Mais de 550 Referências Científicas Sobre Redução dos Danos do Tabagismo

Este artigo reúne mais de 550 estudos científicos, relatórios técnicos e documentos institucionais relacionados à Redução dos Danos do Tabagismo (RDT). Esse conjunto de evidências foi compilado a partir de pesquisas conduzidas por universidades, centros acadêmicos, agências reguladoras, fabricantes, órgãos de saúde pública e instituições científicas de diversos países.

É fundamental deixar claro desde o início: apesar de extensa, essa lista representa apenas uma pequena parcela do volume total de evidências científicas já existente sobre o tema. Hoje, há milhares de estudos publicados analisando produtos de nicotina sem combustão — como cigarros eletrônicos, produtos de tabaco aquecido, sachês de nicotina oral e terapias de reposição de nicotina — sob perspectivas que incluem toxicologia, epidemiologia, biomarcadores de risco, cessação do tabagismo, comportamento do consumidor, saúde pública e políticas regulatórias.

Ainda assim, persiste no debate público a narrativa de que “não há estudos suficientes” para afirmar que esses produtos apresentam menor risco em comparação ao cigarro tradicional. Essa afirmação não resiste a uma análise honesta da literatura científica disponível.

A falsa ideia de “evidência insuficiente”

Um dos pilares do discurso contrário à Redução dos Danos do Tabagismo é a alegação de que as evidências seriam escassas, inconclusivas ou prematuras. No entanto, os estudos reunidos neste documento — provenientes de fontes como The Lancet, National Academies of Sciences, Royal College of Physicians, Public Health England, FDA, CDC, NICE e outras instituições de referência — apontam de forma consistente para um mesmo ponto central:

O principal responsável pelos danos do tabagismo é a combustão do tabaco, e não a nicotina em si.

Ao eliminar a queima, produtos sem fumaça reduzem drasticamente a exposição a milhares de substâncias tóxicas e carcinogênicas presentes na fumaça do cigarro. Essa redução não é teórica: ela é observada de maneira objetiva em estudos que analisam emissões químicas, biomarcadores de exposição e indicadores fisiológicos de risco.

Em fumantes que migram total ou majoritariamente para produtos sem combustão, os níveis de diversos marcadores associados a câncer, doenças cardiovasculares e respiratórias caem de forma significativa, muitas vezes se aproximando dos níveis observados em pessoas que não fumam.

Produtos de menor risco como política de saúde pública

Os estudos aqui listados também demonstram que a Redução dos Danos do Tabagismo não deve ser vista apenas como uma escolha individual, mas como uma estratégia eficaz de saúde pública.

Experiências internacionais mostram que políticas baseadas em acesso, informação correta e diferenciação de risco entre produtos:

Aceleram a redução da prevalência do tabagismo, como observado em países como Suécia, Reino Unido, Japão e Nova Zelândia;
Ajudam fumantes que não conseguem ou não desejam parar abruptamente a abandonar o cigarro, substituindo-o por alternativas de menor risco;
Reduzem de forma substancial os danos associados ao consumo de nicotina por meio da combustão, com impactos positivos mensuráveis em saúde populacional.

Ignorar ou suprimir essas evidências não elimina o consumo de nicotina, apenas mantém milhões de pessoas presas ao produto mais letal disponível no mercado: o cigarro convencional.

Como este artigo está organizado

Abaixo você encontrará mais de 550 estudos organizados de forma categorizada por macrotema. O objetivo é permitir que qualquer pessoa — jornalista, pesquisador, profissional de saúde, legislador ou cidadão interessado — possa consultar diretamente as fontes científicas e formar sua própria opinião com base em evidências.

Essa lista inclui tanto estudos independentes, conduzidos por universidades, centros acadêmicos, órgãos públicos e organizações sem qualquer vínculo com a indústria fabricante de cigarros, quanto estudos produzidos ou financiados por fabricantes de produtos de nicotina. Essa inclusão não é acidental nem ingênua, mas reflete uma compreensão básica do funcionamento da ciência contemporânea.

Nos últimos anos, fabricantes cigarros passaram a também comercializar produtos de nicotina sem combustão, investindo volumes significativos de recursos em pesquisa científica, incluindo estudos toxicológicos, clínicos, epidemiológicos e de biomarcadores. Esses estudos são, em grande parte, publicados em revistas científicas revisadas por pares, com dados divulgados publicamente, permitindo escrutínio independente, replicação e contestação por outros pesquisadores.

É inegável que um trabalho financiado por quem fabrica os produtos alvo de uma pesquisa científica caracteriza um claro conflito de interesse, que deve sempre ser declarado e considerado de forma crítica. No entanto, isso não pode invalidar automaticamente um estudo, seus métodos ou resultados. A validade científica de uma pesquisa é determinada pela qualidade metodológica, transparência dos dados, reprodutibilidade e consistência das conclusões, e não exclusivamente pela origem do financiamento.

Opositores da Redução dos Danos do Tabagismo adotam uma postura alarmista, focada quase exclusivamente em atacar a indústria fabricante e a origem do financiamento dessas pesquisas, sem confrontar os dados apresentados, sem refutar metodologias ou sequer demonstrar evidências científicas contrárias de igual robustez. Esse tipo de abordagem desloca o debate do campo científico para o campo ideológico, o que empobrece a análise e não contribui para a proteção da saúde pública.

Ainda mais importante, essa tática entra em conflito com o próprio marco regulatório internacional estabelecido pela Organização Mundial da Saúde, que no relatória da CQCT – Convenção-Quadro para Controle do Tabaco, apresentado na 6ª Conferência das Partes, a OMS afirma que a regulamentação dos Sistemas Eletrônicos de Entrega de Nicotina (ENDS) é necessária para permitir a avaliação científica de seus efeitos. No mesmo documento, a CQCT reconhece que a responsabilidade primária por comprovar cientificamente as alegações sobre esses produtos recai sobre seus fabricantes.

A ciência não avança por exclusão seletiva de evidências com base em preferências morais ou políticas, mas pela avaliação crítica dos dados disponíveis, independentemente de quem os produziu. Cabe à comunidade científica — e não a discursos falaciosos — analisar resultados, identificar limitações, exigir transparência e verificar se as conclusões se sustentam diante do conjunto mais amplo de evidências.

Até o momento, uma parcela significativa das pesquisas financiadas pela indústria tem apresentado resultados consistentes com estudos independentes de alta qualidade, especialmente no que se refere à redução substancial da exposição a substâncias tóxicas quando a combustão é eliminada. Ignorar esses dados não os torna falsos; apenas impede que sejam corretamente avaliados.

O problema do tabagismo e a evolução das respostas em saúde pública

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Steinberg, M.B., et al., Nicotine risk misperception among US physicians. J Gen Intern Med, 2021. 36(12): p. 3888-3890. DOI: 10.1007/s11606-020-06172-8

Wackowski, O.A., et al., Smokers’ sources of e-cigarette awareness and risk information. Prev Med Rep, 2015. 2: p. 906-910. DOI: 10.1016/j.pmedr.2015.10.006

Perspectivas sobre ciência e redução de danos

Action on Smoking and Health (ASH), Use of e-cigarettes (vapes) among adults in Great Britain. 2024. https://ash.org.uk/uploads/Use-of-vapes-among-adults-in-Great-Britain-2024.pdf.

Human D., et al, Saving Lives Like Sweden. Smoke Free Sweden, 2023. https://smokefreesweden.org/wp-content/themes/smokefreesweden/assets/pdf/reports/Report_SAVING%20LIVES%20LIKE%20SWEDEN.pdf

Perspectivas diversas sobre redução de danos do tabagismo

Gottlieb, S. and Zeller, M., A nicotine-focused framework for public health. N Engl J Med, 2017. 377(12): p. 1111-1114. DOI: 10.1056/NEJMp1707409

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Public Health England, Evidence review of e-cigarettes and heated tobacco products 2018: executive summary. 2018. https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review/evidence-review-of-e-cigarettesand-heated-tobacco-products-2018-executive-summary (3 julho 2024)

Smokefree, What is vaping? Health New Zealand. https://www.smokefree.org.nz/help-advice/learn-about-vaping

Cummings, K.M., et al., The past is not the future in tobacco control. Prev Med, 2020. 140:106183. DOI: 10.1016/j.ypmed.2020.106183

Balogun, B. and Harker, R., The smokefree 2030 ambition for England. House of Commons Library, 2023. https://commonslibrary.parliament.uk/research-briefings/cbp-9655/

Healthdirect, Vaping. https://www.healthdirect.gov.au/vaping

Nicotina, produtos sem fumaça e padrões reais de uso

Nicotina: o que a ciência realmente mostra

Villanti, A.C., et al., Latent classes of nicotine beliefs correlate with perceived susceptibility and severity of nicotine and tobacco products in US young adults. Nicotine Tob Res, 2019. 21(Supplement_1): p. S91-S100. DOI: 10.1093/ntr/ntz156

World Health Organization and International Agency for Research on Cancer, IARC Monographs on the Identification of Carcinogenic Hazards to Humans. https://monographs.iarc.who.int/agents-classified-by-the-iarc/ (15 julho 2024)

Valentine, G. and Sofuoglu, M., Cognitive effects of nicotine: recent progress. Curr Neuropharmacol, 2018. 16(4): p .403-414. DOI: 10.2174/1570159X15666171103152136

Royal College of Physicians, Nicotine without smoke: Tobacco harm reduction. London: RCP, 2016. https://www.drugsandalcohol.ie/25448/1/Nicotine%20without%20smoke_0.pdf

Steinberg, M.B., et al., Nicotine risk misperception among US physicians. J Gen Intern Med, 2021. 36(12): p. 3888-3890. DOI: 10.1007/s11606-020-06172-8

Kim, M. M., et al., “Study title: A systematic review of RCTs to examine the risk of adverse cardiovascular events with nicotine use” Front Cardiovasc Med, 2023. 10:1111673. DOI: 10.3389/fcvm.2023.1111673

U.S. Food & Drug Administration, Nicotine is Why Tobacco Products are Addictive. https://www.fda.gov/tobacco-products/healtheffects-tobacco-use/nicotine-why-tobacco-products-are-addictive (1 agosto 2024)

Moldoveanu, S.C., et al., Nicotine analysis in several non-tobacco plant materials. Contrib Tob Nicotine Res, 2016. 27(2): p. 54-59. DOI: 10.1515/cttr-2016-0008

Public Health England, Health matters: stopping smoking – what works? Gov.UK, 2019. https://www.gov.uk/government/publications/health-matters-stopping-smoking-what-works/health-matters-stopping-smoking-what-works (15 julho 2024)

U.K. National Health Service (NHS), Vaping myths and the facts. https://www.nhs.uk/better-health/quit-smoking/vaping-to-quitsmoking/vaping-myths-and-the-facts/

Jenkins, R.A., et al., Mainstream and sidestream smoke. In The chemistry of environmental tobacco smoke: composition and measurement (2nd ed.), CRC Press, 2000. p 49-75. DOI: 10.1201/9781482278651

National Institute for Health and Care Excellence (NICE), Nicotine replacement therapy. 2024. https://cks.nice.org.uk/topics/smoking-cessation/prescribing-information/nicotine-replacement-therapy-nrt/ (15 julho 2024)

Rodgman, A. and Perfetti, T.A., The chemical components of tobacco and tobacco smoke. CRC press, 2013. DOI: 10.1201/b13973

U.S. National Cancer Institute, How much do you agree or disagree that the nicotine in cigarettes is the substance that causes most of the cancer caused by smoking? Health Information National Trends Survey. https://hints.cancer.gov/view-questions/question-detail.aspx?nq=1&qid=1514

Office of Health Improvement and Disparities, Smoking and tobacco: applying All Our Health. Gov. UK, 2022. https://www.gov.uk/government/publications/smoking-and-tobacco-applying-all-our-health/smoking-and-tobacco-applying-all-our-health

World Health Organization, No level of alcohol consumption is safe for our health. 2023. https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health

Risco relativo entre produtos sem fumaça e cigarros convencionais

Doll, R., et al., Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J, 2004. 328(7455):1519. DOI: 10.1136/bmj.38142.554479.AE

Nutt, D.J., et al., Estimating the harms of nicotine-containing products using the MCDA approach. Eur Addict Res, 2014. 20(5): p. 218-225. DOI: 10.1159/000360220

AP News, Insider Q&A: FDA official on vaping’s “promise or peril”. 2022. https://apnews.com/article/science-health-public-tobaccoindustry-regulation-6af0d635d7859bab914cc249ef43b6e2

McNeill, A., et al., E-cigarettes: an evidence update. Public Health England, 2015. https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update (8 agosto 2024)

Glasser, A.M., et al., Overview of electronic nicotine delivery systems: a systematic review. Am J Prev Med, 2017. 52(2): p. e33-e66. DOI: 10.1016/j.amepre.2016.10.036

Royal Australian College of General Practitioners (RACGP), Supporting smoking cessation: A guide for health professionals. 2014. https://extranet.who.int/ncdccs/Data/AUS_D1bib_Supporting%20smoking%20cessation.pdf

Chen, J., et al., A comparative health risk assessment of electronic cigarettes and conventional cigarettes. Int J Environ Res Public Health, 2017. 14(4): 382. DOI: 10.3390/ijerph14040382

Eaton, D.L., et al., Public Health Consequences of E-Cigarettes. National Academies Press, 2018. DOI: 10.17226/24952

Mallock, N., et al., Levels of selected analytes in the emissions of “heat not burn” tobacco products that are relevant to assess human health risks. Arch Toxicol, 2018. 92(6): p. 2145-2149. DOI: 10.1007/s00204-018-2215-y

Caponnetto, P., et al., Carbon monoxide levels after inhalation from new generation heated tobacco products. Respir Res, 2018. 19:164. DOI: 10.1186/s12931-018-0867-z

Académie Nationale de Médecine, L’ Académie nationale de médecine rappelle les avantages prouvés et les Inconvénients Indûment allégués de la cigarette électronique (vaporette). Communique de Presse, 2019. https://www.academie-medecine.fr/wp-content/uploads/2019/12/Cigarette-e%CC%81lectronique-10-12-19.pdf

U.S. Food & Drug Administration, FDA permits sale of IQOS Tobacco Heating System through premarket tobacco product application pathway. 2019. https://www.fda.gov/news-events/press-announcements/fda-permits-sale-iqos-tobacco-heating-system-throughpremarket-tobacco-product-application-pathway (18 julho 2024)

Public Health England, Vaping in England: 2020 evidence update summary. 2020. https://www.gov.uk/government/publications/vaping-in-england-evidence-update-march-2020/vaping-in-england-2020-evidence-update-summary (18 julho 2024)

Slob W., et al., A Method for Comparing the Impact on Carcinogenicity of Tobacco Products: A Case Study on Heated Tobacco Versus Cigarettes. Risk Anal, 2020. 40(7): p. 1355-1366. DOI: 10.1111/risa.13482

U.S. Food & Drug Administration, FDA Authorizes Marketing of IQOS Tobacco Heating System with ‘Reduced Exposure’ Information. 2020. https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-iqos-tobacco-heating-system-reducedexposure-information (18 julho 2024)

German Federal Institute for Risk Assessment (BFR), Frequently asked questions about e-cigarettes. 2020. https://www.bfr.bund.de/en/frequently_asked_questions_about_e_cigarettes-130598.html

Action on Smoking and Health (ASH), Electronic Cigarettes Fact Sheet. 2021. https://ash.org.uk/resources/view/electronic-cigarettes

Marques, P., et al., An updated overview of e-cigarette impact on human health. Respir Res, 2021. 22(1):151. DOI: 10.1186/s12931-021-01737-5

Benowitz, N.L., et al., Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame. J Clin Pharmacol, 2021. 61: p. S18-S36. DOI: 10.1002/jcph.1915

Snowdon, C., et al., Vaping Works. International Best Practises: United Kingdom, France, Canada and New Zealand. Property Rights Alliance, 2021. https://www.propertyrightsalliance.org/wp-content/uploads/PRA_VapingWorks.pdf

Hidayat, S. and Alayyannur, P.A., The content of harmful and potentially harmful constituents in heated tobacco product: Systematic review. J Drug Deliv Ther, 2021. 11(3-S): p. 111-120. DOI: 10.22270/jddt.v11i3-S.4830

Office for Health Improvement & Disparities, Nicotine vaping in England: 2022 evidence update summary. Gov. UK, 2022. https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidenceupdate-summary (18 julho 2024)

Bundesinstitut für Risikobewertung (BfR). Health Risk Assessment of Nicotine Pouches: Updated BfR Opinion No. 023/2022. 2022. DOI: 10.17590/20220204-105615

Hu, H., et al., Heated tobacco products and circulating high-density lipoprotein cholesterol concentrations. Sci Rep, 2022. 12(1):17385. DOI: 10.1038/s41598-022-22337-3

Hartmann-Boyce, J., et al. Biomarkers of potential harm in people switching from smoking tobacco to exclusive e-cigarette use, dual use or abstinence: secondary analysis of Cochrane systematic review of trials of e-cigarettes for smoking cessation. Addiction, 2023. 118(3): p. 539-545. DOI: 10.1111/add.16063

Institut National Du Cancer, Cigarettes électroniques : ce qu’il faut savoir. 2023. https://www.e-cancer.fr/Comprendre-prevenirdepister/Reduire-les-risques-de-cancer/Tabac/La-cigarette-electronique

U.S. Centers for Disease Control and Prevention (CDC), Health Effects of Vaping. 2024. https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html (24 julho 2024)

Auer, R., et al., Electronic Nicotine-Delivery Systems for Smoking Cessation. N Engl J Med, 2024. 390(7): p. 601-610. DOI: 10.1056/NEJMoa2308815

Beaglehole, R., and Bonita, R., Harnessing tobacco harm reduction. Lancet, 2024. 403(10426): p. 512-514. DOI: 10.1016/S0140-6736(24)00140-5

Canadian Cancer Society, Tobacco Control. https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/tobacco-control

O debate científico sobre o efeito “porta de entrada”

Vlaams Instituut Gezond Leven, Alle jongeren aan de e-sigaret? https://www.gezondleven.be/nieuws/alle-jongeren-aan-de-esigaret (1 agosto 2024)

Shahab, L., et al., Unpacking the gateway hypothesis of e-cigarette use: the need for triangulation of individual-and population-level data. Nicotine Tob Res, 2022. 24(8): p. 1315-1318. DOI: 10.1093/ntr/ntac035

Cancer Research UK, Exploring the Evidence: The Role of E-Cigarettes in Smoking Cessation. 2018. https://publications.cancerresearchuk.org/sites/default/files/publication-files/AP1732%20CRUK%20Meeting%20Report_FINAL.pdf

Khouja, J.N., et al., Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis. Tob Control, 2021. 30(1): p. 8-15. DOI: 10.1136/tobaccocontrol-2019-055433

Vlaams Instituut Gezond Leven, Alle jongeren aan de e-sigaret? Tijd voor een diepgaande analyse van het vapegedrag van Vlaamse jongeren. https://www.gezondleven.be/files/tabak/Rapport-e-sigaret-en-jongeren.pdf

Cancer Research UK, Vaping: what we know and what we don’t about e-cigarettes. 2021. https://news.cancerresearchuk.org/2021/04/26/ecigarettes-what-we-know-and-what-we-dont/ (24 julho 2024)

Qual a importância dos sabores nos produtos sem fumaça e nas estratégias de RDT?

Mok, Y., et al., Associations between E-cigarette use and E-cigarette flavors with cigarette smoking quit attempts and quit success: evidence from a US Large, Nationally Representative 2018–2019 Survey. Nicotine Tob Res, 2023. 25(3): p. 541-552. DOI: 10.1093/ntr/ntac241

Royal College of Physicians, The RCP responds to the government’s consultation on creating a smokefree generation and tackling youth vaping. 2023. https://www.rcp.ac.uk/policy-and-campaigns/policy-documents/the-rcp-responds-to-the-government-s-consultation-oncreating-a-smokefree-generation-and-tackling-youth-vaping/

Li, L., et al., How does the use of flavored nicotine vaping products relate to progression toward quitting smoking? Findings from the 2016 and 2018 ITC 4CV surveys. Nicotine Tob Res, 2021. 23(9): p. 1490-1497. DOI: 10.1093/ntr/ntab033

Action on Smoking Health (ASH), Use of e-cigarettes (vapes) among adults in Great Britain. 2023. https://ash.org.uk/uploads/Use-of-e-cigarettes-among-adults-in-Great-Britain-2023.pdf

Russell C., et al., Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA. Harm Reduct J, 2018. 15:33. DOI: 10.1186/s12954-018-0238-6

Há relação entre a disponibilidade de produtos sem fumaça e a queda do tabagismo?

Tobacco Free Life, History of Tobacco. https://tobaccofreelife.org/tobacco/tobacco-history/

ECigIntelligence, Regulatory & Market Intelligence for the e-Cigarette Sector, ECigIntelligence market database, July Report. 2024.

World Bank Group, Population, total-Brazil. https://data.worldbank.org/indicator/SP.POP.TOTL?locations=BR

Maia E.G., et al., Trends in Prevalence of Cigarette Smoking in Brazil: 2006-2019. Am J Public Health, 2021. 111(4): p. 730-738. DOI: 10.2105/AJPH.2020.306102

TobaccoIntelligence, Regulatory & Market Intelligence for Alternative Tobacco & Nicotine Products, Heated Tobacco Market Database, Quarter 1 Report. 2024.

World Health Organization, WHO report on the global tobacco epidemic 2021: addressing new and emerging products. 2021. https://iris.who.int/handle/10665/343287

Worldometer, Countries in the world by population (2024). https://www.worldometers.info/world-population/population-bycountry/ (25 julho 2024)

TobaccoIntelligence, Regulatory & Market Intelligence for Alternative Tobacco & Nicotine Products, Nicotine Pouch Market Database, Quarter 1 Report. 2024.

The Tobacco Atlas, Product Sales. https://tobaccoatlas.org/challenges/product-sales/ World Bank Group, Population, total-India. https://data.worldbank.org/indicator/SP.POP.TOTL?locations=IN

Tendências de uso: cigarro, vaping e alternativas

Lindson, N., et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev, 2024. 1: CD010216. DOI: 10.1002/14651858.CD010216.pub8

Cochrane Library. www.cochranelibrary.com

Office of National Statistics, Adult smoking habits in the UK. 2021. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2021

Health and Food Safety, Special Eurobarometer: Attitudes of Europeans towards tobacco and electronic cigarettes. European Commission, 2021. https://europa.eu/eurobarometer/surveys/detail/2240 (22 julho 2024)

World Medical Organization, Declaration of Helsinki (1964). Br Med J, 1996. 313(7070): p. 1448-1449. DOI: 10.1136/bmj.313.7070.1448a

Aspectos sociais e ambientais do uso de produtos sem fumaça

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Dalrymple, A., et al., Enamel staining with e-cigarettes, tobacco heating products and modern oral nicotine products compared with cigarettes and snus: An in vitro study. 2021. Am J Dent, 34(1): p. 3-9. https://pubmed.ncbi.nlm.nih.gov/33544982/

Baker, R.R., and Proctor, C.J., The origins and properties of environmental tobacco smoke. Environment International, 1990. 16(3): p. 231-245. DOI: 10.1016/0160-4120(90)90117-O

McAughey, J., et al. The impact of e-cigarettes and tobacco heating products on indoor air quality. J Aerosol Med Pulm Drug Deliv, 2017. 30:3 (abstract 116). DOI: 10.1089/jamp.2017.ab01.abstracts

Disponibilidade e acesso a produtos sem fumaça

Global Tobacco Control, Nicotine Pouches. https://www.globaltobaccocontrol.org/en/policy-scan/nicotine-pouches/sale

Bates, C., Regulation: Why less is more. E-cigarette summit, 2013. https://www.slideshare.net/slideshow/ecigarette-summit-12-novem/28364227 (4 julho 2024)

Global Tobacco Control, Heated Tobacco. https://www.globaltobaccocontrol.org/en/policy-scan/heated-tobacco/sale

Global Tobacco Control, Country Laws Regulating E-Cigarettes. https://www.globaltobaccocontrol.org/en/policy-scan/e-cigarettes/sale

Cessação do tabagismo e alternativas terapêuticas

Padrões populacionais de cessação do tabagismo

Doll R., et al., Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J, 2004. 328:1519. DOI: 10.1136/bmj.38142.554479.AE

U.S. Department of Health and Human Services, Smoking Cessation: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. https://www.cdc.gov/tobacco-surgeon-general-reports/reports/2020-smoking-cessation/

U.S. Department of Health and Human Services, The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S.

Tratamentos tradicionais para dependência de nicotina

Joseph, A.M., et al., Chronic disease management for tobacco dependence: a randomized, controlled trial. Arch Intern Med, 2011. 171(21): p. 1894-1900. DOI: 10.1001/archinternmed.2011.500

World Health Organization, WHO Model List of Essential Medicines. 2021. https://iris.who.int/bitstream/handle/10665/345533/WHO-MHP-HPS-EML-2021.02-eng.pdf

García-Rodríguez, O., et al., Probability and predictors of relapse to smoking: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend, 2013. 132(3): p. 479-485. DOI: 10.1016/j.drugalcdep.2013.03.008

U.S. Food and Drug Administration, Drug Approval Package: Chantix (Varenicline) Tablets. 2006. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_chantixtoc.cfm

Institute of Medicine, Scientific Standards for Studies on Modified Risk Tobacco Products. Washington, DC: The National Academies Press, 2012. DOI: 10.17226/13294

Global Action to End Smoking, State of Smoking and Health in the United Kingdom. https://globalactiontoendsmoking.org/research/tobacco-around-the-world/united-kingdom/

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World Health Organization, WHO clinical treatment guideline for tobacco cessation in adults. 2024. https://iris.who.int/bitstream/handle/10665/377825/9789240096431-eng.pdf

Cornelius, M.E., et al., Tobacco Product Use Among Adults – United States, 2021, Morbidity and Mortality Weekly Report, 2023. 72: p. 475–483. DOI: 10.15585/mmwr.mm7218a1

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U.S. Food and Drug Administration, Modifications to labeling of nicotine replacement therapy products for over-the-counter human use. Federal Register, 2013. 78(63): p. 19718-19721. https://www.govinfo.gov/content/pkg/FR-2013-04-02/pdf/2013-07528.pdf

Como a ciência avalia riscos, exposição e impactos

Como a ciência avalia riscos e exposição

Cordery, S., et al., The Product Science of Electrically Heated Tobacco Products: An Updated Narrative Review of the Scientific Literature. Cureus, 2024. 16(5): e61223. DOI: 10.7759/cureus.61223

Bachand, A.M. and Sulsky, S.I., A dynamic population model for estimating all-cause mortality due to lifetime exposure history. Regul Toxicol Pharmacol, 2013. 67(2): p. 246-251. DOI: 10.1016/j.yrtph.2013.08.003

Margham, J., et al., Chemical composition of aerosol from an e-cigarette: a quantitative comparison with cigarette smoke. Chem Res Toxicol, 2016. 29(10): p. 1662-1678. DOI: 10.1021/acs.chemrestox.6b00188

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Lowe, F., et al., A framework for the assessment of reduced risk tobacco and nicotine products. Recent Adv Tob Sci, 2015. 41: p. 51-82. https://www.bat-science.com/pdfs/a-framework-for-the-assessment-of-reduced-risk-tobacco-and-nicotine-products.pdf

Bentley, M. C., et al., Comprehensive chemical characterization of the aerosol generated by a heated tobacco product by untargeted screening. Anal Bioanal Chem, 2020. 412: p. 2675-2685. DOI: 10.1007/s00216-020-02502-1

Smith, M.R., et al., Evaluation of the Tobacco Heating System 2.2. Part 1: Description of the system and the scientific assessment program. Regul Toxicol Pharmacol, 2016. 81(2): p. S17-S26. DOI: 10.1016/j.yrtph.2016.07.006

Miller-Holt, J., et al., In vitro evaluation of mutagenic, cytotoxic, genotoxic and oral irritation potential of nicotine pouch products. Toxicol Rep, 2022. 9: p. 1316-1324. DOI: 10.1016/j.toxrep.2022.06.008

Lee, P.N., Epidemiological evidence relating snus to health–an updated review based on recent publications. Harm Reduct J, 2013. 10: 36. DOI: 10.1186/1477-7517-10-36

Murphy, J., et al., Assessing modified risk tobacco and nicotine products: description of the scientific framework and assessment of a closed modular electronic cigarette. Regul Toxicol Pharmacol, 2017. 90: p. 342-357. DOI: 10.1016/j.yrtph.2017.09.008

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Bishop, E., et al., An approach for the extract generation and toxicological assessment of tobacco-free ‘modern’ oral nicotine pouches. Food Chem Toxicol, 2020. 145:111713. DOI: 10.1016/j.fct.2020.111713

Lee, P.N., Summary of the epidemiological evidence relating snus to health. Regul Toxicol Pharmacol, 2011. 59(2): p. 197–214. DOI: 10.1016/j.yrtph.2010.12.002

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Rawlinson, C., et al., Chemical characterisation of aerosols emitted by electronic cigarettes using thermal desorption–gas chromatography–time of flight mass spectrometry. J Chromatogr A, 2017. 1497: p. 144-154. DOI: 10.1016/j.chroma.2017.02.050

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Jones, J., et al., A cross-category puffing topography, mouth level exposure and consumption study among Italian users of tobacco and nicotine products. Sci Rep, 2020. 10(1): 12. DOI: 10.1038/s41598-019-55410-5

Azzopardi, D., et al., Assessment of biomarkers of exposure and potential harm, and physiological and subjective health measures in exclusive users of nicotine pouches and current, former and never smokers. Biomark, 2023. 28(1): p. 118-129. DOI: 10.1080/1354750x.2022.2148747

Gale, N., et al., Changes in biomarkers of exposure and biomarkers of potential harm after 360 days in smokers who either continue to smoke, switch to a tobacco heating product or quit smoking. Intern Emerg Med, 2022. 17(7): p. 2017-2030. DOI: 10.1007/s11739-022-03062-1

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Avaliação clínica da exposição a substâncias tóxicas

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Impactos populacionais e modelagem de risco

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Mecanismos biológicos associados a desfechos adversos

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Síntese de métodos científicos para avaliação de risco

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Regulação, comunicação científica e experiências internacionais

Abordagens regulatórias sobre produtos de nicotina

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Snowdon, C., et al., Vaping Works, International Best Practises: United Kingdom, France, Canada and New Zealand. Property Rights Alliance, 2021. https://www.propertyrightsalliance.org/wp-content/uploads/PRA_VapingWorks.pdf

Como o FDA (EUA) regula produtos sem fumaça

U.S. Food and Drug Administration, Premarket Tobacco Product Applications. https://www.fda.gov/tobacco-products/market-anddistribute-tobacco-product/premarket-tobacco-product-applications

U.S. Food and Drug Administration, PMTA Acceptance Phase Metrics. https://www.fda.gov/media/169533/download?attachment

U.S. Food and Drug Administration, Public Law: Family smoking prevention and tobacco control and federal retirement reform, 2009. https://www.govinfo.gov/content/pkg/PLAW-111publ31/pdf/PLAW-111publ31.pdf

U.S. Food and Drug Administration, Modified Risk Granted Orders. https://www.fda.gov/tobacco-products/advertising-andpromotion/modified-risk-granted-orders

AP News, Thousands of unauthorized vapes are pouring into the US despite the FDA crackdown on fruity flavors. 2023. https://apnews.com/article/fda-vapes-vaping-elf-bar-juul-80b2680a874d89b8d651c5e909e39e8f

Consequências do mercado ilegal de produtos de nicotina

Triantafyllou, G.A., et al., Long-term outcomes of EVALI: a 1-year retrospective study. Lancet, 2021. 9(12): p. e112–e113. DOI: 10.1016/S2213-2600(21)00415-X

Ulep, V.G., et al., Measuring the capacity to combat illicit tobacco trade in 160 countries. Global Health, 2021. 17:130. DOI: 10.1186/s12992-021-00783-4

AP News, 5 takeaways from the AP’s report on Chinese disposable e-cigarettes flooding the US market. 2023. https://apnews.com/article/fda-vapes-vaping-elf-bar-juul-5e45cf57dc78f6b94213047c97b10f7e

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ECigIntelligence, Regulatory & Market Intelligence for the e-Cigarette Sector, ECigIntelligence market database, July Report, 2024

Comunicação científica e publicações revisadas por pares

International Agency for Research on Cancer and World Health Organization, Are e-cigarettes less harmful than conventional cigarettes? https://cancer-code-europe.iarc.fr/index.php/en/ecac-12-ways/tobacco/247-are-e-cigarettes-less-harmful-than-conventionalcigarettes

Science and Technology Committee, E-cigarettes. Seventh Report of Session 2017–19. House of Commons, 2018. https://publications.parliament.uk/pa/cm201719/cmselect/cmsctech/505/505.pdf

Office for Health Improvement & Disparities, Nicotine vaping in England: 2022 evidence update main findings. Gov.UK, 2022. https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidenceupdate-main-findings

Monitoramento de tendências regulatórias

Bates, C., Regulation: Why less is more. E-cigarette Summit, 2013. https://www.slideshare.net/slideshow/ecigarette-summit-12-novem/28364227

Ramström, L. and Wikmans, T., Mortality attributable to tobacco among men in Sweden and other European countries: an analysis of data in a WHO report. Tob Induc Dis, 2014. 12(1):14. DOI: 10.1186/1617-9625-12-14

European Commission, Europe’s Beating Cancer Plan. https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf

Tobaksfakta, The Swedish Government aims at Smoke Free Sweden 2025. 2016. https://tobaksfakta.se/the-swedish-governmentaims-at-smoke-free-sweden-2025/

TobaccoIntelligence, Regulatory & Market Intelligence for Alternative Tobacco & Nicotine Products, Heated Tobacco Market Database, Quarter 1 Report, 2024

ECigIntelligence, Regulatory & Market Intelligence for the e-Cigarette Sector, ECigIntelligence market database, July Report, 2024

TobaccoIntelligence, Regulatory & Market Intelligence for Alternative Tobacco & Nicotine Products, Nicotine Pouch Market Database, Quarter 1 Report, 2024

Reino Unido: políticas públicas e redução do tabagismo

Royal College of Physicians, E-cigarettes and harm reduction: An evidence review. RCP, 2024. https://www.rcp.ac.uk/policy-andcampaigns/policy-documents/e-cigarettes-and-harm-reduction-an-evidence-review/

BBC News, E-cigarettes could be prescribed by the NHS to help smokers quit, report says. 2015. https://www.bbc.co.uk/news/health-33978603

Office for Health Improvement and Disparities (OHID), The Khan review: making smoking obsolete. Gov. UK, 2022. https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete

McNeill, A., et al., E-cigarettes: an evidence update. Public Health England, 2015. https://www.gov.uk/government/publications/ecigarettes-an-evidence-update

Action on Smoking and Health (ASH), Use of vapes (e-cigarettes) among adults in Great Britain. 2024. https://ash.org.uk/uploads/Use-of-vapes-among-adults-in-Great-Britain-2024.pdf

Office of Health Improvement and Disparities (OHID), Nicotine vaping in England: 2022 evidence update main findings. Gov. UK, 2022. https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-main-findings

Department of Health and Social Care, Press release: Smokers urged to swap cigarettes for vapes in world first scheme. Gov. UK, 2023. https://www.gov.uk/government/news/smokers-urged-to-swap-cigarettes-for-vapes-in-world-first-scheme

Office of Health Improvement and Disparities (OHID), E-cigarettes and vaping: policy, regulation and guidance. Gov. UK, 2022. https://www.gov.uk/government/collections/e-cigarettes-and-vaping-policy-regulation-and-guidance#e-cigarettes-evidence-reviews

National Institute for Health and Care Excellence (NICE), Tobacco: preventing uptake, promoting quitting and treating dependence (NG209). 2021. https://www.nice.org.uk/guidance/ng209/resources/tobacco-preventing-uptake-promoting-quitting-and-treatingdependencepdf-66143723132869

Action on Smoking and Health (ASH), Vaping: what you need to know. https://ash.org.uk/key-topics/vaping-what-you-need-to-know

U.K. National Health Service (NHS), Vaping to quit smoking. https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/vaping-to-quit-smoking/

U.K. National Health Service (NHS), NHS stop smoking services help you quit. https://www.nhs.uk/live-well/quit-smoking/nhs-stopsmoking-services-help-you-quit/

Balogun, B. and Harker, R., The smokefree 2030 ambition for England. House of Commons Library, 2023. https://commonslibrary.parliament.uk/research-briefings/cbp-9655/

Office for National Statistics (ONS), Adult smoking habits in the UK: 2023. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2023

Eurobarometer, Attitudes of Europeans towards tobacco and related products. European Commission, 2023. https://europa.eu/eurobarometer/surveys/detail/2995

UK Parliament, Tobacco and Vapes Bill. https://bills.parliament.uk/bills/3879#timeline

Department of Health and Social Care (OHID), Tobacco and Vapes Bill: creating a smoke-free UK and tackling youth vaping factsheet. Gov. UK, 2024. https://www.gov.uk/government/publications/the-tobacco-and-vapes-bill-creating-a-smoke-free-uk-and-tackling-youthvaping/tobacco-and-vapes-bill-creating-a-smoke-free-uk-and-tackling-youth-vaping

Grécia: comunicação de risco voltada a fumantes adultos

Institute for Health Metrics and Evaluation (IHME), Health by location, Greece. https://www.healthdata.org/research-analysis/health-by-location/profiles/greece

Eurobarometer, Attitudes of Europeans towards tobacco and related products. European Commission, 2024. https://europa.eu/eurobarometer/surveys/detail/2995

Greek Government, National Action Plan Against Smoking. 2019. https://www.government.gov.gr/ethniko-schedio-drasis-kata-toukapnismatos-i-igia-mas-enoni/

OECD, Tobacco Consumption, Measure: share of population who are daily smokers. https://data-explorer.oecd.org/vis?tm=daily%20smokers&pg=0&hc[Unit%20of%20measure]=&snb=2&vw=tb&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_HEALTH_LVNG%40DF_HEALTH_LVNG_TC&df[ag]=OECD.ELS.HD&df[vs]=1.0&dq=.A…..&pd=2010%2C&to[TIME_PERIOD]=false

Smoke Free Greece. https://smokefreegreece.gr/en/smoke-free-greece/

Global Action to End Smoking, State of Smoking and Health in Greece. https://globalactiontoendsmoking.org/research/tobaccoaround-the-world/greece/

Greek Law 4715/2020 (Article 36). https://www.kodiko.gr/nomothesia/document/634794/nomos-4715-2020

Eurobarometer, Attitudes of Europeans towards tobacco and related products. European Commission, 2021. https://europa.eu/eurobarometer/surveys/detail/2240

Statista, Health Indicators Greece report 2024. https://www.statista.com/study/173878/health-indicators-greece-report/

TobaccoIntelligence, Greece: Heated tobacco market snapshot, November 2024

Japão: a experiência com produtos de tabaco aquecido

Forey, B., et al., Japan in International Smoking Statistics: A collection of historical data from 30 economically developed countries (2nd ed). Oxford University Press, 2002. DOI: 10.1093/acprof:oso/9780198508564.001.0001

Xu, S.S., et al., Reasons for Regularly Using Heated Tobacco Products among Adult Current and Former Adult Smokers in Japan: Findings from 2018 ITC Japan Survey. Int J Environ Res Public Health, 2020. 17(21): 8030. DOI: 10.3390/ijerph17218030

Otsuka, Y., et al., Comparison of the responses of cross-sectional web- and paper-based surveys on lifestyle behaviors of Japanese adolescents. Prev Med Rep, 2023. 36:102462. DOI: 10.1016/j.pmedr.2023.102462

Euromonitor International, Market Sizes, Heated Tobacco – Japan. Tobacco: Euromonitor from trade sources/national statistics

World Economic Forum, 5 Japanese innovations that changed the world. 2016. https://www.weforum.org/agenda/2016/10/5-japanese-innovations-that-changed-the-world/

Bloomberg, Japan: Where innovation is borderless. https://sponsored.bloomberg.com/article/jco/japan-where-innovation-isborderless

Euromonitor International, Market Sizes, Cigarettes – Japan. Tobacco: Euromonitor from trade sources/national statistics

Estados Unidos: evolução do mercado de produtos de vapor

Bao, W., et al., Electronic Cigarette Use Among Young, Middle-aged, and Older Adults in the United States in 2017 and 2018. JAMA Intern Med, 2020. 180(2): p. 313–314. DOI: 10.1001/jamainternmed.2019.4957

King, B.A., et al., Trends in awareness and use of electronic cigarettes among US adults, 2010–2013. Nicotine Tob Res, 2015. 17(2): p. 219–227. DOI: 10.1093/ntr/ntu191

National Academies of Sciences, Engineering, and Medicine, Public Health Consequences of E-Cigarettes. The National Academies Press, 2018. DOI: 10.17226/24952

U.S. Centers for Disease Control and Prevention, National Centers for Health Statistics, National Health Interview Survey. https://www.cdc.gov/nchs/nhis/index.htm

U.S. Food and Drug Administration, The Relative Risks of Tobacco Products. https://www.fda.gov/tobacco-products/health-effectstobacco-use/relative-risks-tobacco-products

U.S. Food and Drug Administration, FDA Permits Marketing of E-Cigarette Products, Marking First Authorization of Its Kind by the Agency. 2021. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-e-cigarette-products-marking-firstauthorization-its-kind-agency

U.S. Food and Drug Administration, FDA Issues Marketing Decisions on Vuse Vibe and Vuse Ciro E-Cigarette Products. 2022. https://www.fda.gov/tobacco-products/ctp-newsroom/fda-issues-marketing-decisions-vuse-vibe-and-vuse-ciro-e-cigarette-products

U.S. Food and Drug Administration, FDA Authorizes Marketing of Vuse Alto Tobacco-Flavored E-Cigarette Pods and Accompanying Power Unit. 2024. https://www.fda.gov/tobacco-products/ctp-newsroom/fda-authorizes-marketing-vuse-alto-tobacco-flavored-e-cigarettepods-and-accompanying-power-unit

Nova Zelândia e Austrália: abordagens regulatórias contrastantes

Ministry of Health New Zealand, New Zealand’s smoking rates continue to decline. 2023. https://www.health.govt.nz/news/new-zealands-smoking-rates-continue-to-decline

New Zealand Legislation, Smokefree Environments and Regulated Products Regulations 2021: Version as at 20 March 2024. 2024. https://www.legislation.govt.nz/regulation/public/2021/0204/latest/whole.html

Action on Smoking and Health (ASH), Smoking rate continues record decline to only 6.8% daily use, Māori and Pacific rates are also reduced. Action for Smokefree 2025, 2023. https://www.ash.org.nz/smoking_rate_continues_record_decline_to_only_6_8_daily_use_m_ori_and_pacific_rates_are_also_reduced

Queensland Health, Everything you need to know about illicit tobacco and vapes. 2025. https://www.health.qld.gov.au/newsroom/news/everything-you-need-to-know-about-illicit-tobacco-and-vapes

New Zealand Legislation, Smokefree Environments and Regulated Products Act 1990, Section 3A. https://www.legislation.govt.nz/act/public/1990/0108/latest/DLM3913904.html

Ministry of Health New Zealand, Vaping facts. https://www.vapingfacts.health.nz/

Roy Morgan, The full picture: a decade of smoking in Australia. 2024. https://www.roymorgan.com/findings/9937-cigarette-smoking-in-australia-press-release

Action on Smoking and Health (ASH), Vaping and young people: ASH position statement. Action for Smokefree 2025, 2023. https://assets.nationbuilder.com/ashnz/pages/193/attachments/original/1683505972/Vaping_and_young_people_ASH_Position_Statment_May_2023.pdf

The Pharmacy Guild of Australia, Vape control smoked. 2024. https://www.guild.org.au/news-events/news/2024/vape-control-smoked

New Zealand Legislation, Smokefree Environments and Regulated Products Regulations 2021: Version as at 21 September 2023. 2023. https://legislation.govt.nz/regulation/public/2021/0204/22.0/whole.html

NewsGP, Have GPs been supported for vaping to go prescription-only from October? 2021. https://www1.racgp.org.au/newsgp/clinical/have-gps-been-supported-for-vaping-to-go-prescript

ALIVE Advocacy, Firebombings. 2025. https://www.aliveadvocacymovement.com/firebombings

Williams, R., Vaping plan up in smoke: Leading supplier pulls out. https://readnow.isentia.com/Temp/29541-1205141376/1097584394_20260616.pdf

Commins, P., Tobacco excise has passed a ‘tipping point’ and is fuelling black market, economists warn. The Guardian, 2025. https://www.theguardian.com/society/2025/jun/11/tobacco-excise-isnt-making-australians-smoke-less-and-should-be-frozen-tocurb-black-market-economists-say

Suécia: trajetória rumo a níveis mínimos de tabagismo

Farsalinos, K., et al., No Smoke Less Harm. Smoke Free Sweden, 2024. https://smokefreesweden.org/No%20Smoke%20Less%20Harm.pdf

Folkhälsomyndigheten, Tobacco and nicotine use (self-reported) by age, sex and year. Percentage. http://fohm-app.folkhalsomyndigheten.se/Folkhalsodata/pxweb/en/A_Folkhalsodata/A_Folkhalsodata__B_HLV__aLevvanor__aagLevvanortobak/hlv1tobaald.px/

World Health Organization and International Agency for Research on Cancer, Cancer Today: Data visualization tools for exploring the global cancer burden in 2022. https://gco.iarc.who.int/today/en

The Swedish Parliament, Excise taxes on nicotine-containing consumer products after the year 2023. 2022. https://www.riksdagen.se/sv/dokument-och-lagar/dokument/svar-pa-skriftlig-fraga/punktskatter-pa-nikotininnehallande_H9121477/

Paquistão: uso de nicotina oral em contextos de baixa e média renda

Rodu, B. and Jansson, C., Smokeless tobacco and oral cancer: A review of the risks and determinants. Crit Rev Oral Biol Med, 2004. 15(5): p. 252–263. DOI: 10.1177/154411130401500502

Niaz, K., et al., Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health, 2017. 39: e2017009. DOI: 10.4178/epih.e2017009

Ahmad, F., et al., Implementing smokeless tobacco control policy in Pakistan: a qualitative study among Naswar supply chain actors. Tob Control, 2021. 30(5): p. 548–552. DOI: 10.1136/tobaccocontrol-2020-055748

Stanfill, S.B., et al., Global surveillance of oral tobacco products: total nicotine, unionised nicotine and tobacco-specific N-nitrosamines. Tob Control, 2011. 20(3): e2. DOI: 10.1136/tc.2010.037465

Rutqvist, L.E., et al., Swedish snus and the GothiaTek® standard. Harm Reduct J, 2011. 8:11. DOI: 10.1186/1477-7517-8-11

Saeed, M., et al., Assessment of potential toxicity of a smokeless tobacco product (naswar) available on the Pakistani market. Tob Control, 2012. 21(4): p. 396–401. DOI: 10.1136/tc.2010.042630

Sankhla, B., et al., Genotoxic and carcinogenic effect of gutkha: a fast-growing smokeless tobacco. Addict Health, 2018. 10(1): p. 52–63. DOI: 10.22122/ahj.v10i1.537

Ahmad, F., et al., Smokeless tobacco control in Pakistan. J Postgrad Med Inst, 2020. 34(3): p. 139–141. https://jpmi.org.pk/index.php/jpmi/article/view/2868

Hossain, M.M., et al., Malondialdehyde and heavy metal contents in Piper betel: Possible Risks of Heavy Metals in Human Health. J Food Compos Anal, 2024. 134:106540. DOI: 10.1016/j.jfca.2024.106540

Saeed, M., et al., Biochemical composition of a smokeless tobacco product (NASWAR) used in Pakistan. J King Saud Univ Sci, 2024. 36(5):103168. DOI: 10.1016/j.jksus.2024.103168

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World Health Organization and International Agency for Research on Cancer, Global Cancer Observatory: Pakistan. 2022. https://gco.iarc.who.int/media/globocan/factsheets/populations/586-pakistan-fact-sheet.pdf

World Health Organization and International Agency for Research on Cancer, Cancer Today – Dataviz. https://gco.iarc.who.int/today/en/dataviz

World Health Organization and International Agency for Research on Cancer, Cancer Today: Data visualization tools for exploring the global cancer burden in 2022. https://gco.iarc.who.int/today/en

World Health Organization and International Agency for Research on Cancer, Agents Classified by the IARC Monographs, Volumes 1–136. https://monographs.iarc.who.int/agents-classified-by-the-iarc/

The Tobacco Atlas, Country Factsheets – Sweden. https://tobaccoatlas.org/factsheets/sweden/

The Tobacco Atlas, Country Factsheets – Pakistan. https://tobaccoatlas.org/factsheets/pakistan/

Swedish Food Agency, Swedish Food Agency’s regulations (LIVSFS 2012:6) on snus and chewing tobacco. https://www.livsmedelsverket.se/globalassets/om-oss/lagstiftning/snus-tuggtobak/livsfs-2022-11-kons-2012-6.pdf

National University of Sciences & Technology (NUST), Illicit Cigarette Trade in Pakistan – Current Situation and Way Forward. 2024

Lahore University of Management Sciences (LUMS), Impact of Taxation on the Cigarette Sector in Pakistan – A Thorough Analysis. 2024. https://actalliance.pk/wp-content/uploads/2024/06/LUMS-Impact-of-Taxation-on-the-Cigarette-Sector-in-Pakistan.pdf

International and Local Tobacco Harm Reduction Experts, Report: Integrating Harm Reduction into Tobacco Control. Lives Saved. https://smokefreesweden.org/lives-saved.pdf

Próximos passos para reduzir o impacto do tabagismo

Travis, N., et al., The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review. Nicotine Tob Res, 2024. ntae131. DOI: 10.1093/ntr/ntae131

McNeill, A., et al., E-cigarettes: an evidence update. Public Health England, 2015. https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update

Government of Canada, Vaping and quitting smoking. 2023. https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/quit-smoking.html

NHS, Vaping myths and the facts. https://www.nhs.uk/better-health/quit-smoking/vaping-to-quit-smoking/vaping-myths-and-the-facts

AP News, Insider Q&A: FDA official on vaping’s “promise or peril”. 2022. https://apnews.com/article/science-health-publictobaccoindustry-regulation-6af0d635d7859bab914cc249ef43b6e2

U.S. Food and Drug Administration, CTP Director Discusses Opportunities and Considerations for Addressing Misperceptions About the Relative Risks of Tobacco Products Among Adults Who Smoke. 2023. https://www.fda.gov/tobacco-products/ctp-newsroom/ctp-directordiscusses-opportunities-and-considerations-addressing-misperceptions-about-relative

Vaping Facts, Our position on vaping. Ministry of Health New Zealand. https://vapingfacts.health.nz/our-position-on-vaping.html

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Visite nossa Biblioteca RDT e confira dezenas de trabalhos acadêmicos sobre Redução de Danos do Tabagismo.

Mais de 550 Referências Científicas Sobre Redução dos Danos do Tabagismo

19/12/2025

Este artigo reúne mais de 550 estudos científicos, relatórios técnicos e documentos institucionais relacionados à Redução dos Danos do Tabagismo (RDT). Esse conjunto de evidências foi compilado a partir de pesquisas conduzidas por universidades, centros...

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Trabalho pode ajudar legisladores a tomar caminhos mais adequados em relação aos produtos de redução de danos do tabagismo.

Relatório mostra que cigarros eletrônicos salvaram 113 mil vidas e economizaram 176 bilhões de dólares na economia americana na última década

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O Direta apresenta o relatório produzido pelo Center for Black Equity (CBE), completamente traduzido ao Português.

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Mais de 550 Referências Científicas Sobre Redução dos Danos do Tabagismo

A falsa ideia de “evidência insuficiente”

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Panorama global do tabagismo

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Consequências do tabagismo para a saúde

Como a saúde pública tentou reduzir os danos do tabagismo

Redução de danos do tabagismo: fundamentos, objetivos e controvérsias

Redução de danos e saúde pública: a busca por abordagens equilibradas

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Objetivos e métricas da redução de danos do tabagismo

A relevância da redução de danos no enfrentamento do tabagismo

Proteção de jovens e controle de acesso a produtos de nicotina

Como o risco é percebido por fumantes e pela sociedade

Perspectivas sobre ciência e redução de danos

Perspectivas diversas sobre redução de danos do tabagismo

Nicotina, produtos sem fumaça e padrões reais de uso

Nicotina: o que a ciência realmente mostra

Risco relativo entre produtos sem fumaça e cigarros convencionais

O debate científico sobre o efeito “porta de entrada”

Qual a importância dos sabores nos produtos sem fumaça e nas estratégias de RDT?

Há relação entre a disponibilidade de produtos sem fumaça e a queda do tabagismo?

Tendências de uso: cigarro, vaping e alternativas

Aspectos sociais e ambientais do uso de produtos sem fumaça

Disponibilidade e acesso a produtos sem fumaça

Cessação do tabagismo e alternativas terapêuticas

Padrões populacionais de cessação do tabagismo

Tratamentos tradicionais para dependência de nicotina

Como a ciência avalia riscos, exposição e impactos

Como a ciência avalia riscos e exposição

Evidência científica produzida por fabricantes: escopo e limites

A Transição da Ciência do Tabaco Combustível para a Ciência dos Produtos sem Fumaça

Biomarcadores e evidências clínicas em estudos humanos

Padrões de uso, absorção e metabolismo da nicotina

Avaliação clínica da exposição a substâncias tóxicas

Risco individual associado ao uso de produtos de nicotina

Impactos populacionais e modelagem de risco

Mecanismos biológicos associados a desfechos adversos

Síntese de métodos científicos para avaliação de risco

Regulação, comunicação científica e experiências internacionais

Abordagens regulatórias sobre produtos de nicotina

Como o FDA (EUA) regula produtos sem fumaça

Consequências do mercado ilegal de produtos de nicotina

Comunicação científica e publicações revisadas por pares

Monitoramento de tendências regulatórias

Reino Unido: políticas públicas e redução do tabagismo

Grécia: comunicação de risco voltada a fumantes adultos

Japão: a experiência com produtos de tabaco aquecido

Estados Unidos: evolução do mercado de produtos de vapor

Nova Zelândia e Austrália: abordagens regulatórias contrastantes

Suécia: trajetória rumo a níveis mínimos de tabagismo

Paquistão: uso de nicotina oral em contextos de baixa e média renda

Próximos passos para reduzir o impacto do tabagismo

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