At GFN26, harm reduction experts Alex Wodak and Ian Fearon reiterated that prohibition could unintentionally lead to the expansion of illicit nicotine markets. They did not say vaping should be unregulated; rather, they argued that if the regulated supply is removed while demand remains, consumers would likely turn to vendors operating outside the usual product and age restrictions. Recent developments in Brazil and the Netherlands offer two very different examples of that proposition.
Brazil’s vape ban has not eliminated vaping
For adult smokers, the issue of relative risk is also important. The appropriate public health question is not whether vaping is entirely harmless, but whether switching from smoking to vaping leads to a reduction in exposure and eventually to smoking-related disease.
Brazil has banned vape sales since 2009. In 2024, the regulator Anvisa confirmed the policy, which prohibits manufacturing, importation, sale, distribution and advertising; however, personal use is not forbidden. Yet vaping continues. In August, Amanda Matos wrote that the Brazilian press increasingly links vapes to diabetes, oral cancer, lung damage and criminal activity while at the same time giving insufficient attention to the illegal market that has developed around a product which is not available through legal retailers.A case study was based on observational research which found a small increased risk of developing pre-diabetes among vapers. While these findings are worth examining, an association does not prove that vaping caused the outcome. Previous smoking, diet, alcohol intake, socioeconomic status and other behaviours can all complicate the results of such observational studies.
The same warning holds true in respect to laboratory studies which identify DNA damage or other cellular changes after exposure to vaping. While these experiments may show possible mechanisms, they alone cannot prove that vaping is leading to an increase in cases of human cancer. For adult smokers, the issue of relative risk is also important. The appropriate public health question is not whether vaping is entirely harmless, but whether switching from smoking to vaping leads to a reduction in exposure and eventually to smoking-related disease.
That distinction has become more important as evidence on cessation has strengthened. The most recent living review by Cochrane shows that there is high-certainty evidence demonstrating that nicotine e-cigarettes result in higher quit rates than nicotine replacement therapy, even though evidence on longer-term safety is still developing.
When contraband becomes the only supply chain
Brazilian police have on several occasions found illegal vapes as a result of operations conducted to seize other kinds of contraband. The number of such seizures might well lead people to think that vaping as such is naturally linked with organised crime. Yet, if millions of people report wanting a banned product, then all suppliers must be engaging in illegal activity.
Legalisation cannot be proven to eliminate illicit trade, but prohibition removes the mechanisms governments normally use to regulate consumer products, such as manufacturing standards, ingredient requirements, taxation, retailer licensing, and enforceable age verification. It thus brings up an uncomfortable question in the light of more than 15 years of prohibition: has Brazil put an end to vaping, or has it mainly eliminated regulated vaping?
Dutch restrictions push sales towards social media
The Netherlands presents another instance of the same issue. Just as in the case of Brazil, vaping is still legal for adults, but access has gradually become more restricted. The sale of tobacco and vaping products at a distance has been banned since July 2023, and non-tobacco vape flavours have been prohibited since January 2024. Data from official enforcement measures indicate that supply has adjusted.
In 2024, the Dutch Food and Consumer Product Safety Authority (NVWA) noted 1,868 violations on social media, finding that illegal trading seemed to be moving from traditional websites to social platforms. The regulators also recognised that violations kept on recurring.
From July 2024 to July 2025, authorities identified flavour-ban violations in 291 of the 701 risk-based retail inspections, or 42 per cent. Additionally, they took down 619 social-media advertisements and 111 listings on sales platforms. One other platform removed 1,434 advertisements in response to regulatory instructions.
These targeted inspections do not mean that 42% of all Dutch retailers break the law; they do, however, show that prohibited products remain easily available and therefore require intensive enforcement.
How to go (and not go) about youth protection
It is legitimate for the Dutch government to aim at preventing young people from vaping; indeed, it has introduced restrictions on flavour and on availability with the aim of reducing the attractiveness of vapes to young people, and legal retailers are not allowed to sell vapes to anyone under the age of 18.
That is, however, another youth-protection problem caused by transferring transactions to anonymous social-media accounts. The NVWA says it generally cannot identify the individuals behind banned online advertisements, so enforcement action usually amounts to deleting the advertisement rather than taking the seller to court.
In contrast, businesses with a licence can be inspected, fined, and asked to verify their customers’ ages. This does not mean unrestricted commercialisation is the alternative. Strong age verification, product standards, sensible nicotine limits, marketing restrictions and enforcement against non-compliant sellers can coexist with adult access. The issue discussed at GFN26 was therefore not whether nicotine should be regulated, but how regulation addresses ongoing demand.
Fearon also raised the question of whether evidence-based harm reduction is treated equally in public health, stating that research supporting established positions can at times attract more attention than more robust evidence pointing in a different direction.
The bottom line: prohibition never works
The experiences of Brazil and the Netherlands show a simpler truth—limiting the legal availability of something does not stop its consumption. Success in the area of tobacco harm reduction should be based mainly on decreases in combustible smoking, toxic exposure, and disease—rather than just on the number of nicotine products taken off legitimate shelves.
When adults keep looking for alternatives to cigarettes, governments eventually have to decide whether to try to suppress that demand or to set up a regulated market which can control it; the experiences of Brazil and the Netherlands indicate that prohibition might at times be more successful in altering where nicotine is bought than in affecting its use.
