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

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.

Automated summary

This study analyzed three policy discussions on the commercialization and marketing of e-cigarettes and HTPs in order to identify proponents and opponents, examine the arguments used by both sides, and compare how these arguments have changed over time. The findings indicate that tobacco companies mainly argue for the harm reduction potential of e-cigarettes and HTPs compared to conventional tobacco. Unions supporting the commercialization also argue that lifting the ban would prevent smuggling and ensure product quality. On the other hand, universities, medical organizations, and anti-tobacco institutions argue that these devices may pose health risks, including the risk of inducing cigarette smoking. In addition, the study found that the focus of the arguments shifted from "health" in 2009 to economic and moral/ethical themes in 2018 and 2019.