A portrait of electronic nicotine delivery systems use in Brazil: findings from the 2019-2023 Vigitel survey

The use of electronic nicotine delivery systems (ENDS) has been increasing globally, raising concerns about their impact on public health, particularly among young adults. In Brazil, despite strong tobacco control policies, data on the prevalence of ENDS use and its associated factors remain limited. This study aimed to analyze sociodemographic and behavioral factors associated with lifetime ENDS use among Brazilian adults from 2019 to 2023. Data from four national surveys conducted in 2019, 2020, 2021, and 2023, including 126,681 participants, were analyzed. Crude and adjusted logistic regression models were applied to estimate odds ratios and 95% confidence intervals to assess associations between sociodemographic characteristics, health behaviors, and lifetime ENDS use. All analyses were weighted to account for the complex sampling design and stratified by survey year. Lifetime ENDS use was significantly higher among young adults (18-24 years), males, individuals living in the Central-West and South regions, and those reporting binge drinking and smoking. Higher educational attainment and prolonged screen time (≥ 3 hours/day) were also positively associated with ENDS use. Lifetime ENDS use in Brazil is influenced by sociodemographic and lifestyle factors, with higher prevalence among young adult males with higher education levels and residents of specific regions. These findings highlight the need for targeted public health strategies aimed at populations at higher risk to curb the growing use of ENDS and prevent potential health consequences.