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Research on smoking behaviour has primarily focused on adolescents, with less attention given to middle-aged and older adults in rural settings. This study examines the influence of personal networks and sociodemographic factors on smoking behaviour in a rural Romanian community. We analysed data from 76 participants, collected through face-to-face interviews, including smoking status (non-smokers, current and former smokers), social ties and demographic details. Multilevel regression models were used to predict smoking status. The results indicate that social networks are essential in shaping smoking habits. Current smokers were more likely to have smoking family members, reinforcing smoking within familial networks, while non-smokers were typically embedded in non-smoking environments. Gender and age patterns show that women were less likely to smoke, and older adults were more likely to have quit smoking. These findings suggest that targeted interventions should focus not only on individuals but also on their social networks. In rural areas, family-based approaches may be particularly effective due to the strong influence of familial ties. Additionally, encouraging connections with non-smokers and former smokers could help disrupt smoking clusters, supporting smoking cessation efforts.

Abstract Background Artificial intelligence (AI) has the potential to transform our healthcare systems significantly. New AI technologies based on machine learning approaches should play a key role in clinical decision-making in the future. However, their implementation in health care settings remains limited, mostly due to a lack of robust validation procedures. There is a need to develop reliable assessment frameworks for the clinical validation of AI. We present here an approach for assessing AI for predicting treatment response in triple-negative breast cancer (TNBC), using real-world data and molecular -omics data from clinical data warehouses and biobanks. Methods The European “ITFoC (Information Technology for the Future Of Cancer)” consortium designed a framework for the clinical validation of AI technologies for predicting treatment response in oncology. Results This framework is based on seven key steps specifying: (1) the intended use of AI, (2) the target population, (3) the timing of AI evaluation, (4) the datasets used for evaluation, (5) the procedures used for ensuring data safety (including data quality, privacy and security), (6) the metrics used for measuring performance, and (7) the procedures used to ensure that the AI is explainable. This framework forms the basis of a validation platform that we are building for the “ITFoC Challenge”. This community-wide competition will make it possible to assess and compare AI algorithms for predicting the response to TNBC treatments with external real-world datasets. Conclusions The predictive performance and safety of AI technologies must be assessed in a robust, unbiased and transparent manner before their implementation in healthcare settings. We believe that the consideration of the ITFoC consortium will contribute to the safe transfer and implementation of AI in clinical settings, in the context of precision oncology and personalized care.