic cigarette (e-cig) and heated tobacco product (HTP) use, attitudes, knowledge, and needs among undergraduates. A questionnaire consisting of 84 items was developed starting from a literature review and existing questionnaires. A two-round validation was performed by a team of 10 experts. The item-level content validity index (I-CVI), the scale-level content validity index (S-CVI), and the kappa statistics k, taking into account chance agreement, were calculated from the experts’ rating. The questionnaire was emailed to 114 students from the Obstetrics Degree of the University of Milan (Italy) to be pilot tested. After the second round of validation, all indexes were above the respective acceptability criteria: the I-CVI was 1.00 for all but three items, k was >0.74 (“excellent”) for all items, and the S-CVI was 0.964. Eighty-nine students participated in the survey: 17 classified themselves as smokers, eight as new product users, and four as former smokers, 72% students declared to routinely spend free time with smokers, while almost all students believed that healthcare professionals play a pivotal role in preventing smoking towards their patients and society. This questionnaire will be used in a survey among students from the University of Milan as a first step for future campaigns targeting health promotion.

Highlights

  • Tobacco smoking represents a dramatic public health problem worldwide, being the direct cause of about 6 million deaths a year [1]

  • One study reported the validation of a questionnaire related to the use of e-cigs [20], while no study reported items on attitudes toward legislation and educational needs

  • As regards the research conducted in web sites of institutional and international bodies, two questionnaires were considered in particular: the GHPSS and the ISS survey

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Summary

Introduction

Tobacco smoking represents a dramatic public health problem worldwide, being the direct cause of about 6 million deaths a year [1]. In the frame of the WHO Tobacco Control Convention [3,4], several initiatives have been implemented in Italy, including the activation of clinics for the cessation of tobacco smoking, the establishment of the toll-free number against smoking, and the issuing of new regulations imposing a ban on smoking in public places [5], which were extended to the external premises of schools and campuses [6] and of the pediatric, obstetric, and gynecological departments and within vehicles in the presence of children and pregnant women [7] The adoption of these measures, and in particular the regulatory measures, have had positive effects. The percentage of smokers in Italy is constantly decreasing, going

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