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Accepted for/Published in: JMIR Formative Research

Date Submitted: Mar 20, 2024
Date Accepted: Nov 7, 2024

The final, peer-reviewed published version of this preprint can be found here:

International Expert Consensus on Relevant Health and Functioning Concepts to Assess in Users of Tobacco and Nicotine Products: Delphi Study

Law V, Afolalu EF, Abetz-Webb L, Wemyss L, Turner A, Chrea C

International Expert Consensus on Relevant Health and Functioning Concepts to Assess in Users of Tobacco and Nicotine Products: Delphi Study

JMIR Form Res 2025;9:e58614

DOI: 10.2196/58614

PMID: 39746194

PMCID: 11739724

International Expert Consensus on Relevant Health and Functioning Concepts to Assess in Users of Tobacco and/or Nicotine Products: a Delphi Study.

  • Vivienne Law; 
  • Esther F. Afolalu; 
  • Linda Abetz-Webb; 
  • Lee Wemyss; 
  • Andrew Turner; 
  • Christelle Chrea

ABSTRACT

Background:

This study was conducted to reach consensus among international experts on the most important health and functioning self-reported concepts to consider when evaluating a switch from smoking cigarettes to using smoke-free tobacco and/or nicotine products (sf-TNPs).

Objective:

This study was conducted to reach consensus among international experts on the most important health and functioning self-reported concepts to consider when evaluating a switch from smoking cigarettes to using smoke-free tobacco and/or nicotine products (sf-TNPs).

Methods:

Experts (N=105) with professional experience and knowledge of sf-TNPs completed a three-round, adapted Delphi panel; online surveys combining quantitative (MaxDiff best–worst scaling and latent class analysis) and qualitative assessments were used to rank and achieve alignment on the importance of 69 health and functioning concepts. All experts participating in Round I completed Round II, and 101 completed Round III.

Results:

The Round I analysis identified 36 out of 69 concepts that were refined for Round II assessment. The highest-ranked concepts reflected health-related impacts; the lowest ranked were related to aesthetics and social impacts. Round II ranking reinforced the importance of concepts relating to health impacts, and the analysis resulted in 20 concepts retained for Round III assessment. In Round III, the four highest-ranked concepts (cardiovascular symptoms, shortness of breath, chest pain, and worry about smoking-related diseases and impact on general health) made up 50% of the total score in the MaxDiff analysis. Experts reported likelihood to see a change in the 20 concepts with a switch to an sf-TNP, and the relative importance of the concepts differed depending on professional specialty and geographic region.

Conclusions:

This study identified key concepts to be considered in the development of a new measurement instrument to assess the self-reported health and functioning status of individuals using sf-TNPs.


 Citation

Please cite as:

Law V, Afolalu EF, Abetz-Webb L, Wemyss L, Turner A, Chrea C

International Expert Consensus on Relevant Health and Functioning Concepts to Assess in Users of Tobacco and Nicotine Products: Delphi Study

JMIR Form Res 2025;9:e58614

DOI: 10.2196/58614

PMID: 39746194

PMCID: 11739724

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