Brazil was one of the first countries in the world to ban Electronic Smoking Devices (ESDs). This ban was motivated by the lack of evidence regarding the alleged therapeutic properties and harmlessness of these products. Anvisa was criticized for this move, especially by electronic cigarette's users groups. These groups argue that prohibition prevented people's access to a product that would aid smoking cessation and be less toxic than ordinary cigarettes. Thus, the question arises as to whether this decision was successful. Available data show that ESDs have diverse formulations and some toxic substances are released at significant levels during use. Studies in animals and humans have shown a potential toxic effect, also affecting the health of passive smokers. Studies are still inconclusive regarding its use as a cessation tool. A high level of use among adolescents was observed in countries whose use was authorized. Thus, Brazil's ban prevented the population from consuming a product that has not been proven effective toward smoking cessation, with indications of significant toxicity and highly attractive to young people.

O tabagismo é reconhecido como uma doença crônica causada pela dependência à nicotina, presente nos produtos à base de tabaco, e está ligado a uma série de doenças tabaco-relacionadas. Somando-se a isso, é considerada uma doença pediátrica. No Brasil, o tratamento para a cessação do tabagismo desde 2004 é oferecido em todos os níveis de complexidade pelo Sistema Único de Saúde (SUS), contudo, os protocolos internacionalmente utilizados parecem ter limitações significativas quando utilizados em populações tabagistas de crianças e adolescentes. Os sais de nicotina apresentam um menor grau de irritação e impacto na boca e na garganta causado pela nicotina, possibilitando o uso de concentrações maiores de nicotina. A nicotina sintética tem se mostrado a cada dia mais viável economicamente falando e já existem no mercado produtos que se utilizam dessa forma de nicotina, entretanto, poucos estudos foram conduzidos no sentido de avaliar seus impactos à saúde. As novas formas de nicotina e sua forma sintética, associadas com produtos com design atraente, especialmente para os mais jovens, trazem desafios técnicos consideráveis para os profissionais da saúde, pois desconhece-se, no momento, protocolos eficazes para tratar a dependência à nicotina originada dessas novas formas de consumo.

Anthropogenic activities have being contributing to the spread of toxic chemicals into the environment, including several toxic metals and metalloids, increasing the levels of human exposure to many of them. Contaminated food is an important route of human exposure and may represent a serious threat to human health. This mini review covers the health effects caused by toxic metals, especially Cd, Hg, Pb and As, the most relevant toxic elements from a human health point of view.

Tobacco-related diseases kill eight million people worldwide ever year and are responsible for thousands of cases of cancer, cardiovascular disease and other illnesses in Brazil. Cigarette filters are believed by many to reduce the health risks of smoking. This article outlines the history of the technology of filters and discusses the impacts of these cigarette design features and their regulation. We conducted a literature review to assess the impacts of this technology. The results show that filters were initially developed for aesthetic purposes and later improved and marketed as a harm reduction technology. The most widely-used filters are those made of cellulose acetate with or without activated carbon. Despite smokers' beliefs and advertising claims, filters have no health benefits and filter tip ventilation can increase the health risks of smoking. Filters can also make cigarettes more appealing and cause significant environmental impacts. Cigarette filters have no health benefits and lull smokers into a false sense of security and should therefore be banned.

Uma série de fatores sociais, ambientais, psicológicos e genéticos estão associados à dependência da nicotina e às doenças tabaco-relacionadas. A relação entre raça e tabagismo talvez seja um dos tópicos mais inexplorados e menos discutidos no âmbito do controle do tabaco no Brasil. Este trabalho realizou uma análise qualitativa retrospectiva, a fim de verificar os dados disponíveis na literatura sobre a relação entre raça/etnicidade e tabagismo no Brasil. Os resultados encontrados demonstraram que as pessoas de origem africana têm maior risco de se tornarem tabagistas e de desenvolverem doenças tabaco-relacionadas. Apesar desse risco, foi verificado que poucos estudos, a respeito dessa relação, foram publicados no Brasil e se, por um lado, os determinantes sociais podem influenciar tal associação, por outro, estudos apontam também uma possível influência de fatores genéticos no tabagismo. Mais estudos seriam necessários para entender a relação raça e tabagismo e para se pensar políticas mais efetivas contra o tabagismo. Os resultados também apontam que possivelmente, em virtude do racismo estrutural, a população com ancestralidade africana no Brasil se tornou “invisível” para pesquisadores e formuladores de políticas de controle do tabaco.

Background

The tobacco industry (TI) uses several strategies to attract new consumers, including using additives in tobacco products, which makes tobacco especially attractive to youth. Based on scientific evidence and the principles of the WHO Framework Convention on Tobacco Control, the Brazilian Health Regulatory Agency (ANVISA, for the name in Portuguese), published the Collegiate Board Resolution (RDC, for the name in Portuguese) 14/2012 in 2012, prohibiting the addition of substances that enhance the flavour and taste of tobacco products in order to make them more attractive. In response, the TI used various strategies to prevent RDC 14/2012 from entering into force. At the time, the Brazilian additive ban was the most comprehensive in the world as it included a ban on menthol.

Objectives

This paper analyses the arguments and strategies used by the TI to prevent the implementation of the additives ban.

Methods

Review of published articles, reports, legislation and legislative activity, internal TI documents, media stories and other documents to describe TI's reaction to the ban.

Results

The results show that the TI used some well-known strategies to delay or cancel the entering into force of the resolution. For example, the TI attempted political interference, used litigation and commissioned studies with findings that questioned the resolution's rationale. The TI strategies used in Brazil are similar to those used at the global level to oppose other tobacco control measures.

Conclusions

TI successfully delayed the most comprehensive additive ban in the world using its usual tactics, despite the fact that none of the arguments presented by the TI had an acceptable scientific basis or evidence.