Brazil is widely recognised for achieving one of the most significant declines in smoking prevalence globally over the past three decades. Comprehensive tobacco control measures, including advertising restrictions, smoke-free laws, warning labels, taxation, and cessation support, have contributed to sustained reductions in cigarette consumption and tobacco-related disease.
At the same time, Brazil maintains one of the most restrictive regulatory environments in the world for non-combustible nicotine alternatives, including the prohibition of electronic nicotine delivery systems. Recent commentary has revisited the question of whether continued bans on lower-risk nicotine products are compatible with long-term harm-reduction objectives.
This discussion is not about weakening tobacco control. It is about assessing whether regulatory frameworks should evolve as product categories and scientific evidence develop.
Brazil’s tobacco control record
Brazil’s decline in smoking prevalence is well documented. Since the late 1980s, adult smoking rates have fallen substantially, reflecting strong implementation of WHO Framework Convention on Tobacco Control measures. Public health authorities have prioritised prevention, denormalisation of smoking, taxation, and cessation programmes.
These achievements demonstrate that traditional tobacco control strategies can drive large reductions in combustible cigarette use when consistently applied.
However, declining smoking rates do not eliminate the residual burden. Millions of Brazilian adults continue to smoke, and smoking remains a leading cause of preventable morbidity and mortality. The policy question is therefore whether maintaining prohibitions on lower-risk nicotine products accelerates or slows further reductions.
The prohibition of alternative nicotine products
Brazil currently bans the sale, importation, and marketing of electronic cigarettes and similar vaping devices. Other non-combustible nicotine products are also tightly restricted.
Regulators have justified these policies on the grounds of youth protection, uncertainty regarding long-term safety, and concerns about industry tactics. These considerations reflect legitimate public health caution.
However, prohibition does not eliminate demand. Informal and illicit markets for vaping products have developed despite regulatory bans. This creates enforcement challenges, limits product oversight, and reduces the ability of authorities to apply product standards, age verification, and quality controls.
The regulatory dilemma is therefore not binary. The choice is not between unrestricted access and prohibition, but between regulated frameworks and unregulated supply channels.
Modern Oral Nicotine Products and the Emerging Evidence Base
Brazil now stands at a regulatory crossroads regarding modern oral nicotine products (ONPs), including nicotine pouches, lozenges, dissolvable tablets, and other non-combustible formats that deliver nicotine without tobacco leaf or smoke.
Emerging international evidence indicates that such products, when subject to appropriate product standards and marketing controls, expose users to substantially fewer toxicants than combustible cigarettes. Because they eliminate combustion entirely, the primary source of tobacco-related disease is removed. While not risk-free and inappropriate for youth and non-users, these products occupy a different position on the risk continuum than cigarettes.
Several countries provide relevant case studies. Sweden and Norway have experienced sustained declines in smoking prevalence in parallel with long-standing use of non-combustible oral nicotine products. The United Kingdom has also reported accelerated reductions in smoking alongside regulated access to smoke-free alternatives. While causation is complex and multifactorial, the convergence of declining cigarette use and increased availability of lower-risk products suggests that substitution can contribute to population-level harm reduction when embedded within a comprehensive tobacco control strategy.
At the same time, regulators in these jurisdictions emphasise strict age restrictions, ingredient standards, nicotine caps, packaging controls, and advertising limitations to minimise youth uptake and unintended consequences. The lesson is not permissiveness, but calibrated regulation.
For Brazil, the policy question is whether a regulated pathway for ONPs could complement existing tobacco control measures without undermining youth protections.
Harm reduction and relative risk
A central principle in modern nicotine regulation is relative risk differentiation. Combustion is the primary driver of smoking-related cancer, cardiovascular disease, and respiratory illness. Non-combustible nicotine products eliminate smoke and significantly reduce exposure to many toxicants, although they are not risk-free.
International regulatory agencies, including the U.S. Food and Drug Administration, have acknowledged that certain non-combustible nicotine products may offer public health benefit when adult smokers switch completely from cigarettes. These determinations are based on toxicological, behavioural, and population-level assessments.
Brazil’s current regulatory position does not meaningfully differentiate between combustible and non-combustible products in terms of market access. The absence of a regulated framework for ONPs and other smoke-free alternatives means that potential substitution effects remain limited to informal channels rather than being integrated into public health strategy.
Youth protection and adult switching
Youth uptake is a central and legitimate concern in nicotine policy debates. International experience demonstrates that youth protection and adult harm reduction are not mutually exclusive objectives. Age-verification systems, marketing restrictions, flavour oversight, nicotine strength controls, and enforcement mechanisms are core components of regulatory design in countries that permit lower-risk products.
The relevant policy question for Brazil is whether a controlled, science-based regulatory framework for ONPs could coexist with strong youth safeguards, rather than relying exclusively on prohibition.
Illicit markets and regulatory oversight
Evidence from multiple jurisdictions indicates that sustained bans on nicotine alternatives may create incentives for informal supply chains. Products circulating outside regulatory oversight are not subject to ingredient disclosure, toxicological assessment, or quality assurance standards.
Regulation enables monitoring. Authorities can require product notification, enforce labelling requirements, impose packaging restrictions, and apply post-market surveillance. Prohibition limits the scope of these tools.
This does not imply that regulatory liberalisation is inherently beneficial. It underscores that effective governance must weigh enforceability, behavioural substitution, and unintended consequences.
A forward-looking regulatory discussion
Brazil’s tobacco control success should be recognised and preserved. The question facing policymakers is how to address the remaining population of adults who continue to smoke, particularly in a global environment where non-combustible nicotine formats are expanding.
An evidence-based regulatory review would consider comparative toxicology across product categories, real-world switching data from countries with regulated ONPs, youth prevalence trends under different regulatory models, and the scale of informal markets under prohibition.
Precaution does not necessarily require static policy. It may require adaptive policy that evolves alongside evidence and international experience.
Conclusion
Brazil’s achievements in reducing smoking are significant. Yet the persistence of combustible tobacco use presents ongoing public health challenges.
Modern oral nicotine products introduce new regulatory questions, but they also present potential tools within a harm-reduction framework. When properly regulated, with strict youth protections and robust product standards, ONPs may contribute to further reductions in cigarette smoking without displacing prevention efforts.
The long-term objective remains unchanged: continued decline in smoking-related disease. The regulatory tools used to achieve that objective may warrant periodic reassessment to ensure they reflect evolving scientific evidence, market realities, and public health priorities.
