Background:
Despite recent advances on smoke-free environments in the European Union (EU), there are important gaps in the current legislation and its implementation. Some European countries started the extension of Smoke and Aerosol-Free Environment (SAFE) policies to some outdoor places and private indoor places, but both enforcement and compliance are poor.

Objective:
The aim of this study is to explore barriers and opportunities for the expansion, compliance, and enforcement of SAFE policies in Europe.

Methods:
Within the Joint Action on Tobacco Control 2, Work Package 8 launched an experts’ consultation about SAFE policies. We invited 110 experts from 31 European countries to complete an online quali-quantitative questionnaire between June 21st and September 12th 2022 (response rate: 57% from 29 countries). We assessed barriers and opportunities for the expansion of, the compliance with or the enforcement of SAFE policies.

Results:
Near half of the respondents identified the lobbying and funding activities of the Tobacco and Nicotine Industry (TNI) as the main barrier to the expansion of SAFE, while the main opportunity was expanding SAFE policies to outdoor public places. Regarding the compliance/enforcement, the main identified barrier was the lack of human/financial resources to apply sanctions, while powerful competent authorities with increased capacities were recommended as the main opportunity to enforce SAFE policies. Near half of respondents believed that TNI largely interfere with the expansion of SAFE policies, but perceived large TNI interference with the enforcement was low.

Conclusions:
Comprehensive regulation of TNI interference and dedicating human/financial resources to SAFE policy enforcement should be a priority to expand the EU SAFE policies.