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Arguments used by proponents and opponents in Brazil’s regulatory discussions of e-cigarettes and heated tobacco products
  1. Mônica Nunes-Rubinstein1,
  2. Teresa Leão1,2,3
  1. 1 EPI-Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
  2. 2 Department of Public Health and Forensic Sciences, and Medical Education University of Porto, Porto, Portugal
  3. 3 Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
  1. Correspondence to Mônica Nunes-Rubinstein, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-091, University of Porto, Porto, Portugal; monicanunesrubinstein{at}gmail.com

Abstract

Objectives To identify proponents and opponents of the commercialisation and marketing of e-cigarettes and heated tobacco products (HTPs), identify the arguments used on both sides and compare how the arguments have changed over time, we analysed three policy discussions occurring in 2009, 2018 and 2019.

Methods We conducted a content analysis of one document and six videos from these discussions, provided on the Brazilian Health Regulatory Agency website, or upon request.

Results The arguments most used by tobacco companies were related to claims that the use of e-cigarettes and HTPs is less harmful than conventional tobacco. Unions that support its commercialisation also argued that lifting the ban would prevent smuggling and guarantee their quality. On the other side, universities, medical and anti-tobacco institutions argued that such devices may have health risks, including the risk of inducing cigarette smoking. In 2009, most arguments belonged to the ‘health’ theme, while in 2018 and 2019 economic arguments and those related to morals and ethics were frequently used.

Conclusions Those that supported the commercialisation and marketing of e-cigarettes and HTPs first focused on arguments of harm reduction, while 10 years later the right to access and potential economic consequences also became common. Public health agents and academics must gather evidence to effectively respond to these arguments and discuss these policies, and must prepare themselves to use and respond to arguments related to moral and economic themes.

  • harm reduction
  • electronic nicotine delivery devices
  • public policy
  • tobacco industry

Data availability statement

We conducted a content analysis of the arguments used by stakeholders involved in three different events of public discussion about the regulation of e-cigarettes and heated tobacco products in Brazil. (1) Public consultation n. 41/2009—the report of the event (analysed document) was requested to the Brazilian government through a simple system of access to information and sent to the corresponding author by email. (2) Panel of 2018—the videos of the event (analysed documents) can be found on these websites: https://youtu.be/PjA3A-BgvC8; https://youtu.be/_UrM6YoF0b4; https://youtu.be/DRRS57m4Sgc. (3) Public hearings of 2019—the videos of the event (analysed documents) can be found on these websites: https://www.youtube.com/watch?v=JLjgDraDDxM; https://www.youtube.com/watch?v=UAuEV3atvdc; https://www.youtube.com/watch?v=MIy9JK3dmm0; https://www.youtube.com/watch?v=tiqA90lZIoc.

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Data availability statement

We conducted a content analysis of the arguments used by stakeholders involved in three different events of public discussion about the regulation of e-cigarettes and heated tobacco products in Brazil. (1) Public consultation n. 41/2009—the report of the event (analysed document) was requested to the Brazilian government through a simple system of access to information and sent to the corresponding author by email. (2) Panel of 2018—the videos of the event (analysed documents) can be found on these websites: https://youtu.be/PjA3A-BgvC8; https://youtu.be/_UrM6YoF0b4; https://youtu.be/DRRS57m4Sgc. (3) Public hearings of 2019—the videos of the event (analysed documents) can be found on these websites: https://www.youtube.com/watch?v=JLjgDraDDxM; https://www.youtube.com/watch?v=UAuEV3atvdc; https://www.youtube.com/watch?v=MIy9JK3dmm0; https://www.youtube.com/watch?v=tiqA90lZIoc.

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Footnotes

  • Contributors Both authors contributed to study design, interpretation of results, writing and revision. TIdCL conceptualised the study. MNR performed data analysis and wrote the first draft of the manuscript. Both authors approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.