BACKGROUND AND IMPLEMENTATION CHALLENGES: Brazil achieved a 64% reduction in smoking prevalence among adults ≥18 years (from 34.8% in 1989 to 12.6% in 2019) [1] through multisectoral tobacco control approaches aligned with the WHO FCTC. Since 2009, the National Health Surveillance Agency (ANVISA) has prohibited the commercialization, importation, and advertising of ENDS/HTPs, contributing to lower prevalence rates than in countries where these products are commercialized. Challenges include tobacco industry lobbying, industry-driven legislative proposals to legalize ENDS/HTPs justified by revenue generation, tax evasion, and illicit trade, as well as attempts to relax additive restrictions. Additional challenges include promoting these products on social media, online sales, and the dissemination of corporate social responsibility narratives. The governmental National Commission for Implementation of the WHO FCTC (CONICQ), established by federal decree, plays a central role in articulating responses to these challenges through the mandate of its diverse Members.
[1] PNS
INTERVENTION OR RESPONSE: CONICQ members' articulated response has been essential in raising awareness of the dangers of ENDS/HTPs, ensuring regular monitoring of consumption, implementing the Protocol on Trade, updating regulations, and coordinating operations for the seizure and disposal of ENDS/HTPs among others. AI-powered chatbots were created to remove websites selling ENDS/HTPs as well. Technical analyses, public hearings, and EVALI case notifications complement these efforts. Research supported by governmental funding and a targeted cooperation agreement between INCA and Fiocruz complements the response.
RESULTS AND IMPACT: These actions have supported the continuity of ANVISA’s prohibition of ENDS/HTPs. From 2019 to 2023, the prevalence of ENDS/HTPs declined slightly (from 2.3% to 2.1%), with higher rates of use observed among young adults (18–24 years) [2].
[2] Vigitel
CONCLUSIONS: Maintaining ANVISA’s regulation and implementing robust intersectoral strategies to monitor consumption and combat illicit trade is essential to consolidating tobacco control progress, preventing setbacks, protecting public health, and providing a critical approach to counteract tobacco industry strategies.