Num movimento coordenado a nível internacional, 83 especialistas em saúde pública subscreveram uma carta aberta dirigida à Comissão Europeia, expressando profunda preocupação com a proposta de diretiva fiscal (Taxation of Excise Duties – TED) que pretende uniformizar a tributação de todos os produtos que contenham nicotina, independentemente do seu risco para a saúde. A iniciativa, coordenada pela plataforma espanhola para a redução de danos do tabaco (Plataforma para la reducción del daño por tabaquismo) e pelo reconhecido investigador grego Konstantinos Farsalinos, surge como uma resposta directa à proposta apresentada pela Comissão em julho, que ignora o princípio fundamental da redução de danos.

O corpo de signatários é composto por especialistas de 18 Estados-membros da União Europeia, incluindo um representante de Portugal (Professor Manuel País Clemente). A lista inclui nove especialistas de Espanha, sete da Polónia, seis do Reino Unido, seis da Grécia, cinco de Itália, três de França, dois da Hungria, dois da República Checa, dois da Áustria, dois da Suécia e um da Dinamarca, Noruega, Estónia, Letónia, Croácia e Alemanha. Este esforço pan-europeu é ainda reforçado pela participação de organizações e peritos independentes dos Estados Unidos, Canadá, Austrália, bem como de vários países de África e da Ásia, conferindo ao aviso um carácter verdadeiramente global.

O cerne da argumentação apresentada na carta reside na defesa intransigente de políticas públicas baseadas em evidência científica robusta. Os peritos sublinham que os produtos de nicotina sem combustão, como os cigarros electrónicos, o tabaco aquecido e as bolsas de nicotina, apresentam um risco significativamente reduzido para a saúde dos utilizadores quando comparados com o contínuo consumo de cigarros tradicionais, que envolvem combustão e produzem milhares de substâncias tóxicas e carcinogénicas. Ao propor uma tributação equivalente para produtos com perfis de risco radicalmente diferentes, a Comissão Europeia está, na prática, a desincentivar os fumadores que procuram alternativas menos prejudiciais e a perpetuar o consumo dos produtos mais mortíferos.

Konstantinos Farsalinos, investigador da Universidade de Patras e um dos principais impulsionadores da missiva, foi incisivo nas suas declarações: “A política fiscal deve refletir de forma precisa e proporcional o risco para a saúde pública. A proposta atual da Comissão, que ignora completamente o continuum de risco dos produtos de nicotina, é anticientífica, moralmente questionável e profundamente contraproducente para a saúde dos cidadãos europeus. Estamos a pedir uma reconsideração urgente que alinhe a política fiscal com a política de saúde, algo que beneficie todos os europeus”. A participação de um especialista português no grupo de subscritores destaca o consenso científico transversal que esta posição gera no seio da comunidade de saúde pública.

Os especialistas alertam que as consequências de uma taxação excessiva e indiferenciada serão particularmente gravosas para os grupos socioeconómicos mais vulneráveis, onde as taxas de tabagismo são persistentemente mais elevadas. Ao eliminar a vantagem financeira que poderia incentivar a transição para alternativas sem combustão, a proposta da Comissão arrisca-se a criar uma barreira económica intransponível para milhões de fumadores, mantendo-os num produto que mata um em cada dois consumidores a longo prazo. A carta apela diretamente à Presidente da Comissão Europeia, Ursula von der Leyen, ao Comissário para a Economia, Paolo Gentiloni, e à Comissária da Saúde, Stella Kyriakides, para que revisitem a proposta e adoptem uma estrutura fiscal diferenciada e progressiva, que reconheça formalmente o potencial de redução de danos destes produtos e os coloque numa categoria tributária distinta e mais baixa.

O documento, que já começou a gerar eco nos meios de comunicação internacional, como o EU Reporter, está publicamente disponível no site da plataforma espanhola, servindo como um recurso transparente para jornalistas, legisladores e cidadãos. Este apelo coletivo representa um esforço crucial para influenciar o debate legislativo em curso, defendendo que as decisões finais sobre a futura fiscalidade dos produtos de nicotina na UE devem ser tomadas com base na ciência e no primado da proteção da saúde pública, e não em preconceitos ou equívocos.

Ligações:
Carta aberta: https://prdtabaquismo.org/wp-content/uploads/2025/09/COMMISSION-TAXES-FINAL-LETTER-1.pdf
Notícia no EU Reporter: https://www.eureporter.co/health/2025/09/22/international-public-health-experts-warn-about-high-nicotine-taxation/

Signatários da carta:

1. Jasjit S. Ahluwalia — MD, MPH, MS, Professor, Behavioral and Social Sciences and Professor of Medicine; Center for Alcohol and Addiction Studies; Brown University School of Public Health and Alpert School of Medicine. USA.

2. Philippe Arvers — MD. Addiction & Tobacco Specialist, Army Medical Center (CMA); Administrator, Francophone Tobacco Society (SFT); Associate Researcher, University of Grenoble Alpes & University of Savoie Mont-Blanc. France.

3. Marcin Bąder — Head of the Clinical Research Support Center. National Institute of Medicine, Ministry of Interior and Administration. Poland.

4. Anastasia Barbouni — MD, MSc, PhD. Professor of Public Health, Hygiene & Disease Prevention. Vice President Department of Public & Community Health School of Public Health, University of West Attica. Greece.

5. Fabio Beatrice — MD. Professor Emeritus of Otolaryngology, Hospital San Giovanni Bosco; Scientific Board Director Medical Observatory on Harm Reduction, (MOHRE). Italy.

6. Carolyn Beaumont — GP, FRACGP, MD, DipChildHealth, BMedSci (Dist.), Tobacco harm reduction clinician, educator and public speaker. Australia.

7. Pavel Bém — MD, PhD. Addictology Clinic, Charles University; Former Mayor of Prague. Czech Republic.

8. György Bodoky — Prof. Dr. Clinical oncologist. St. László Hospital, Dept. of Oncology. Hungary.

9. John Britton — Emeritus Professor, Former Director of the UK Centre for Tobacco and Alcohol Studies, Former Chair of the Royal College of Physicians Tobacco Advisory Group, and member of the board of trustees of Action on Smoking and Health. University of Nottingham. UK.

10. Hugo Caballero Durán — MD Former president of the Colombian Society of Pneumology. Former Clinical Scientific Director of Marly Clinic. Director of the Pneumology and Respiratory Therapy Service, Marly Clinic Bogotá. Colombia.

11. Salvatore Chirumbolo — PhD. Professor, Department of Engineering for Innovation Medicine, University of Verona. Italy.

12. Alice Alberta Cittone —Dental Hygienist, Myoralcare app project manager Scientific Director, Inter-Parliamentary Group on Lifestyles and Risk Reduction. Turin. Italy.

13. Manuel País Clemente — MD, PhD. Retired Full Professor Department of Otorhinolaryngology, Porto University School of Medicine, Vice-President European Medical Association. President World Voice Consortium, Portugal. International Association on Smoking Control and Harm Reduction (SCOHRE) Founding member. Portugal.

14. Kenneth Michael Cummings — PhD, MPH Professor of Psychiatry & Behavioral Sciences, and co-director Tobacco Research Hollings Cancer Center, Medical University of South Carolina, Charleston. USA

15. Ole Davidsen — MD. Specialist in Geriatrics & Internal Medicine. Denmark.

16. Izabella Dessoulavy-Gładysz — CEO, Mental Power- Brain Health Foundation. Poland.

17. Carmen Escrig — PhD. Genetics & Cell Biology, Autonomous University of Madrid. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) Founding member. Spain.

18. Sharifa Ezat Wan Puteh — Professor of Hospital Management and Health Economics; Deputy Dean (Relation & Wealth Creation), Faculty of Medicine, UKM Medical Centre; Previous Head of International Centre for Casemix and Clinical Coding (ITCC), UKM Medical Centre, Malaysia.

19. Karl Fagerström — PhD, Lic. Psych. Professor Emeritus; President, Fagerström Consulting. International Association on Smoking Control and Harm Reduction (SCOHRE) Founding member. Sweden.

20. Andrzej M. Fal — Dr. Professor of Medicine. President, Polish Society of Public Health. Poland.

21. Konstantinos Farsalinos — MD, MPH, PhD. Researcher, University of Patras & University of West Attica; Vice-President, International Association on Smoking Control and Harm Reduction (SCOHRE). Greece.

22. Fernando Fernández Bueno — MD. Oncological surgeon at the Hospital Central de la Defensa Gómez Ulla. Professor at the University of Alcalá de Henares Madrid. International Association on Smoking Control and Harm Reduction (SCOHRE) Founding member. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) Founding member. Spain.

23. José Mª García Basterrechea — MD. Associate Professor of Medicine, University of Murcia; Former Head, Addiction & Dual Pathology Unit, Reina Sofía Hospital. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

24. José David García Muñiz — MD, PhD. Clinical Pharmacology & Internal Medicine; Clinical Trials Coordinator & Principal Investigator, University Hospital of Ceuta. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

25. Guillermo González Balmaseda — MD. Specialist in Psychiatry, Madrid. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

26. Miguel de la Guardia — PhD. Professor of Analytical Chemistry, University of Valencia. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

27. Carlos Gutiérrez Rodríguez — MD. Specialist in Intensive Care Medicine. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

28. Peter Hajek — PhD. Professor of Clinical Psychology, Wolfson Institute of Population Health, Queen Mary University of London. UK.

29. Wayne Hall — PhD. Emeritus Professor, National Centre for Youth Substance Use Research, University of Queensland. Australia.

30. Eszter HALMY —PhD, MSc Obesity researcher, health services manager. President of the Hungarian Society for Study of Obesity. Hungary.

31. Ignatios Ikonomidis — MD, PhD, FESC, Professor of Cardiology, Member of EACVI, ex. Nucleus member of ESC WG on Aorta & Peripheral Vascular Diseases, Director of Echocardiography and the Laboratory of Preventive Cardiology, 2nd Cardiology Department, National and Kapodistrian University of Athens, Attikon Hospital, Athens. International Association on Smoking Control and Harm Reduction (SCOHRE) Board President. Greece.

32. Martin Jarvis — Emeritus Professor of Health Psychology. University’ College London. UK.

33. Martin Juneau — MD, MPSc, FRCP(C), FACC. Cardiologist; Director, Observatoire de la Prévention, Montreal Heart Institute; Maître de Clinique, Faculté de Médecine, Université de Montréal. Canada.

34. Māris Jurušs — PhD. OEC. Associate Professor, Riga Technical University. Latvia.

35. Piotr Karniej — PhD. Assistant Professor, WSB Merito University, Wrocław; Collaborating Researcher, University of La Rioja. Poland/Spain.

36. Joe Kosterich — M.B.B.S WA State Medical Director for IPN, Clinical Editor of Medical Forum Magazine and Vice Chairman of the Arthritis and Osteoporosis Association of WA Perth West Australia.

37. Lynn T. Kozlowski — PhD. Professor Emeritus & Dean Emeritus, School of Public Health & Health Professions, University at Buffalo, State University of New York. USA.

38. Jacques Le Houezec — PhD. Scientist & Smoking-Cessation Specialist; Manager, Amzer Glas – CIMVAPE, training and certification organisation. France.

39. Manuel Linares Abad — PhD. Nurse Specialist in Obstetrics & Gynecology; Former Dean, Faculty of Health Sciences, University of Jaén. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

40. Karl E. Lund — PhD. Senior Researcher, Norwegian Institute of Public Health. International Association on Smoking Control and Harm Reduction (SCOHRE) Board Vice President. Norway.

41. Olivia Maynard — PhD. Associate Professor, School of Psychological Science, University of Bristol. UK.

42. Bernhard-Michael Mayer — PhD. Professor of Pharmacology, University of Graz. Austria.

43. Garrett McGovern — MD. GP specialising in Addiction Medicine; Medical Director, Priority Medical Clinic, Dublin. Ireland.

44. Colin P. Mendelsohn — MB BS (Hons). Tobacco Treatment Specialist; Founding Chairman, Australian Tobacco Harm Reduction Association (ATHRA). Sydney. Australia.

45. Fares Mili — MD, CTTS. Pulmonologist & Addictologist; Chairman, Tunisian Society of Tobacology and Addictive Behaviors (STTACA). International Association on Smoking Control and Harm Reduction (SCOHRE) Board Member. Tunisia.

46. Kristina Mitikj — PhD, DDS. Professor, Faculty of Dentistry, Ss. Cyril and Methodius University. North Macedonia.

47. Vincenzo Montemurro — MD. Cardiology and Internal Medicine. Head of the Cardiology Service of the CDC “Scilla d’America” (ASP Reggio Calabria) Scilla, National Secretary of the “We Are the Heart” Foundation of the S.I.C. (Italian Society of Cardiology). Italy.

48. Viktor Mravčík — MD, PhD, Assoc. Prof. Vice-chairman of the board of the Society for addictive diseases of the Czech Medical Association, Scientific advisor to national drug coordinator, head of research and innovations, Spolecnost Podane Ruce. Czech Republic.

49. Maddu Narendra — PhD. Assistant Professor, Department of Biochemistry, Sri Krishnadevaraya University. India.

50. Ethan Nadelmann — JD, PhD. Founder & former Executive Director, Drug Policy Alliance. USA.

51. Joel L. Nitzkin — MD, MPH, DPA. CEO & Principal Consultant, JLNMD Consultants, New Orleans, LA. USA.

52. Fredrik H. Nystrom — MD, PhD. Professor of Internal Medicine, Linköping University. Sweden.

53. David Nutt — Prof. DM FRCP FRCPsych FBPhS FMedSci DLaws. Professor of Neuropsychopharmacology, Imperial College London. UK.

54. Marko Ölluk — MD. Clinical Lead, Confido Health Centre; Family Practitioner. Estonia.

55. Fiona Patten — former Member of Parliament Victoria Australia. Harm Reduction speaker.

56. Uladzimir Pikirenia — MD, PhD, Psychiatrist, Psychiatric Hospital in Frombork, Frombork, Poland.

57. Wolfgang Popp — MD. Professor. Pulmonologist. Vienna. Austria.

58. Marek Postula — MD, PhD. CEO, Polish Society of Longevity Medicine; Medical University of Warsaw. Poland.

59. Hernán Prat — MD. Professor, University of Chile; Former Director Cardiovascular Department, Clinical Hospital of the University of Chile. Former President, Chilean Society of Hypertension. Chile.

60. Josep Maria Ramon Torrell — MD, PhD. Professor of Epidemiology & Public Health; Tobacco Prevention Service, Bellvitge Hospital, University of Barcelona. Spanish Medical Platform for Tobacco Harm Reduction (PRDT) member. Spain.

61. Solomon Rataemane — Prof. Independent Psychiatrist. Former Chairman of Department of Psychiatry Sefako Makgatho Health Sciences University. Africa regional Rep. World Association for Psychosocial Rehabilitation. Chair: Ministerial Advisory Committee on Mental Health. International Association on Smoking Control and Harm Reduction (SCOHRE) Founding member. South Africa.

62. Dimitri Richter — MD. Cardiologist, FESC. Head of Cardiac Department, Euroclinic; Vice-President, Hellenic Heart Foundation. International Association on Smoking Control and Harm Reduction (SCOHRE) Founding member. Greece.

63. Randall Rodríguez Obando — MD. Specialist in Internal Medicine & HIV Harm Reduction. Costa Rica.

64. Brad Rodu — Professor of Medicine; Endowed Chair in Tobacco Harm Reduction Research, University of Louisville, Louisville, KY. USA.

65. Benjamin Rolland —Prof. Psychiatre, Addictologue Pôle MOPHA (Médecine-Odontologie-Pharmacie-Addictologie), CH Le Vinatier Service Universitaire d’Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier Service d’Accompagnement Médical des Centres de Rétention Administrative Lyonnais (SAMCRAL), Hospices Civils de Lyon. France.

66. Louise Ross — Stop-Smoking Lead, Smoke Free Digital; Former Manager, Leicester Stop Smoking Service. UK.

67. Christos Savopoulos — Professor of Internal Medicine. Director of 1st Medical Propedeutic Dept of Internal Medicine & Stroke Unit, Excellence Center of Hypertension AHEPA University Hospital. Thessaloniki. Greece.

68. Rohan Savio Sequeira — Prof. Dr. MD PhD Endocrine (HARVARD – USA) Consultant Cardio-Metabolic Physician. Specialist in Non-Invasive Cardiology, Diabetes, Endocrinology and Obesity Management Hon. Consultant Physician to the Governor of Maharashtra Professor and Head of the Department of Geriatric Medicine: Sir JJ Group of Govt Hospitals and Grant Govt Medical College. India.

69. Evangelos Sdogkos — MD. Director of Cardiology, General Hospital of Veroia. Greece.

70. Andrzej Sobczak — PhD Professor. Head of Department of General and Inorganic Chemistry Faculty of Pharmaceutical Sciences in Sosnowiec Medical University of Silesia Katowice. Poland.

71. Ranko Stevanović — MD, PhD. President, Croatian Society for Pharmacoeconomics and Health Economics; Croatian National Institute of Public Health. Croatia.

72. Roberto A Sussman — PhD. Institute for Nuclear Research, National Autonomous University of Mexico, ICNUNAM.

73. David T. Sweanor — JD. Chair of the Advisory Board, Centre for Health Law, Policy & Ethics, University of Ottawa; Legal Counsel, Non-Smokers’ Rights Association (1983-2005). Canada.

74. Andrzej W. Szawlowski — Prof. MD, PhD, FACS. Oncologic Surgeon, Warsaw. Poland.

75. Ingrid D. Taricano — Prof. PhD. Independent toxicologist. São Paulo. Brazil.

76. Enrique Terán — MD, PhD. Professor, College of Health Sciences, Universidad San Francisco de Quito. Ecuadorian Academy of Medicine. Academy of Science of Ecuador. Ecuador.

77. Umberto Tirelli — Prof. Scientific and Health Director Tirelli Medical Group Clinic. Specialist in Oncology, Hematology and Infectious Diseases. Italy.

78. Philip Tønnesen — MD. Specialist in Pulmonary Medicine; Expert in smoking cessation. Senior Consultant, Søernes Privathospital. Denmark.

79. Francisco E. Urresta — MD. Medical Director, Hospital Clínica Metropolitana, Ibarra. Ecuador.

80. Diego Verrastro — MD. Independent Specialist in Obesity and Emergency Medicine Surgeon. Argentina.

81. Kenneth E. Warner — PhD. Distinguished University Professor Emeritus & Dean Emeritus, University of Michigan School of Public Health. USA.

82. Alex Wodak — AM, FRACP, FAChAM. Emeritus Consultant, St Vincent’s Hospital, Sydney, Australia.

83. Dirk Ziebolz — Prof. Dr. M.Sc. Dental, Oral & Maxillofacial Surgery Specialist. Germany.

Signatory Entities:

• ETHRA — European Tobacco Harm Reduction Advocates. EU Transparency Register: 354946837243-73
• MOHRE — Medical Observatory on Harm Reduction. Via Tomba di Nerone 14, 00189 Rome. Italy. https://mohre.it/
• PRDT — Spanish Medical Platform for Tobacco Harm Reduction. EU Transparency Register: 166296541422-35
• SCOHRE — International Association for Smoking Control and Harm Reduction, Michel Ange 12, B-1000 Brussels, Belgium.
• Tobacco Harm Reduction, Inc. (THR101) — Registered 501(c)(3) nonprofit organization dedicated to promoting public health through science-based education, research, and advocacy. Florida, USA

NR/HN