Arguments used by proponents and opponents in Brazil’s regulatory discussions of e-cigarettes and heated tobacco products

Abstract

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

An analysis of key stakeholder policy perspectives in the proposed e‐cigarette regulations in New Zealand

“…Our study reveals that industry actors in NZ regularly justify their positions under the semblance of public health interest. This is consistent with other international regulatory debates 28 . In its submission, e‐cigarette brand JUUL expressed concern that restricted advertising may hinder smoking cessation efforts as people who smoke may not be able to identify suitable alternative products.…”

“…This is consistent with other international regulatory debates. 28 In its submission, e-cigarette brand JUUL expressed concern that restricted advertising may hinder smoking cessation efforts as people who smoke may not be able to identify suitable alternative products. Yet, JUUL, owned in part, by Altria, manufacturer of the established cigarette brand, Marlboro has aggressively marketed their e-cigarettes to young people.…”

Moving targets: how the rapidly changing tobacco and nicotine landscape creates advertising and promotion policy challenges

“…62 PMI and ENDS advocacy groups used reduced risk messaging on websites and social media to pressure the government to lift the ENDS ban in Thailand. 25 Similarly, in South Africa, tobacco harm reduction claims were used by ENDS manufactures, to challenge efforts to regulate ENDS, 56 63 and in Brazil the National Regulatory Agency has been pressured by ENDS advocates and PMI to lift the ban on ENDS and HTPs using harm reduction arguments in public comment 64 and on social media. 65 66 pAIrIng TobACCo produCTS wITH oTHEr ConSumEr goodS New ENDS/ENNDS features will continue to emerge with unclear regulatory authority.…”

“…The embrace of tobacco harm reduction may allow tobacco and ENDS companies to reposition themselves as partners in public health, which contradicts the Framework Convention on Tobacco Control Article 5.3 and allows the industry to undermine tobacco control 107. The tobacco industry continues to use harm reduction arguments to argue against bans on ENDS and recently developed products, taxation of new products, and to push for medical authorisation of nicotine products which might later lead to subsidy of the nicotine products for smoking cessation 64 125. Finally, as the industry continues to reinvent itself to stay in business, regulatory authorities mostly play ‘catch up’.…”