Objective To analyse the prevalence and correlates of smoking in cars as well as attitudes towards the extension of smoking bans in private vehicles among Italian adults.

Methods We used data from two surveys conducted in 2011 and 2012 on an overall sample of 6167 individuals representative of the Italian population aged ≥15 years.

Results The prevalence of smoking while driving was 65.5% among adult smokers. There was a negative trend with age and a positive one with education level. Smoking while driving was more prevalent among men, heavy smokers and smokers who believe there is little or no increased risk of accidents from smoking while driving. Among smokers who smoke while driving, 20.9% smoke in cars carrying children. Overall, 79.6% of Italians (88.2% non-smokers and 48.8% current smokers) support a ban on smoking in cars, and 92.5% (95.0% non-smokers and 83.5% current smokers) support such a ban in cars carrying children.

Conclusions Despite the high percentage of smokers who smoke in private vehicles, the majority of the Italian population (including smokers) support the introduction of a smoking ban in cars, particularly in cars carrying children. Smoke-free laws should therefore be extended to private vehicles, particularly if they are carrying children. Moreover, warning labels on cigarette packages should include information on the increased risk of accidents when smoking while driving. Mass media campaigns should also consider targeting this topic.