Dr. Derek Yach Denounces Misleading Statements by the Brazilian Society of Cardiology

The Brazilian Society of Cardiology advocates prohibiting electronic nicotine delivery systems. In a forceful statement, Dr. Derek Yach harshly criticized their recent communiqué on these products, calling it “misleading and distorted.” The public health expert urged the organization to retract and adopt harm-reduction strategies. These measures could be crucial for improving heart health in Brazil and preventing the premature deaths of thousands.

In a recent report, the Brazilian Society of Cardiology (SBC) listed ten reasons to maintain the ban on electronic nicotine delivery systems (ENDS), which include vaporizers and heated tobacco products.

This ban, which has been in effect since 2009 and was recently reaffirmed, aims to demonstrate the country’s commitment to tobacco control.

However, the measure’s effectiveness has been consistently questioned, especially since history has shown that bans without a solid regulatory framework grounded in rigorous scientific evidence can cause more problems than they solve.

This includes the rise of the black market, the use of more dangerous products without any quality control, and the lack of harm reduction options for smokers seeking safer alternatives.

What Do the Experts Say?

Renowned experts have focused on Brazil’s situation. Among them is Dr. Derek Yach, who recently expressed vehemently that the country’s ban ignores scientific evidence and the potential benefits these devices offer in reducing smoking-related harms.

The SBC argues that lifting the ban could weaken Brazil’s global leadership in tobacco control and encourage youth smoking.

However, Dr. Yach contradicts these claims, citing studies from countries like the United States and the United Kingdom, which suggest that the use of vaporizers could reduce the likelihood of youth starting to smoke cigarettes or using harder drugs.

One of the main arguments from the Brazilian Society of Cardiology is the potential risk vaporizers pose to cardiovascular diseases.

Nevertheless, Dr. Derek Yach criticizes the methodology of the studies supporting this claim, noting that several have been withdrawn due to methodological biases.

This situation raises serious doubts about the robustness of the research underpinning the SBC’s stance.

Beyond methodological criticisms, Dr. Yach highlights the effectiveness of vapes as a smoking cessation tool.

He references meta-analyses conducted by the Cochrane group, comparing vapes to traditional nicotine replacement therapies.

These studies conclude that vaporizers are significantly more effective in helping smokers quit the habit altogether.

The discussion about vaporizers extends beyond medicine into ethical territory.

Dr. Derek Yach invites reflection on the medical responsibility and ethics behind offering patients the best opportunities to improve their health.

He quotes Nancy Rigotti, who, in a New England Journal of Medicine editorial, emphasized the importance of doctors considering vapes as a viable option for their smoking patients, particularly those at risk of developing heart disease.

A Global Discussion

The debate in Brazil reflects a global tension between reactionary public health policies focused on prohibition and a more humanized, person-centered approach promoting harm reduction.

This discussion transcends public health, raising questions about how societies determine acceptable risks in pursuit of the greater good.

As often happens with bans, the one in Brazil has not achieved its goals for various reasons.

Despite the ban in place since 2009, millions of people who have quit smoking through vaping continue to use these products, forcibly driving a lucrative illegal market that benefits from the prohibition.

This underscores the ineffectiveness of severe restrictions. Furthermore, as Dr. Yach demonstrated, policies supporting these bans often rely on misinterpreted or methodologically flawed studies.

This contributes to a scenario of public misinformation that perpetuates the lack of safety and quality control in products circulating in the black market, managed by criminal organizations.

Moreover, these restrictions have an unequal social impact, primarily affecting vulnerable groups and exacerbating health inequalities.

Dr. Yach notes that countries like the United Kingdom and the United States have shown that proper regulation of ENDS can facilitate smoking cessation without increasing youth use.

Imposing bans also raises ethical dilemmas regarding limiting access to potentially less harmful alternatives and restricting individual and collective rights. This is especially problematic when evidence suggests significant benefits in harm reduction associated with these alternatives.

This conflict highlights the need to base public policies on solid evidence and foster an open and honest dialogue about the most effective strategies to combat smoking.

Dr. Yach emphasizes that Brazil’s experience in harm reduction in areas like HIV and drug use could serve as a model for rethinking the current approach to tobacco and nicotine.

Meanwhile, he warns that the medical community and policymakers must address this complex situation with a critical and compassionate perspective, balancing scientific foundations with social sensitivity.

This way, a path that genuinely protects and improves public health could be charted.

In this regard, Dr. Yach harshly criticized the Brazilian Society of Cardiology: “The Brazilian Society of Cardiology should be ashamed of publishing a misleading and distorted statement, leading their medical colleagues to offer incorrect advice that could result in the premature death of many patients worldwide. We hope they will formally retract as soon as possible and reconsider the previous successes they have had in harm reduction in areas such as drug abuse and HIV/AIDS, adopting this approach instead. It is the way forward to improve the heart health of Brazilians.”

Listen to Dr. Yach’s full statement here:

We attempted to contact the Brazilian Society of Cardiology (SBC) by phone and email to address some questions. Still, as of the time of this publication, we have not received responses. This article will be updated if it becomes available.

1. Do Brazil’s public health priorities differ significantly from those of the UK or New Zealand, especially regarding smoking rates and patterns?

Are regulatory decisions in Brazil influenced by local policies and economic pressures differently than in other countries?

Do cultural and social perceptions of ENDS in Brazil differ from those in other countries, and are they viewed with more skepticism?

Is there a divergence in the interpretation of scientific evidence regarding the risks and benefits of ENDS between Brazil and countries that have regulated these products?

Is Brazil’s regulatory capacity to implement effective ENDS regulation less developed than that of the UK and New Zealand?

How does Brazil’s history and experience in tobacco control policies influence the approach to ENDS regulation?