Electronic cigarette for smoking cessation: a fast-track Delphi consensus of French-speaking experts

The French-speaking Society for Smoking Cessation (Société francophone de tabacologie, SFT), which promotes scientific knowledge and training on smoking cessation, asked us to identify and quantify consensual agreements among its members on the use of e-cigarette for smoking cessation.

We used the fast-track Delphi process, starting with a modified version of the Nominal Group Technique where experts generated propositions to answer the target question: "What is the place and usefulness of vaping in the clinical care of people who smoke?", followed by two Delphi surveys (e-questionnaires), in which they expressed their opinion on each statement (9-point Likert-scale) and commented. Consensual agreement is reached on a statement with a median ≥ 7 on the 1-9 Likert-scale (agreement) and an interquartile range (IQR) ≤ 3 scale points (consensus).

Over 40 days in autumn 2023, 87/163 (53%) experts reached consensual agreement on 26/33 (79%) statements, notably on the main outcome "According to current data, the e-cigarette is effective for smoking cessation (abstinence of 6 months or more)" (median 7, IQR 6.5-7.5). They considered that e-cigarette very likely reduces the risks compared to smoking (8, 7-9), and "can be used in association with nicotine replacement products" (9, 8-9). No consensual agreement was reached for adverse effects and potential benefits for subgroups (i.e. pregnancy, hospitalized).

Participating experts agreed that e-cigarette can help to quit smoking. Agreeing on priority actions for smoking cessation is a base to develop clinical guidelines and trainings, and to tackle the industry-led tobacco epidemic.