摘要：Introduction. Gender disparity in different fields of addiction such as tobacco smoking, alcohol use, drugs of abuse consumption and doping practice has been investigated in Italian population. Methods. We used the surveys and studies carried out for the above reported issues in recent years as revised by the "National Observatory on Tobacco smoke, Drugs of abuse, Alcohol and Doping" at Istituto Superiore di Sanità. Results. Concerning tobacco habit, the trend of smoking women has been in constant decrease from a 19.7% in 2010 to a 16.9% in 2015, differently from men who passed from a 23.9% in 2010 to a 25.1% in 2015 with a slight increase in the habit. With respect to alcohol, in the last five years an increasing trend of consumption has been observed in 18-24 years old women, with 53% drinking women in the age range of 18-19 years overcoming the 50.4% general female population. Generally speaking, a one to four ratio can be underlined in the percentage of elderly women with a risky alcohol consumption with respect to men, while in case of adolescents and young adults gender disparity is not so pronounced. Drug abuse still remains a prevalent male phenomenon. However, an increase in cannabis users for both genders has been reported with a prevalence of "once in the life" around 20%, although more pronounced in females (+2.66 percentage points for females vs +0.93 percentage points in male). With respect to cocaine, the second most consumed drug, a reduction in consumption has been recently observed mainly in female population (-42.1%) than in men one (-27.5%). Finally, there are significant gender differences in doping attitude and/or in doping profiling. First of all, males seem to be more exposed to doping than females The prohibited substances most frequently used by females athletes are "Diuretics and Masking Agents" (38.3% positive female vs 14% males) compared to males athletes who use mostly anabolic agents (20.1% males vs 11.2% females). Conclusions. Results presented for the different fields of addiction show that a gender disparity is apparent and that females are less prone in having an addiction behaviour, although the young generation seems to increase that tendency. var currentpos,timer; function initialize() { timer=setInterval("scrollwindow()",10);} function sc(){clearInterval(timer); }function scrollwindow() { currentpos=document.body.scrollTop; window.scroll(0,++currentpos); if (currentpos != document.body.scrollTop) sc();} document.onmousedown=scdocument.ondblclick=initialize G ender and addiction 177 most involved in addiction and psychiatric co-morbid- ity. The female abuse is more often related to the pres- ence of diseases such as anxiety, depression, stress, and addictions to substances for men are more influenced by the social context. As for drug use and addiction behaviours statistical data reported by the WHO show that in Europe the gap between men and women in illegal psychotropic sub- stances is gradually reducing. One example is the use of cannabis, for which can no longer notice the over- whelming prevalence in men [3, 4]. With respect to doping, it is important to underline that nowadays a significant number of women joined official and olympic competitions. Accordingly, doping to enhance female sport performances took importance from the two last decades of the past century. Gender differences regarding type of prohibited substances ad- ministered are apparent. In this study we present data on Italian population collected and/ or revised by the "National Observatory on Tobacco smoke, Drugs of abuse, Alcohol and Dop- ing" at Istituto Superiore di Sanità with respect to prin- cipal types of addiction. With respect to smoking habit, harmful use of alco- hol, consumption of psychotropic illegal drugs data from National Surveys carried out in the last five-six years will be shown and discussed. Concerning doping practice, all the data from the "Reporting System Doping Antidoping" edited by the National Observatory on controls performed from 2003 on Italian nonprofessional athletes will be presented. TOBACCO SMOKING Tobacco is the only legal drug that kills many of its users. WHO has estimated that tobacco use (smok- ing and smokeless one) is currently responsible for the death of about six million people across the world each year with many of these deaths occurring prematurely. The trend in Italy shows that there are 10.9 million smokers, 6.3 million former smokers and 35.1 million non smokers [3]. The smoking habit, which in the past was almost ex- clusively prerogative of the male population, because of the significant socio-cultural changes, is increasingly af- fecting women. Although in the last fifty years, the phenomenon is steadily decreasing in the general population, it is inter- esting to observe the prevalence trend among women. In the decades of the twentieth century, the percentage of smoking women increased significantly until the '90s when it reached a peak of 25.9%; since then there has been a progressive decrease of the phenomenon, with a prevalence of female smokers in 2015 around a 16.9%. In 2010, 70.4% women and 60.4% male respondents have never smoked. These percentages decreased dur- ing the 2011, where 54.3% males and 69.8% women did not smoke. Percentages did not change significantly in the following years and finally during 2015 where 74.8% women and 58.7% men declared they have never smoked. With respect to smokers, in the last five years, a de- creasing trend has been observed: 15-64 years old smok- ing women decreased from 19.7% in 2010 to 16.9% in 2015, differently from men who passed from a 23.9 % in 2010 to a 25.1% in 2015 indicating a slight increase in the habit [3]. The highest percentage of smoker women fell in two ages groups: 25-44 years (23.7%) and 45-64 years (25%), while in case of men (32.9%) the group was that of 25- 44 years. This trend did not vary significantly along the years from 2010 to 2014. Prevalence data for 2010 show that smokers are mostly men from Southern peninsula (26.4%) and women from central Italy (21.3%). Trend changed in 2011, when smoking men lived mainly in central Italy (31%) and women in the north (20.6%). In 2012 smok- ing men and women came mainly from southern Italy (respectively 26% and 20.9%) while in 2013 smokers were mainly men living in central Italy (28.5%) and women living in the South (16.9%). These percentages did not vary significantly in 2014 and 2015 (Figure 1). The analysis of the five-year period shows that the critical period for both males and females to start smok- ing is adolescence and young adultness between 15 and 20 years old. On average men started smoking before women, 17 vs 18 years, women begin around 18 years (the table to five years of age). Conversely, both men and women, on average quit smoking habit at the age of forty years. In the last five years period, "the influence of peers" has been the first reason to start smoking habit, both for males and females followed by the pleasure of the habit with other reasons (relatives, partners, curiosity) being negligible. With no gender differences, the major- ity of men (40.5%) and women (39.8%) quit smoking, due to the perception of harm caused by this form of addiction. Since 2000, the "National Observatory on Tobacco smoke, Drugs of abuse, Alcohol and Doping" hosted an Antismoking helpline to help smokers in quitting habit. This is national free and anonymous service that pro- vides consulting on issues related to tobacco smoking. Since 2013, the helpline number started to appear in the cigarette package raising the number of phone call more than one or two orders of magnitude and render- ing the data interesting and representative of smokers population. The last five years data indicates that, apart from 2012, usually males calling the help line are almost the double than calling females (Supplemental Figure 1, available online as Supplementary materials). In particular, a peak in phone calls was observed in 2014, but this peak was mainly due to calls from males and principally in the age-range 46-55 years. The same trend could be seen in 2015, meaning that the increased request of help is a male behaviour more than a female behaviour. Still women are less prone in asking profes- sional help to quit smoking habit (Supplemental Figure 2, available online as Supplementary materials). Over the last five years geographical area did not in- fluence the gender differences in the phone calls and passing from northern Italy to central peninsula to the South, the gap between males and females resulted even more evident. With respect to the sources of information on the
关键词：gender disparity; tobacco smoking; drugs; alcohol abuse; doping; addiction; population based study; Italy
