Increase of electronic cigarette use and awareness in Brazil: findings from a country that has strict regulatory requirements for electronic cigarette sales, import, and advertising
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Brazilian National Cancer Institute, Epidemiology, Brazil
Fundaçao do Cancer, Brazil
Executive Secretariat of National Commission for Implementing WHO Framework Convention on Tobacco Control/ Brazilian National Cancer Institute, Brazil
Brazilian National Cancer Institute, Brazil
University of Waterloo, Canada
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A273
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Because of the uncertainty about the health impact of Electronic Cigarettes (EC), Brazil established strict regulatory requirements in 2009 that prohibit the sale, import, and advertising of them until a manufacturer can demonstrate that the devices are safe and/or effective as cessation aid. This paper examined self-reported: (1) EC awareness and ever-use; (2) correlates of awareness and ever-use.

Data were analyzed from the 2012/2013 (n=1,830) and 2016/2017 (n=1,828) waves of the International Tobacco Control Survey in Brazil.We calculated the differences over time in the proportion of individuals who have ever heard about ECs, and have ever tried an EC, stratified by smoking status. All estimates were adjusted for sampling weights and time in sample, taking also into consideration intraindividual correlation of data from participants observed at both waves. Moreover, a log-Binomial regression model was used to estimate the association between sociodemographic covariates and EC awareness (and ever-use).

The proportion of EC awareness increased over time for both smokers (37.5% to 71.9%) and non-smokers (28.8% to 61.6%).The proportion of EC ever-use also increased over time for both smokers (7.8% to 18.3%) and non-smokers (1.1% to 2.2%). However, among EC users interviewed in 2016/2017 (n=218), the proportion of recent/regular EC use was very low (daily use, 2.5%; weekly use, 0.6%, monthly use, 2.6%; less than monthly, 20.7%; not all, 73.6%). Irrespective of the smoking status, EC awareness and ever-use were associated with younger ages, having higher income, and being better-educated.

Despite strict EC regulatory requirements in Brazil (i.e.,EC are de facto banned), this was not sufficient to prevent EC awareness and consumption among Brazilians. Our findings may help in the discussion about what can happen to Brazil´s strong reduction in the prevalence of ordinary cigarette smokers achieved in the last few years if the current EC regulatory regime is changed to allow smokers/non-smokers to have legal access to non-combusted sources of nicotine.

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