Quaranta et al. BMC Public Health 2011, 11:774 http://www.biomedcentral.com/1471-2458/11/774 body art were unable to explain a reason for this choice. Both these findings are in agreement with those found in a survey conducted by Greif et al [25] in 1999 among 887 American college students. The fact that, even if most of the whole sample stated that it is possible to remove a tattoo, only 59.9% knew that a surgical procedure is necessary to remove it, shows that young adults are not so well informed, as they perhaps believe. It has to be noted that the lack of a specific response about laser among those provided might have been confusing. Many freshmen having body art claimed to have been informed about the risks related to such practices before entering them; the information came especially from the body artist. According to Millner and Eichold [26], common themes for modifying bodies in the West include image management, sexual expression/sexual enhancement. In our study, the main reason given by young adults who underwent body art was related to the improvement of aesthetic aspect; smaller percentages are related to the need to be different from the others and to fashion. These motivations are in agreement with those having emerged from other investigations in this field [26-29]. The fact that 29% of the 1.598 sample have at least one piercing or tattoo and that 20.7% of those who underwent body art have declared they have both pier- cing and tattoos shows that body art is fairly common among young adults, as previous work confirms [26,30,31]. Moreover, in accordance with Stieger et al, our study shows that women are more inclined than men to undergo body art [31]. Fortunately, unlike what is reported in the scientific literature by Houghton et al [32], our investigation shows that only a limited number of freshmen have car- ried out body art on themselves and with improvised instruments. As pointed out by other authors, in most cases they turn to external operators [11,25,26,28]. The percentage of adolescents undergoing body dec- oration that reported complications might seem una- larming (13.2%); but when we consider that 9.2% of those treated at an authorized centre had complications, the percentage could be considered notable. Moreover, this finding fits well with that reported by Deschesnes et al [33] in a survey carried out in Quebec: while most teens say that a “professional” in a studio performed their body modification and that they received aftercare instruction, a high percentage of students reported health complications following the procedure. The occupation of both mother and father does not affect the practice of body art. In fact, nowadays this practice has become customary, independent of social and cultural origin [26,34]. Page 6 of 8 In terms of piercing, our data show that, in agreement with other works, the piercing is more common than tattooing [11,31,35]. Women are more inclined than men to have a piercing; in addition, females showed a higher interest than males in acquiring further piercings in the future. This fits well with work reported by Mayers et al [30] who examined a sample of university undergraduates in Pleasantville (NY, US). Our data con- cerning those who have stated to have never had a pier- cing, but were likely to consider it in the future are comparable to those of another group - Cegolon et al [34] - who examined a larger sample of young adoles- cents (4.277 students attending secondary schools). The age at the first piercing is lower than the one of the first tattoo. A hypothesis for this difference could be given by the replies to the question on how to remove the piercing and the tattoo: procedures for removing a tattoo are more invasive than those for removing the piercing. In fact, 92.1% of the sample states that to remove the piercing it is sufficient to close the hole; 59.8% knew that a surgical procedure is necessary to remove the tattoo. Although those who underwent piercing when they were underage are more than those who underwent tat- tooing when they were underage, the attitude towards informing the parents is quite similar. The head is the favorite part of the body to place the piercing, while the limb is the favorite part of the body to place the tattoo. This finding seems to correspond with Antoszewski et al [11] examining body art location. Those who live in urban areas are more inclined than those who live in smaller municipalities to undergo pier- cing; this finding is confirmed also by Antoszewski et al [29] in a survey among 968 Polish people living in Lodz. In terms of tattoos, in contrast to piercing, women are not more inclined than men to have a tattoo and neither does the female show a higher interest than the male in acquiring tattoos in the future. This agrees with work reported by Mayers et al [30]. Nevertheless, our survey is comparable with data published by Stieger et al. [31], which indicated that many non-tattooed young adults would consider being tattooed in the future. It is worth noting that, in contrast to Antoszewski et al [29], our survey shows that those who live in urban areas are more inclined than those who live in smaller municipalities to undergo tattooing. In general, compar- ing the tattoo group to the piercing group we can state that our survey shows that young adults coming from main towns are more likely to undergo body art. In accordance with Stieger at al. [31], the average number of tattoos per tattooed participant seems lower than the average number of piercings per pierced participant.