Dr. Khalil Ahmad Dogar
Every year on 31 May, the world observes World No Tobacco Day to highlight the devastating consequences of tobacco use and to strengthen global efforts to reduce tobacco related disease and death. This year’s theme, “Unmasking the Appeal – Countering Nicotine and Tobacco Addiction,” shines a spotlight on the tactics employed by the tobacco industry to attract new users, particularly children and youth, through flavored products, deceptive marketing, attractive packaging, and the promotion of emerging nicotine products.
The urgency of this year’s message cannot be overstated. According to the World Health Organization (WHO), tobacco kills more than 8 million people annually, including approximately 1.3 million non-smokers who die from exposure to second hand smoke. This translates into nearly 22,000 preventable deaths every day. Tobacco remains one of the leading causes of cancer, heart disease, stroke, chronic respiratory illnesses, and other non-communicable diseases that place immense pressure on health systems and economies worldwide.
Pakistan is not immune to this crisis. Tobacco use claims more than 192,000 Pakistani lives every year over 526 deaths every day. Beyond these tragic figures lies an equally alarming reality: nearly 1,200 children between the ages of 6 and 15 start smoking every day as a replacement smoker. For many of these children, early nicotine exposure leads to lifelong addiction, poor health outcomes, reduced educational attainment, and diminished economic opportunities. Meanwhile, millions of children continue to suffer from second-hand smoke exposure, increasing their risk of asthma, pneumonia, ear infections, low birth weight, and sudden infant death.
The burden of tobacco extends far beyond public health. Pakistan incurs an estimated economic cost of nearly Rs. 1,835 billion (1.6 % of GDP) annually due to tobacco related illnesses, healthcare expenditures, lost productivity, and premature mortality. These costs far exceed the revenue generated from tobacco taxes and represent a significant drain on national development. Every rupee spent treating preventable tobacco related diseases is a rupee diverted from education, infrastructure, social protection, and economic growth.
Recognizing the scale of the challenge, Pakistan became one of the early signatories to the WHO Framework Convention on Tobacco Control (FCTC), the world’s first international public health treaty. The FCTC provides a proven roadmap for reducing tobacco consumption through evidence based measures, including higher tobacco taxes, smoke-free environments, comprehensive advertising bans, strong health warnings, cessation support, and protection from tobacco industry interference.
Since ratifying the FCTC, Pakistan has made notable progress through implementation of the WHO MPOWER package. Smoke-free laws have been introduced in public places and public transport, tobacco advertising restrictions have been strengthened, sales to minors have been prohibited, and pictorial health warnings covering 60 percent of cigarette packs have been implemented. Recent increases in tobacco taxation have also contributed to higher revenues and reduced consumption. These achievements demonstrate that effective tobacco control policies can save lives while generating resources for national development.
However, progress should not be mistaken for completion. Pakistan continues to lag behind international best practices in several critical areas. Graphic health warnings remain below the WHO recommended standard of at least 85 percent of tobacco packaging. Cigarettes remain relatively affordable for many consumers, particularly children and youth, due to insufficient taxation and the availability of low cost tobacco products. Sustainable domestic financing for tobacco control programs remains limited, constraining public awareness campaigns, cessation services, research, and enforcement efforts.
Equally concerning is the incomplete enforcement of comprehensive bans on Tobacco Advertising, Promotion and Sponsorship (TAPS). Tobacco industry continue to exploit digital platforms, social media, point of sale displays, and indirect promotional strategies to reach young audiences. As marketing techniques evolve, regulatory responses must evolve as well.
The rapid emergence of new nicotine products presents another significant challenge. E-cigarettes, heated tobacco products, nicotine pouches, and other novel nicotine delivery systems are increasingly being promoted as modern alternatives, often through youth oriented marketing. Yet these products contain addictive nicotine and can serve as gateways to long term dependence. Pakistan urgently requires a comprehensive regulatory framework that addresses the sale, marketing, taxation, packaging, and public use of all emerging nicotine and tobacco products.
World No Tobacco Day is more than a symbolic observance; it is a call to action. The Government of Pakistan must strengthen tobacco taxation to reduce affordability, increase the size of graphic health warnings, fully enforce bans on Tobacco Advertising, Promotion, and Sponsorship (TAPS), regulate emerging nicotine and tobacco products, expand tobacco cessation services, and establish sustainable funding mechanisms for tobacco control initiatives. At the same time, government institutions, civil society organizations, healthcare professionals, educators, parents, and the media must work together to protect children and youth from nicotine addiction and the influence of the tobacco industry.
The tobacco epidemic is neither inevitable nor irreversible. The solutions are known, evidence based, and cost effective. What is required now is the political will to implement them fully. On this World No Tobacco Day, Pakistan has an opportunity to reaffirm its commitment to the FCTC, accelerate implementation of MPOWER measures, and place the health and future of its people especially its children above the interests of an industry whose profits depend on addiction.
The choice is clear: either continue to bear the enormous human and economic costs of tobacco use or take decisive action to build a healthier, more prosperous, and tobacco-free Pakistan.
(The writer is a public health advocate and working as a Program Manager at Society for the Protection of the Rights of the Child (SPARC)
