Opinion – Saúde em Público: It’s time to stop the trend of hip electronic cigarettes


Responsible for the deaths of 8 million people annually worldwide, tobacco use is still a reality among at least 1 billion individuals, according to the latest Tobacco Atlas.

These alarming numbers are the result of decades of heavy tobacco industry strategies, based on exorbitant investments, persistent lobbying and advertising campaigns with strong emotional appeal and messages linked to adventure, sophistication and freedom.

In Brazil, fortunately, since the creation of Law 10,167 in December 2000, cigarette advertising is prohibited. The initiative was part of a set of public policies that have been successful in reducing the prevalence of smoking. Despite this, when we talk about an insistent industry such as tobacco, vigilance in relation to smoking and the maintenance and strengthening of policies to combat smoking need to be constant to avoid setbacks.

Tobacco companies are an old business and their customers are dying for their product. They then need to replace these consumers, but they end up facing a problem: people aged 21 and over generally do not start using tobacco products. Therefore, the main audience that these companies need to attract to keep their businesses alive is young people. And in their eyes, the younger the better.

Targeting this audience, the industry has found new ways to spread the same “cool” messages as before. In place of traditional cigarettes, we now have e-cigarettes and vaporizers. Instead of TV commercials, we currently see the rules being circumvented by digital influencers and celebrities who display tobacco consumption indiscriminately on social media.

According to data from the two editions of the National Health Survey (PNS), from 2013 and 2019, the use of tobacco derivatives (such as cigarettes, cigarillos, straw cigarettes and others) is present among the youngest. Among those aged 18 to 29, the prevalence of smoking was 11.4% in 2013 and 11.1% in 2019.

When we talk specifically about electronic cigarettes, the Covitel* (Telephone Survey of Risk Factors for Chronic Non-Communicable Diseases in Pandemic Times) brought unprecedented data, released last April. According to the survey, 0.6% of young people between 18 and 24 years old make daily use of electronic cigarettes in Brazil. The prevalence rises considerably when it comes to other frequencies of use: 8.5% of young people report occasional use, while another 10.6% have already tried it. Putting all these numbers together, 19.7% of young people have had at least one contact with the devices in their lives, either through experimentation, sporadic use or daily consumption.

These data are even more valuable as we are living in Brazil at an important moment in terms of tobacco control policy. Since 2009, the National Health Surveillance Agency (ANVISA) prohibits the importation, advertising and commercialization of electronic cigarettes in the country. Now, in 2022, the agency is revisiting the topic, through the opening of a public procurement of subsidies that will gather technical and scientific evidence on Electronic Smoking Devices (DEF).

In order to avoid setbacks, it is essential to advocate for the maintenance of the ban on the dissemination and sale of electronic cigarettes in the country, in addition to defending – greater inspection to prevent illegal trade from allowing the product to reach the hands of young Brazilians. Covitel itself showed, for example, that the prevalence of electronic cigarette consumption is higher in the Center-West and South regions of Brazil, whose borders with Paraguay are proven gateways for the smuggling of traditional cigarettes. The data may provide evidence that the same dynamic is happening with electronic devices.

Focusing on this young audience is not just important to stop the industry’s efforts in its tobacco consumer rejuvenation strategy. It is also urgent to care for the health of this population, which mistakenly believes that electronic cigarettes are not harmful. According to the Brazilian Society of Pulmonology and Tisiology (SBPT), these devices contain chemical substances that are proven to be carcinogenic. Its use also increases the risk of serious cardiovascular problems, such as heart attack and stroke, among other pathologies. In young people, e-cigarettes have also been found to cause headaches, difficulty concentrating and anxiety.

It is necessary to maintain successful policies and invest in the expansion of initiatives to combat smoking, on the most diverse fronts, following industry innovations. This is the only way to reverse a devastating scenario, in which we see 443 deaths a day caused by smoking in Brazil, costing BRL 125 billion to our health system every year, according to April 2022 data from the National Cancer Institute ( INCA). In addition to avoiding great human suffering, this cost could be reversed in investment for the prevention and health promotion of Brazilians.

* Carried out by Vital Strategies and the Federal University of Pelotas (UFPel), based on articulation and funding from UMANE, the initiative also has co-financing from the Ibirapitanga Institute and support from the Brazilian Association of Collective Health (Abrasco). Covitel is a nationwide survey, with 9,000 people interviewed, representing the five major regions of the country: Midwest, Northeast, North, Southeast and South.

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