In this study we evaluated the smoking habits, beliefs and attitudes of nurse and medical students at the University of Siena and Florence, Italy. Students who entered the 1st year of school in 1998 were asked to complete a self-administered anonymous questionnaire. Two hundred medical students completed the questionnaire; they had a mean age (+/-SD) of 19.8+/-1.7 years and 68% were females. A total of 205 nurse respondents answered to the questionnaire; they had a mean age of 21.8+/-4.1 years and females were 83% of the total. The overall response rate among students always remained higher than 85%. Thirty per cent of medical students were current smokers, and 5% former-smokers. A total of 43% of nurse students were current smokers and 11.5% former-smokers. Nurse students were more likely to smoke than medical students (p = 0.001). Among current smokers, the number of daily cigarettes smoked and the degree of nicotine addiction did not differ between groups. The prevalence of maternal smoking were higher among nurse students. In spite of students' beliefs the knowledge about smoking remained generic in both groups. Nurse students were less aware than medical students of their special responsibility towards people about tobacco smoking. Such a difference remained significant also after adjustment for smoking status (p < 0.01). Students overestimated the prevalence of current smokers among health caregivers of the local hospitals, and Italian people and adolescents. Targeted and continuous training about smoking prevention should be mandatory in Italian medical and nurse schools.

This prospective cohort study has been performed to evaluate the changes in student nurses smoking habits and beliefs during their training. The source of information was an anonymous questionnaire about tobacco smoking, administered to students who entered the first year of School of Nursing in Florence in 1991-1992, 1992-1993 and 1993-1994. Five hundred and thirty-six (95%) of these student nurses completed the questionnaire. Five hundred and one (93%) of these 536 respondents completed the questionnaire again at the end of the third (final) year of training. Student nurses who smoked increased the average number of cigarettes smoked per day (p < 0.01) and the degree of dependence to nicotine (p < 0.01). Tobacco smoking remained widespread and the percentage of ex-smokers who started smoking again increased (p < 0.05). The knowledge about the health hazards due to tobacco smoking remained generic and the prevalence of current smokers among student nurses and health care workers was overestimated. We conclude that Nursing School does not succeed in reducing the smoking habits of students. Effective antitobacco strategies and smoking cessation services still need be organized in Italy.