The Yale Food Addiction Scale 2.0 (YFAS 2.0) consists of 35 items and assesses food addiction (FA) according to the 11 DSM-5 diagnostic criteria for substance-related and addictive disorders, plus impairment or distress. Its 13-item short form, the modified YFAS 2.0 (mYFAS 2.0), has been found to yield a lower symptom count and a lower FA prevalence. This work aimed to develop an alternative short form of the YFAS 2.0, the revised YFAS 2.0 (rYFAS 2.0), designed to reproduce the YFAS 2.0 results as closely as possible. Two studies were conducted in large, independent samples of adolescents recruited from middle and high schools to develop the instrument and to evaluate its psychometric properties (factor structure, internal consistency, and measurement invariance across gender and school level), as well as its ability to reproduce YFAS 2.0 symptom counts, FA diagnoses, and FA correlates. The rYFAS 2.0 consists of 24 items and showed a one-dimensional factor structure, very good internal consistency, and invariance across gender and school level. It reproduced YFAS 2.0 symptom counts and FA diagnoses very well and better than the mYFAS 2.0 (for comparisons with YFAS 2.0 symptom counts, mean Cohen’s d = 0.47 and 0.75 for rYFAS 2.0 and mYFAS 2.0, mean Pearson’s r = .99 and .92 for rYFAS 2.0 and mYFAS 2.0; mean overall accuracy in replicating YFAS 2.0 FA diagnoses was .982 and .911 for rYFAS 2.0 and mYFAS 2.0, respectively). It also reproduced YFAS 2.0 findings on FA prevalence and correlates. The rYFAS 2.0 is a valuable instrument for use in clinical settings and studies requiring an efficient yet sensitive measure of FA.

The increasing prevalence of social media addiction (SMA) among adolescents poses significant challenges for mental health, highlighting the need for effective prevention and intervention strategies. This study investigates how two well-known emotion regulation strategies-cognitive reappraisal and expressive suppression-relate to SMA, with depressive symptoms and social anxiety as mediators, focusing on gender differences in an Italian adolescent sample. Using multiple-group path analysis, results showed that both expressive suppression and cognitive reappraisal directly predict SMA similarly across genders, while indirect effects via depressive symptoms and social anxiety differ by gender. Expressive suppression was positively associated with depressive symptoms and social anxiety, with stronger expressive suppression-depressive symptom links in males and stronger expressive suppression-social anxiety links in females. Cognitive reappraisal was protective, particularly against social anxiety in females. Depressive symptoms mediated the impact of emotion regulation strategies on SMA more strongly in females, whereas social anxiety mediated these effects mainly in males, with social anxiety directly linked to SMA only in males. These gender-specific pathways highlight distinct emotional vulnerabilities contributing to SMA. The study also provides a primary validation of the Italian Social Media Use Disorder Scale for Adolescents, reinforcing its utility as a reliable tool for assessing SMA. Overall, these findings offer valuable insights for developing gender-sensitive, targeted prevention and treatment programs aimed at improving adolescent emotional well-being and reducing SMA risk.

Most gambling research focuses on problem gambling, often neglecting milder but more prevalent harmful patterns, whose prevention could prove highly cost-effective. This study analyzed factors associated with at-risk or problem gambling (Problem Gambling Severity Index ≥ 1) among 1060 recent gamblers in Italy (2022–2023). At-risk or problem gambling was reported by 17

INTRODUCTION:Tobacco use is one of the world's leading preventable causes of death and is a major preventable risk factor of non-communicable diseases. Although smokers are aware of the health risks, their attempts to quit often fail, primarily due to the strong nicotine and/or tobacco dependence. Antismoking helplines have become an integral part of tobacco control efforts in many countries. In Italy, the ISS Antismoking Helpine is active since 2000. MATERIAL AND METHODS:The professional staff of the ISS Antismoking Helpline have gathered socio-demographic and smoking-related data via an electronic form, related to the received calls. The collected data have been processed in a dedicated database and analyzed to monitor the use and the quality of the service. In this study, a descriptive statistical analysis was conducted to inform about the activity of the helpline over the years. RESULTS:From May 2003 to June 2023 the helpline received 99,423 calls. Most smokers called to receive "support to quit" (82.6%). Counselling was provided in 11.4% of cases, and in the last two years has been strongly increased (40.0% of cases). The percentage of users requesting information on emerging tobacco and nicotine products is 1.2%, even if in 2023 this percentage has risen significantly (6.0%). Two legislative measures (in 2012 and in 2016) required to add the helpline number to all packets of tobacco cigarettes. Accordingly, the offer of counselling increased from 2.6% to 12.2%. CONCLUSIONS:The available resources in tobacco control, including the helpline, are still not sufficient to meet all the users needs. Adequate policies and stable funding to fight tobacco and nicotine dependence need increased commitment from government institutions to ensure equal access to treatments for all Italian citizens.

BACKGROUND:The lockdowns imposed by the government during coronavirus disease 2019 (COVID-19) pandemic have had a significant impact on the Italian population habits. METHODS:LOckdown and lifeSTyles in Italy and in Tuscany studies collected data on a representative sample of the Italian adult population in 2020 (n = 6,003) followed up through 2023 via four additional surveys (3,000 ≤ n ≤ 6,600) through an online self-administered questionnaire. The Alcohol Use Disorders Identification Test-Concise was used to identify at-risk drinkers. Considering the cohort of individuals who took part to the first and at least one other wave (n = 5,378), a multilevel logistic model was used to derive odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of being at-risk drinkers. RESULTS:The prevalence of at-risk drinkers was 26.4% before, 23.4% during the first lockdown, and stabilized around 30.0% thereafter. Being at-risk alcohol consumers decreased with decreasing economic status (P for trend <0.001), was less frequent among middle-aged compared to younger (OR 0.73; 95% CI, 0.60-0.89) and among divorced/separated (OR 0.77; 95% CI, 0.60-0.99) or single (OR 0.75; 95% CI, 0.64-0.89) compared to married individuals. It was more frequent among individuals with anxiety or depressive symptoms (OR 1.24; 95% CI, 1.12-1.37), those using psychotropic drugs (OR 1.99; 95% CI, 1.69-2.35) and users of conventional and/or alternative nicotine products (OR 3.67; 95% CI, 3.00-4.48). CONCLUSION:The long-term trends in alcohol consumption after the COVID-19 pandemic are unfavorable in Italy. The results point to an increased vulnerability for at-risk alcohol consumption among younger individuals, women with higher economic status, and married individuals. At-risk drinking is strongly related to mental health symptoms and nicotine consumption.

Objective. Psychoactive substance use is largely found to involve multiple substances. In recent years, the COVID-19 pandemic has changed psychoactive substance use patterns. Aim of this study is to investigate profiles of polysubstance and their pattern during and after the COVID-19 pandemic. Methods. We collected information on alcohol consumption, use of tobacco, cannabis and other psychotropic substances, and nicotine-containing electronic devices (NCEDs; i.e., heated tobacco products and electronic cigarettes) on representative samples of the Italian adult population in five surveys from 2020 to 2023 (3,000 <= n <= 6,600). We used a Latent Class Analysis model to identify substance use profiles and their associated variables in each time period. Results. We initially identified two profiles, "light users", characterized by a low use of tobacco and NCEDs (3%-20%) and a 40% at-risk alcohol consumption, and "polysubstance users", characterized by a large use of all psychoactive substances. After the 2020 COVID-19 lockdown, we also found the "dual users" profile, which show a large use of tobacco (90%) and NCEDs (50%), and also alcohol (50%). Being "dual users" and "polysubstance users" were associated with younger age and high economic status, with strengths of association less pronounced during lockdown but more marked immediately thereafter. Moreover, reporting anxiety or depressive symptoms as well as using psycho- tropic drugs were strongly associated with both profiles, especially in the last two years. Conclusions. Heterogeneity of polysubstance users and their socio-demographic characteristics need to be considered to design tailored prevention interventions, with special attention to the new "dual users" profile, which confirmed the increasing trend in NCED use.

Background. Self- and hetero-directed violence (SHDV) is a serious public health problem and a complex phenomenon, influenced by individual and environmental factors. SHDV may occur particularly in moments of personal, economic and/or social crisis. During the COVID-19 pandemic, the ISS-Helplines operators have perceived an increase in psychological distress and self-isolation among callers. The ViolHelp project aimed at identifying potential warning signs and risk factors of SHDV emerging in the activity of the ISS-Helplines (Istituto Superiore di Sanity, ISS, Italian National Institute of Health). Materials and methods. A dashboard collecting warning signs and risk factors of SHDV was developed to be used during the ISS-Helplines activity. Results. In one year of data collection, 135 calls were compiled. In 106 calls, callers referred experienced violence: 72 self-directed violence (SDV), 20 hetero-directed violence (HDV), 14 both. The most frequent warning signs and risk factors for SDV were desire to die (68.6%), previous suicide attempts (31.4%) and threat of self-harm (25.6%); for HDV were depressed mood (32.4%), diagnosis of pathology and/or psychiatric disorders, desire to die, use of psychotropic drugs, and alcohol abuse (29.4%). Conclusions. The results of this pilot project show the importance of being able to read the warning signs and to create a network that can improve information, prevention and support activities for people at risk of violence and their families.

ObjectiveFood Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was to assess the association between the diagnosis/severity of FA and psychosocial domains typically related to risk behavior syndrome in a large, nationally representative community sample of Generation Z underage Italian students.MethodThe sample consisted of 8,755 students (3,623 from middle schools, 5,132 from high schools). A short version of the Yale Food Addiction Scale 2.0 was administered to evaluate FA. Risk and protective factors related to demographic, personality, behavior, and family variables were examined. Stepwise multivariate logistic and linear regressions were conducted.ResultsThe prevalence of FA was 30.8%. Female gender, social anxiety and depression symptoms, social withdrawal risk, Internet gaming disorder, social media addiction, current substance use, social challenge engagement and experienced doxing boosted the chance of FA diagnosis, whereas eating fruit and vegetables, playing competitive sports and an average sleep duration of 7–8 h per night reduced these odds. FA severity was significantly and positively associated with trait impulsiveness, social anxiety and depressive symptoms, risk of social withdrawal, recent substance use, social media, and gaming addiction, doxing suffered and risky social challenges participation. Negative associations between the severity of FA and fruit and vegetable diet habits were found.ConclusionOur findings confirm that FA is widespread among Italian adolescents. The associations between the diagnosis and severity of FA and psychosocial risk factors for health, including, addictive and deviant behaviors related to digital misuse, suggest its belonging to the risk behavior constellation. Health promotion schemes based on a multicomponent strategy of intervention should consider the inclusion of FA and its psychosocial correlates.

INTRODUCTION:To assess nicotine-containing products (NCPs; heated tobacco products and/or electronic cigarettes) use in relation to conventional smoking. METHODS:"LOST IN ITALY" ("LOckdown and Lifestyles IN ITALY") and "LOST IN TOSCANA" cross-sectional surveys estimated lifestyles changes before, during, and after the lockdown in a representative sample of the Italian population. A Poisson regression model was used to estimate prevalence ratios of NCP use according to socio-demographic, mental distress, and smoking variables. RESULTS:The prevalence of conventional cigarette smokers did not decrease, remaining stable at 23%. Exclusive conventional cigarette smokers decreased from 21% before the lockdown in 2020 to 15% in 2023 but dual users, representing the large majority of NCP users, increased by 4 times, and exclusive NCP users decreased from 7% in 2020 to 5% in 2023. CONCLUSIONS:NCPs are mostly accompanying instead of replacing conventional cigarettes. A targeted campaign should be developed in Italy to raise awareness on that.

The Hikikomori phenomenon often starts during adolescence and, once it develops, it tends to persist. Thus, having an instrument specifically validated for detecting it at early ages could play a pivotal role to reduce the chronicity risk. This work aims to validate the 24-item Hikikomori Risk Inventory (HRI-24) on adolescents and to develop a short version of it. In Study 1, an exploratory structural equation model was used to evaluate the functioning of the HRI-24 and to select the items for inclusion in the short version. In Study 2, confirmatory factor analyses were run on the short version, and measurement invariance across gender and school levels was investigated. Structural validity and measurement invariance of the HRI-24 were supported. The psychometric properties of the short version, denoted as HRI-15, were satisfactory and analogous to those of the HRI-24, while accuracy and specificity in identifying at-risk individuals were slightly higher. Measurement invariance of the HRI-15 was supported as well. The validation of the HRI-24 on adolescents would help professionals to screen young people at the first onset of the Hikikomori phenomenon, and the short version could be highly useful in large epidemiological and screening studies.

INTRODUCTION:COVID-19 lockdown in Italy resulted in increased smoking consumption, mainly associated with mental distress. This study aims to update previous findings investigating changes in smoking intensity during the whole COVID-19 pandemic.METHODS:This analysis was carried out within the "LOST IN ITALY" ("LOckdown and lifeSTyle IN ITALY") and "LOST IN TOSCANA" studies on 880 smokers with information collected during main pandemic peaks. Changes in cigarettes/day were investigated in association with survey-periods, socio-demographic and psychological characteristics through a linear mixed-model.RESULTS:Net of psychological distress and socio-demographic variables, in comparison to pre-pandemic period cigarettes/day increased by 1.16 during lockdown, and remained over half higher subsequently. In the overall period, an increase of >1 cigarette/day was also associated to lower education, older age, male gender and psychotropics drugs use.CONCLUSIONS:After 2 years of pandemic, cigarettes/day have not yet returned to the pre-pandemic levels, mainly due to socio-demographic factors, but also to nicotine addiction, that tends to stabilize consumption.

reports of data from original research.• Policy Case Studies -brief articles on policy development at a regional or national level.• Study Protocols -Articles describing a research protocol of a study.• Methodology Papers -Papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.• Tobacco Industry Monitoring Letters -brief articles on tobacco industry tactics.

In the framework of tobacco control, it is important to develop a culture of prevention through information campaigns and interventions aimed at cessation of tobacco and nicotine dependence. In this context, the National Centre on Addiction and Doping of Istituto Superiore di Sanità has been carrying out studies and research based on scientific evidence for many years, producing and disseminating guidelines and recommendations, promoting surveillance systems, offering training for social-health operators, facilitating the meeting of citizens' demand and the offer of local healthcare services (also through counselling interventions administered via the Tobacco Quitline - 800 554088). (...)

BACKGROUND: For most people, gambling is a harmless activity, but for some it can be addictive with negative consequences. In Italy, there is no estimate of the prevalence of this phenomenon on large samples of the adult populationMETHODS: The purpose of this epidemiological study (N.=12,061) was to estimate the prevalence and to describe the Italian gamblers characteristics. Data were collected from adult aged 18 and over, between late 2017 and early 2018 with a response rate of 51.2%. The presence of problem gambling was assessed with the Problem Gambling Severity Index (PGSI). Information on socio-economic and demographic characteristics as well as lifestyle, individual traits, gambling motivation, gambling behaviour characteristics was collected.RESULTS: Findings indicated that 36.4% Italians gambled at least once in the year before the survey, 3% met criteria for problem gambling, 4.1% for low risk gambling and 2.8% for moderate risk gambling. A percentage of 3.5% were problem gamblers in the 50-64 age group while 3.4% in the 40-49 and 3.3% in the 25-39 age group. Geographical area (e.g., living in North-West or North-East or Center or South or Italian Islands), living with family of origin, unhealthy lifestyle (e.g., smoking, alcohol consumption), gaming, time devoted to gambling, variables related to the relational context, economic situation of the last 12 months and downloading gaming applications were risk factors for problem gambling.CONCLUSIONS: The spread of problematic gambling-related behaviors is a worrying phenomenon, which must be studied in order to design and implement effective prevention interventions.

The World Health Organization (WHO) on May 31st of each year celebrates the World No Tobacco Day, with the aim at informing citizens about the risks associated with the use of tobacco, the commercial practices implemented by large multinationals, the policies to reduce consumption and what people around the world can do to claim their own right to health and a healthy life. (...)