Summary
Detailed epidemiology of Chronic Respiratory Diseases (CRDs) and of their risk and protective factors is needed to plan preventive interventions to reduce the burden of CRDs on population health. This study determines the prevalence of doctor-diagnosed CRDs and its associated factors in the adult Italian population. Methods: Data was collected from adults participating in the ongoing cross-sectional Italian Behavioural Risk Factor Surveillance System (PASSI) between 2013 and 2015. Results: Among 108 705 respondents, 7.0% reported a CRD (3.4% asthma, 2.6% COPD, 1.0% Asthma-COPD Overlap Syndrome). Current smoking was more frequent in the group with CRD compared to those without (30.8% vs. 25.2%, P < 0.001), as was physical inactivity (41.9% vs. 36.4%, P 0.009) and overweight/obesity (52.4% vs. 41.4%, P 0.009). Adults with CRDs also reported appropriate perception of insufficient physical activity and excessive body weight, adopted protective behaviours and received preventive interventions more often than those without CRDs. Conclusions: Italian adults with CRDs are more likely to be exposed to aggravating factors but are also knowledgeable of their condition and amenable to behaviour change. Since effective interventions for modifying these factors are available, there is an opportunity to reduce the significant disease burden of CRDs through specifically targeted health promotion interventions.

Relevance
This analyses is to provide an updated estimate of CRDs in the adult Italian population (18–69years) utilizing data from the Italian behavioural risk factor surveillance system (BRFSS), PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia). The specific objectives are (i) to estimate the prevalence of CRDs, overall and in different population groups, and (ii) to assess the occurrence of modifiable risk/aggravating factors for CRDs, protective individual behaviours and preventive interventions in people with and without CRDs to better target new policies.