Medical entities appeal to Anvisa against electronic cigarettes

Representatives of almost 50 Brazilian medical entities released a document this Monday (9) to warn about the health problems that the use of electronic cigarettes can bring.

They defend the importance of maintaining the ban on these products at a time when Anvisa (National Health Surveillance Agency) collects new technical information about them. “Electronic cigarettes cannot reverse decades of efforts by tobacco control policy in Brazil,” says the document, presented at an online event that debated the topic.

Officially called DEF (Electronic Devices for Smoking), electronic cigarettes have been banned in Brazil since 2009 by Anvisa’s Collegiate Board Resolution No. 46.

In 2019, the agency discussed the matter again for a possible update of the adopted standards. Currently, Anvisa has an open TPS (Public Taking of Subsidies), to which anyone can send scientific evidence related to the subject.

An eventual decision on the release of the product, however, needs to be taken by the collegiate board of the body. Although illegal, these devices are easily found in the country.

In addition to advocating that the agency maintain the ban, the entities ask for stricter measures for inspection and punishment of those who violate the norm. They argue that the tobacco industry “underhandedly” presents the products as a “harm reduction” alternative for smokers.

Experts say that e-cigarettes do not represent the end of smoking, but a simple replacement for traditional cigarettes with similar harm.

“Scientific studies show that the use of DEFs, both acute and chronic, is directly linked to the emergence of various respiratory, gastrointestinal and oral diseases, among others, in addition to causing dependence and encouraging the use of conventional cigarettes”, write the entities.

According to Aristotle Alencar, representative of the SBC (Brazilian Society of Cardiology), one of the entities that organized the letter, electronic cigarettes are also associated with greater risks of cardiovascular problems. “The equipment generates particles that fall into the bloodstream, causing inflammation and cardiovascular events”, he explains.

concern for young people

In the positioning, the associations highlight the concern with the increase in the consumption of these products, especially among young people.

They cite the results of the Pense (National School Health Survey), which in 2019 looked at the rates of product experimentation in teenagers. In the Midwest, which recorded the highest percentages, the usage rate reached 24% among students from the private network.

Sabrina Presma, representative of Abead (Brazilian Association for the Study of Alcohol and Other Drugs), says that studies show that the inclusion of flavors in products increases the incidence of their use among younger people.

“E-cigarette smokers are two to four times more likely to become smokers of conventional cigarettes in the future. In addition, smoking e-cigarettes increases the chance of a young person or teenager becoming a marijuana user by five times”, he adds.

The document also mentions Evali (pulmonary disease associated with the use of electronic cigarette products) as an example of the harm caused by this consumption. In the United States, 68 people have died from the disease, with an average age of 24 years, the entities point out.

“The paper [das sociedades médicas] is to deliver the scientific evidence to Anvisa proving the harmful effects of electronic cigarettes and then wait for the agency’s next steps”, says Ricardo Meireles, representative of the AMB (Brazilian Medical Association).

THE Sheet contacted Anvisa for comment, but the agency did not respond until the report was published.

What companies say

Alessandra Bastos, consultant for BAT Brasil (British American Tobacco, formerly Souza Cruz), pharmacist and former director of Anvisa, says that there is “scientific evidence that supported several health authorities around the world”, such as Canada and the United Kingdom, so that the products are manufactured following a sanitary criterion.

Bastos argues, for example, that Evali is not necessarily caused by e-cigarettes, but by the fact that users tampered with the mixtures placed in the vaporizers, causing the complication.​

This practice, according to her, reinforces the need to regularize the equipment in Brazil in order to avoid situations like these.

The company Philip Morris claims that its product consists of heated tobacco and that “all documents submitted to the regulatory body demonstrate the difference between this device and electronic cigarettes illegally traded in Brazil”. Through its press office, the company also says that the absence of combustion and smoke reduces the amount of toxic compounds by up to 95% compared to the common cigarette.

JIT (Japan Tobacco Internacional) says that the ban in Brazil goes against what is happening in the world and contributes to the growth of smuggling and illegal trade. “It is worth remembering that today the use of these products is already common – and growing, supplied by products of 100% illegal origin, without any sanitary control. and the use of these products”, he says.