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REVIEW article

Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1349265

Delphi Consensus Methodology to Gauge Expert Perspectives on Smoking Prevention, Cessation and Harm Reduction in Italy

Provisionally accepted
Pasquale Caponnetto Pasquale Caponnetto 1*Vincenzo Contursi Vincenzo Contursi 2Francesco Fedele Francesco Fedele 3Fabio Lugoboni Fabio Lugoboni 4Salvatore Novo Salvatore Novo 5
  • 1 University of Catania, Catania, Italy
  • 2 ASLBari - Azienda Sanitaria Localedella provincia di Bari (ASL BA), Bari, Italy
  • 3 Umberto 1 Hospital, Rome, Italy
  • 4 University of Verona, Verona, Veneto, Italy
  • 5 Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Sicily, Italy

The final, formatted version of the article will be published soon.

    The role of smoke-free alternatives to cigarettes for tobacco harm reduction remains controversial. This study was conducted to understand the perspectives of a panel of Italian experts on this topic. Using Delphi consensus methodology, expert opinions on the use of smoke-free alternatives, tobacco harm reduction and anti-smoking legislation were gathered and analyzed. In July 2022, a Scientific Committee, including five members, proposed 38 statements spanning three areas: (1) harm from tobacco smoking and strategies for harm reduction; (2) smoke-free alternatives to cigarettes; and (3) anti-smoking legislation. Between August and November 2022, the Expert Panel, including members of the Scientific Committee and 15 other key opinion leaders, voted on the statements in two rounds. Consensus was achieved on 24 of 38 statements. The results emphasized the persistent national health threat posed by tobacco smoking in Italy, with a smoking prevalence of 20-24% between 2007 and 2022. Emphasizing harm reduction as a pivotal public healthcare strategy, the Expert Panel agreed on 10 statements related to smoke-free alternatives, but underlined the need for further research despite promising initial findings. The Expert Panel also reached consensus on six statements regarding anti-smoking legislation, stressing the importance of crafting and upholding rigorous anti-smoking laws that are consistent with World Health Organization guidelines. This pioneering Delphi consensus statement illuminates the complicated debate regarding the role of smoke-free alternatives for tobacco harm reduction in Italy. The findings highlight the evolving nature and advocate the need for ongoing discussions and further research on this important issue.

    Keywords: Delphi consensus, electronic cigarettes, heated tobacco products, Italy, Public Health, smoke-free products, Smoking cessation strategies, Tobacco harm reduction

    Received: 07 Dec 2023; Accepted: 06 Jan 2025.

    Copyright: © 2025 Caponnetto, Contursi, Fedele, Lugoboni and Novo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Pasquale Caponnetto, University of Catania, Catania, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.