Cigarettes are legal in Brazil. They are taxed, inspected and protected by federal law. Even so, up to half of long-term smokers die because of them: around 174,000 deaths a year in the country, nearly 480 a day.
Combustion is what kills. Cigarette smoke carries thousands of chemicals, dozens of them carcinogenic. Nicotine is what smokers are looking for. It is addictive and not harmless, but it is not what causes cancer.
For decades, talking about nicotine meant talking about cigarettes. Today there are patches, gum, lozenges, pouches and vapes, and Brazil’s official debate is still about “smoking”. We want to talk about nicotine.
Science has already done the math. Cochrane, the leading independent reference for evidence reviews, concluded with high certainty that nicotine vapes help more people quit smoking than the patches and gum on offer today. The United Kingdom bet on that evidence. Sweden uses nicotine at the European average, but in forms that don’t burn, and has the lowest smoking rate and far less tobacco-related disease than its neighbours.
We banned everything except using it.
Brazil went the opposite way. Making, importing, selling, and even bringing an e-cigarette in your luggage are all banned. Using one is not: you cannot ban nicotine use in a country where cigarettes are legal.
The result is a ban that, in practice, works as a free-for-all. There is no nicotine limit and no rule on flavours, packaging or format. There is no enforceable minimum age, no health oversight, no tax and no formal jobs. What there is, is a supply chain fed by organised crime at the borders and ports, and by clandestine production inside the country. Every e-cigarette in use in Brazil has, at some point, passed through illegality.
The United States did the opposite: it regulated. It required pre-market authorisation, a minimum age of 21 and retail enforcement. Use among students fell to its lowest level in over a decade. Here, the ban did not take the product off the streets. It only took the State out of the conversation. And smoking went up again for the first time since 2007.
Confusing smoking with nicotine costs lives.
Institutions have started treating smoking and using nicotine as the same thing. In 2023, Anvisa, Brazil’s health regulator, concluded there is no evidence these products help people quit, and dismissed Cochrane. In the same process, it cited EVALI as a risk of e-cigarettes without saying what the CDC concluded: the disease came from adulterated THC products.
A public policy designed with that blind spot protects no one. It pushes millions of people back towards the deadliest product.
We don’t want to create a culture of consumption, least of all among young people: nicotine is not for minors. Brazil is already one of the world’s largest tobacco producers. We just don’t want to die from combustion.
No one should get sick just because they use nicotine.