[Expert consensus for the organization of smoking management in Spain]

To generate a cost-effective healthcare model for the management of smoking in Spain.

This was a qualitative study based on nominal group methodology and a literature review. Nine tobacco experts (3 pulmonologists, 3 primary care physicians, and 3 community pharmacists) analysed the current smoking care context and available evidence on interventions. Based on this information, they generated a healthcare model for the management of smoking.

A total of 11 general principles were agreed upon, including, for example, the recognition of smoking as a chronic disease, the need for a comprehensive, coordinated approach adjusted to the characteristics and needs of the smokers, or the training of health care professionals on smoking cessation. Two proposed levels of smoking care were established and described (characteristics, competencies, resources, etc.); one is non-specialized (primary care, hospital care and community pharmacy) and another is specialized (smoking units). The objective of the non-specialized level is to identify the smoker, establish the diagnosis, evaluate the patients, and provide at least a brief intervention. The non-specialized level provides highly specialized comprehensive assistance to smokers with special characteristics. The document summarizes the evidence of the main interventions on smoking and has recommendations and care algorithms (actions in the patients' first and subsequent visits and referral criteria).

Smoking in Spain requires a comprehensive, structured, interdisciplinary, coordinated, and efficient approach adapted to the characteristics and needs of the smokers.