Comprehensive legislation covering the use of all types of tobacco and nicotine products
to provide a smoke- and aerosol-free environment (SAFE) should be part of strategies
aimed at phasing out tobacco use. There is a need to identify challenges and opportunities
for advancing SAFE policies and their implementation. This study aims to identify
barriers and opportunities to extend, enforce, and comply with SAFE policies in Europe.Within
the Joint Action on Tobacco Control 2, a cross-sectional expert consultation was launched
in 2022. Data obtained through an online questionnaire including closed and open-ended
questions on barriers, opportunities, and interference by the tobacco and/or nicotine
industry (TNI) on the extension, and compliance with/enforcement of SAFE policies,
were analyzed thematically and descriptively.From 29 European countries, 61 experts
(response rate: 55.5%) were included in our sample. The most commonly identified barriers
for the extension of SAFE policies were tobacco industry lobbying and funding activities,
while the most commonly reported opportunity was extending SAFE policies to specific
outdoor public or private places, especially where children are present. In terms
of compliance with/enforcement of SAFE policies, the lack of human and financial resources
and capacity to monitor/enforce compliance were the most commonly identified barriers,
while opportunities included more powerful enforcement authorities with increased
capacity. The experts identified greater TNI interference on the extension than on
the enforcement of SAFE policies.Comprehensive regulation of TNI interference and
allocation of human/financial resources for policy enforcement, should be a priority
for the extension of SAFE policies in Europe.
