Brazil losing the fight against smoking as safer alternatives are kept out of reach

BRASILIA – Brazil is losing the battle against smoking due its negative stance on safer nicotine alternatives, according to a major new report released today.

Leading international health experts have compared Brazil’s experience and New Zealand.

to reveal how different policy choices are producing sharply different outcomes. Just over a decade ago, New Zealand had a higher smoking rate than Brazil. Today, its rate is around half Brazil’s.

The report, Tale of Two Nations: Brazil v New Zealand, shows that New Zealand has cut adult smoking to 6.8% by integrating regulated, smoke-free alternatives into its tobacco control strategy. Brazil’s smoking rate now stands at 11.6% and, according to official figures, has begun rising again for the first time since 2007.

“New Zealand started from a worse position than Brazil and has moved far ahead,” said Dr Delon Human, report author and former Secretary-General of the World Medical Association. “That progress followed deliberate choices to regulate safer alternatives and give smokers clear, credible pathways away from cigarettes.”

Brazil remains home to more than 21 million smokers, with tobacco use still among the country’s leading causes of preventable death. While traditional measures such as taxation and public smoking bans helped drive earlier declines, progress has slowed. The report links this to Brazil’s long-standing ban on vapes and heated tobacco products, in place since 2009.

Despite the ban, demand has continued. An estimated 10–12 million Brazilians have tried vaping, with around 3.5 million regular users relying on illicit, unregulated products. At the same time, Brazil faces one of the world’s largest illegal cigarette markets.

New Zealand followed a different course. Vaping products are legal, regulated and supported by clear public health guidance aimed at adult smokers. Since 2015, smoking rates have almost halved, while most adult vapers are former smokers or people trying to quit. They are nearing official smoke-free status, defined as a daily smoking prevalence below 5%.

“Prohibition hasn’t protected Brazilians from harm,” Dr Human said. “It has pushed people toward unsafe products and kept them smoking for longer.”

The report also highlights nicotine pouches and other low-risk oral products, which remain unregulated in Brazil, creating further space for illicit supply.

“Real-world evidence shows that countries that combine strong tobacco control with harm reduction are seeing faster declines in smoking,” said Dr Human. “Where safer alternatives are regulated and communicated clearly, smokers are more likely to move away from combustible cigarettes.”

The report calls on Brazil to introduce proportionate regulation for safer nicotine products, strengthen consumer protections and invest in evidence-based public education to accelerate the decline in smoking.