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Background Smoking status, dependence and cessation efforts of the disadvantaged Hungarian Roma living in segregated settlements were compared to those of the general population. Methods Data were collected through survey. Each study group consists of 500 randomly drawn subjects, and are representative of the adult (18-64) general and Roma population, living in two counties of North-East Hungary. Questions on smoking from the European Health Interview Survey were used with some modifications. Prevalence data were analysed according to age strata (18-29, 30-44 and 45-64 years) by chi2 test, and were compared to data from 2003 and 2014. Results In Roma the proportion of never smokers is much less compared to the general ones (men:27.27% vs.75%, women:38.6% vs.70.75%, p &amp;lt; 0.05). Less Roma reported never smoking in all age compared to 2014, increasing trend can be found in the general population since 2003. Smoking prevalence is higher in Roma in all ages (72.73% vs.20 83%; 68.42% vs.28.42%; 59.02 vs. 32.26%, p &amp;lt; 0.05, respectively). Interestingly, the prevalence of Roma men smokers is decreasing by age, in the general population the trend is the opposite. Heavy smoker status is the highest in 30-44 age group of both populations. Increasing trend of heavy smoking can be detected in the Roma, but the opposite holds for general population compared to 2014. Half of the Roma smoke within 5 minutes after wakeup (50% vs. 36.92%, p &amp;lt; 0.05), smoke hand-rolled cigarettes (68.91%vs 30.77%, p &amp;lt; 0.05), higher proportion of them tried to quit (34.78% vs. 23.38%, p &amp;lt; 0.05) but smaller proportion of them obtained advise on how to quit (48.53% vs.59.09%, p &amp;lt; 0.05). Initiation starts earlier age among them (men: 15.1 vs.16.6, women: 16.2 vs.18.2, p &amp;lt; 0.05). Conclusions Regular smoking (especially heavy) is much higher in the Roma and decreasing by age compared to the general in all age-groups. The 30-44 age group of Roma mean are exclusively heavy smokers but half of the Roma show effort to quit. Key messages Tailoring cessation programs for Roma men especially those belong to 30-44 age group is a priority to reduce tobacco-related adverse effects. Complex public health programmes that taking into account special socio-cultural environment and lower formal education level of the Roma are needed.

Disparities in smoking habits in Hungarian Roma and general populations