The Growing Tobacco Epidemic in Pakistan

Tobacco use is a growing epidemic in Pakistan, with severe implications for public health, economic stability, and social development. Despite numerous global and national initiatives aimed at curbing tobacco consumption, Pakistan continues to grapple with this issue. The situation is exacerbated by the easy availability of tobacco products, ineffective enforcement of regulations, and aggressive marketing strategies employed by tobacco companies. This blog delves into the rising tide of tobacco consumption in Pakistan, its multifaceted impact on society, and the urgent need for stronger policies and collective efforts to curb the epidemic.

Tobacco Use in Pakistan: Alarming Statistics

Pakistan is home to over 31 million tobacco users, making it one of the largest consumers of tobacco in the world. According to the Pakistan Demographic and Health Survey (PDHS), 19.1% of adults aged 15 and older use tobacco in some form. Among men, the prevalence is much higher, with over 31% of adult males consuming cigarettes or smokeless tobacco products. Women, though less likely to smoke cigarettes, contribute significantly to the consumption of smokeless tobacco, particularly in rural areas where awareness of the risks is limited.

A disturbing trend is the rise in smoking among young people. Around 1,200 children between the ages of 6 and 15 start smoking every day in Pakistan. With such trends, the long-term consequences for public health are alarming, as tobacco-related diseases are likely to increase in the coming decades.

The Health Burden

Tobacco use in Pakistan is a leading cause of preventable deaths. It is responsible for over 160,000 deaths annually, with diseases such as cardiovascular disorders, chronic respiratory conditions, and various cancers being closely associated with tobacco consumption. Smoking, in particular, is linked to lung cancer, which is on the rise in Pakistan, especially among younger populations.

Smokeless tobacco (SLT) is another growing concern. Chewing tobacco, pan, and gutka are commonly consumed, particularly in lower socioeconomic classes. These products are just as harmful as smoking cigarettes, often leading to oral cancers and other serious health conditions. Many users mistakenly believe SLT is a safer alternative to smoking, but evidence suggests otherwise. SLT products are highly addictive, and their prolonged use leads to a range of debilitating health issues, including oral and esophageal cancers.

Economic Consequences

The tobacco epidemic in Pakistan not only places an immense strain on the healthcare system but also hampers economic development. Tobacco-related diseases cost the country billions in healthcare expenditures and lost productivity each year. According to a World Health Organization (WHO) report, the economic burden of smoking in Pakistan exceeds USD 3.85 billion annually, far outweighing the revenue generated through tobacco taxation.

Furthermore, the medical costs associated with treating tobacco-related illnesses disproportionately affect low-income families, who are already burdened by poverty and inadequate access to healthcare services. Tobacco consumption in these households diverts a significant portion of the family income away from essential needs such as education, nutrition, and housing, exacerbating the cycle of poverty.

The Role of the Tobacco Industry

The tobacco industry in Pakistan is a powerful entity, with multinational corporations and local producers alike playing a significant role in shaping the landscape of tobacco consumption. These companies employ aggressive marketing strategies to target vulnerable populations, including youth and women, through colorful packaging, promotional offers, and advertisements that glamorize smoking and tobacco use.

Despite the existence of regulations aimed at controlling tobacco marketing, enforcement remains weak. Pakistan has ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC), which mandates the implementation of measures to reduce tobacco demand and supply. However, the industry’s influence often undermines these efforts, as loopholes in the law allow for continued advertising and promotional activities in certain forms.

Challenges in Regulation and Enforcement

Pakistan has taken some steps to address the tobacco epidemic. The Ministry of Health and other regulatory bodies have introduced laws that mandate health warnings on cigarette packaging, restrict smoking in public places, and ban tobacco advertising on electronic and print media. Yet, enforcement remains a significant hurdle.

Graphic Health Warnings (GHWs), which cover 60% of cigarette packages, have shown some impact, but the tobacco industry continues to exploit legal loopholes. Moreover, the sale of loose cigarettes remains widespread, making tobacco products easily accessible to minors. Another issue is the availability of low-cost cigarettes, which undermines the effect of tobacco taxes in reducing consumption.

The Way Forward: Urgent Reforms and Collective Action

The growing tobacco epidemic in Pakistan requires a multi-faceted approach, involving stronger regulations, effective enforcement, public awareness campaigns, and international collaboration. Some key steps to consider include:

Strengthening Tobacco Taxation

Increasing taxes on tobacco products can discourage consumption, particularly among low-income populations and young people. Currently, the tax system in Pakistan is not stringent enough, with many low-cost tobacco products still easily accessible. Higher taxes would not only reduce consumption but also generate additional revenue that could be allocated to public health programs.

Expanding Health Warnings

The existing health warnings on tobacco products should be expanded to include larger and more graphic images, and strict penalties should be enforced against companies that fail to comply.

Addressing Smokeless Tobacco

Awareness campaigns specifically targeting SLT users are essential, as there is a widespread misconception that SLT is less harmful than smoking. Regulations should also extend to SLT products, with taxes and health warnings similar to those imposed on cigarettes.

Youth-Focused Initiatives

Educating young people about the dangers of tobacco use through school-based programs and social media campaigns can play a pivotal role in reducing initiation rates among youth. Stricter controls on the sale of loose cigarettes and greater penalties for vendors selling to minors are crucial.

International Collaboration

Pakistan must continue to work with global bodies like WHO and neighboring countries to tackle the cross-border challenges of tobacco control, including illicit trade and smuggling.

Conclusion

Tobacco is an epidemic that Pakistan can no longer afford to ignore. The country’s rising consumption rates, coupled with weak enforcement of existing regulations, call for urgent and coordinated action. By implementing stronger policies, improving enforcement mechanisms, and educating the public, Pakistan can begin to reverse the tide of tobacco-related illness and death, moving towards a healthier and more prosperous future for its citizens.

This article is written by Radma Nouman. Radma is a research analyst at IMARAT Institute of Policy Studies (IIPS).