Across Brazil, smoking rates have fallen dramatically over the past three decades. Lives have been saved. Entire generations have grown up breathing cleaner air. For years, Brazil has been recognized by the World Health Organization (WHO) and the Pan American Health Organization as a. It is one of only four countries in the world that has fully implemented all the measures recommended by the WHO to reduce tobacco consumption—from smoke-free spaces and smoking cessation support to graphic warnings, advertising bans and tax increases—and the only one in the Americas to have achieved this achievement. The results are undeniable. Today, that legacy faces a new challenge.
E-cigarettes, banned nationwide since 2009 to protect public health, are quietly reappearing in everyday life. Marketed as modern, attractive and “less harmful”, these products are achieved with great effort. Globally, there is growing concern about the way these products are targeted at children and young people, and data shows that more people use e-cigarettes than adults.
In , it is estimated that 263,000 people have already tried electronic cigarettes, and nearly 76,000 are current users, placing the city among the most affected by vaping in the country. Nicotine addiction is being reformulated: with flavors, digitalized and normalized in spaces where smoking had practically disappeared. Nicotine is the same; only the formats have changed.
Nicotine addiction is being reframed
Tobacco control is under attack again. When vaping becomes visible in restaurants, bars, and other public spaces, social norms begin to change. What was previously unacceptable begins to seem familiar. This change constitutes the essence of renormalization and represents one of the main challenges in the current panorama of tobacco and nicotine consumption.
Brazil’s health authorities understand this risk. Expanding smoke-free nicotine use may introduce new health harms, increase the likelihood that youth will begin vaping and then migrate to traditional cigarettes or become dual users, and compromise decades of progress.
However, national regulations are only as strong as their enforcement capacity. Since 2019, faced with the growing challenge of e-cigarette use, the city has adopted a bold set of coordinated, evidence-based measures to transform policies into concrete actions, using its local authority. In collaboration with the Partnership for Healthy Cities – a global network of more than 70 cities working to prevent non-communicable diseases and injuries – the municipality is strengthening and sustaining efforts to protect the health of the population.
The city mobilized health surveillance teams, law enforcement authorities, municipal health leaders and intelligence units to combat illegal sales, advertising and distribution. Hundreds of coordinated inspections targeted illicit supply chains that thrived on weak oversight.
At the same time, the city recognized a simple truth: Enforcement without communication is less effective. In public health, changing social norms is as important as enforcing the rules. The city launched a modern awareness campaign that reached hundreds of thousands of people, combating misinformation and clearly communicating the risks of vaping. The campaign sparked debate in communities, and many residents began actively discouraging e-cigarette use among family and friends.
In 2025, Rio further strengthened its response. Following a resolution by ANVISA in 2024 that reaffirmed that the marketing of electronic cigarettes is prohibited throughout the country and that their use is prohibited in all spaces where smoking is prohibited, regardless of the way in which they were obtained, two important municipal policies were implemented to reinforce this measure at the local level. One established a permanent awareness and prevention campaign throughout the city. The other explicitly banned the use of all tobacco and nicotine products, including vapes, in indoor public and private spaces. Clear signage, active monitoring and sanctions for non-compliance transformed the policy into a concrete reality.
Tobacco control must evolve in the face of new products and increasingly covert industry tactics
The city also modernized enforcement by digitizing inspection systems, making supervision faster, smarter, and data-driven: a quiet but high-impact innovation. The Rio experience offers two important lessons for global tobacco control. First, it demonstrates that tobacco control must evolve in the face of new products and increasingly covert industry tactics. Maintaining progress is not automatic: it requires constant vigilance, sustained commitment and proactive action.
Secondly, it highlights the power of joint action between national and local authorities. Brazil banned electronic cigarettes to protect public health. Rio de Janeiro is ensuring that this protection is real. This dynamic is especially important in large, decentralized federal countries, where effective implementation depends largely on subnational action. It is a commitment to the health of future generations.
