15 years of Gaining Health strategy in Italy: what's new about behavioral risk factors?

Abstract In Europe chronic non-communicable diseases (NCDs) are responsible for the majority of deaths, premature deaths and disabilities. Actions to fight against smoking, excessive alcohol consumption, sedentary behaviours and obesity are central for the prevention of NCDs. In Italy in 2007 the National Program Gaining Health (GH) was launched and the behavioral risk factor surveillance system (including PASSI and PASSI d’Argento) was promoted. This study has the aim to contribute to assess the impact of the strategies implemented with GH, analyzing over time data on behavioral risk factors in Italy since 2008. Data from PASSI 2008-2021 (468.000 interviews of 18-69 years old people) and PASSI d’Argento 2016-2021 (74.000 interviews of over 65 years old people). i) time series models on smoking, alcohol, sedentary behaviours and obesity data in adults, stratified by gender, age, residence and social determinants; ii) Regression models to evaluate the changes in associations over time between behavioral and social determinants. Smokers’ prevalence dropped from 30% to 24%, not equally in population groups. Excessive consumption of alcohol is stable since 2010 (∼16%); although, it is the result of opposite trends in the different components of the indicator (binge, between meals and usually high) and of improvements in some groups and worsening in others: it increases in the North but not in the Center-South, it is reduced in men but increased among women; it remains stable among young people aged 18-24 (∼27%). Sedentariness is increasing everywhere (31% in 2021), especially in the South (43%) and among the youngest. Obesity also increased in the South and in the North; today about one out of 10 is obese. Social inequalities continue and worse in affecting these phenomena. These data show no improvement in the last 15 years. Prevention Plan is an opportunity to change course. Surveillance is strategic, as long as it is used to guide policies and to monitor their effectiveness over time. Key messages • Data on behavioral risk factors show no improvement in Italy since 2008. • Surveillance is strategic to guide health policies and to monitor their effectiveness over time.