Research Article Demographic Characteristics, Nicotine Dependence, and Motivation to Quit as Possible Determinants of Smoking Behaviors and Acceptability of Shocking Warnings in Italy Alice Mannocci, 1 Vittoria Colamesta, 1 Vittoria Conti, 2 Maria Sofia Cattaruzza, 1 Gregorino Paone, 3 Maria Cafolla, 1 Rosella Saulle, 1 Vincenzo Bulzomì, 4 Daniele Antici, 1 Pasquale Cuccurullo, 5 Antonio Boccia, 1 Giuseppe La Torre, 1,6 and Claudio Terzano 2 1 Department Public Health and Infection Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy 2 Respiratory Diseases Unit and ALS Respiratory and Critical Care Unit, Policlinico Umberto I-Sapienza University of Rome, 00185 Rome, Italy 3 Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, San Camillo-Forlanini Hospital, Sapienza University of Rome, 00149 Rome, Italy 4 Gynaecology Obstetric Department, Casilino Hospital, 00169 Rome, Italy 5 Clinic Center, 80126 Naples, Italy 6 Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University of Rome, 00185 Rome, Italy Correspondence should be addressed to Alice Mannocci; alice.mannocci@uniroma1.it Received 11 February 2014; Accepted 10 April 2014; Published 12 May 2014 Academic Editor: Maria Caterina Grassi Copyright © 2014 Alice Mannocci et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. his paper presents the inal results of a cross-sectional study started in 2010. It compares the perceived eicacy of diferent types of tobacco health warning (texts versus shocking pictures) to quit or reduce tobacco use. Methods. he study conducted between 2010 and 2012 in Italy enrolled adults smokers. Administering a questionnaire demographic data, smokers behaviors were collected. Showing text and graphic warnings (the corpse of a smoker, diseased lungs, etc.) the most perceived eicacy to reduce tobacco consumption or to encourage was quit. Results. 666 subjects were interviewed; 6% of responders referred that they stopped smoking at least one month due to the textual warnings. he 81% of the smokers perceived that the warnings with shocking pictures are more efective in reducing/quitting tobacco consumption than text-only warnings. he younger group (<45 years), who are more motivated to quit (Mondor’s score ≥ 12), and females showed a higher efectiveness of shocking warnings to reduce tobacco consumption of, 76%, 78%, and 43%, respectively with  < 0.05. Conclusions. his study suggests that pictorial warnings on cigarette packages are more likely to be noticed and rated as efective by Italian smokers. Female and younger smokers appear to be more involved by shock images. he jarring warnings also appear to be supporting those who want to quit smoking. his type of supportive information in Italy may become increasingly important for helping smokers to change their behavior. 1. Introduction Worldwide tobacco use continues to cause more deaths, nearly 6 million, and costs hundreds of billions of dollars of economic damage each year. If current trends continue, it will cause more than 8 million deaths annually by 2030 [1]. his high burden of tobacco is related to the causal association between smoking and a wide range of diseases. In fact, 10 types of cancer and 18 other diseases (includ- ing abdominal aortic aneurysm, acute myeloid leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, pneumonia, periodontitis, and stomach cancer) are identiied as smoking-related diseases [2, 3]. here has been a progressive decrease of the incidence of Italian smokers; in 50 years, the prevalence was estimated at 35.4%; recently, in 2012, the prevalence has fallen to 20.8%. Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 723035, 10 pages http://dx.doi.org/10.1155/2014/723035