title: Experts' consensus on use of electronic cigarettes: a Delphi survey from Switzerland.
abstract: OBJECTIVE
  In some countries, nicotine-containing electronic cigarettes (e-cigarettes) are considered a consumer product without specific regulations. In others (eg, Switzerland), the sale of e-cigarettes containing nicotine is forbidden, despite the eagerness of many smokers to obtain them. As scientific data about efficacy and long-term safety of these products are scarce, tobacco control experts are divided on how to regulate them. In order to gain consensus among experts to provide recommendations to health authorities, we performed a national consensus study.
  
  
  METHODS
  We used a Delphi method with electronic questionnaires to bring together the opinion of Swiss experts on e-cigarettes.
  
  
  METHODS
  40 Swiss experts from across the country.
  
  
  METHODS
  We measured the degree of consensus between experts on recommendations regarding regulation, sale, use of and general opinion about e-cigarettes containing nicotine. New recommendations and statements were added following the experts' answers and comments.
  
  
  RESULTS
  There was consensus that e-cigarettes containing nicotine should be made available, but only under specific conditions. Sale should be restricted to adults, using quality standards, a maximum level of nicotine and with an accompanying list of authorised ingredients. Advertisement should be restricted and use in public places should be forbidden.
  
  
  CONCLUSIONS
  These recommendations encompass three principles: (1) the reality principle, as the product is already on the market; (2) the prevention principle, as e-cigarettes provide an alternative to tobacco for actual smokers, and (3) the precautionary principle, to protect minors and non-smokers, since long-term effects are not yet known. Swiss authorities should design specific regulations to sell nicotine-containing e-cigarettes.
authors: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors: Jeremie
authors: http://orcid.org/0000-0002-4291-9918
authors: J
authors: Blaser
authors: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors: Jacques
authors: J
authors: Cornuz
mesh_terms: D000367:Age Factors; D003697:Delphi Technique; D066300:Electronic Nicotine Delivery Systems; D006801:Humans; D009538:Nicotine; D011356:Product Labeling; D011634:Public Health; D011795:Surveys and Questionnaires; D013557:Switzerland
chemical_list: D009538:Nicotine
keywords: Delphi method; Electronic cigarettes; Nicotine