| E |
arlier this month, the Punjab government decided to ban the sale, purchase and use of vapes, e-cigarettes and nicotine pouches, in a decisive step by Chief Minister Maryam Nawaz Sharif. The Provincial Assembly passed the legislation and authorities swiftly began a crackdown on shops selling vape devices, flavour enhancers and the paraphernalia across the province. A petition filed by shop owners at the Lahore High Court was rejected keeping in view the gravity attached to youth nicotine addiction.
As some readers may recall, this move mirrors earlier efforts to eliminate the sheesha culture in the 2010s — an intervention that followed reported fatalities from the fumes breathed by hookah users. Not only that, sheesha cafés had also developed a reputation for being dens of all sorts of undesirable activities. The crackdown relied on sustained enforcement and public awareness campaigns, successfully shifting the youth away from a harmful addiction and saving hundreds of lives.
In a familiar echo, vaping has emerged since Covid-19, and become increasingly popular, especially among the urban youth. Following the pandemic, the allure of fruity flavours, the promise of stress relief amid academic pressures and social anxiety and the absence of burning odour after consumption has drawn many young adults to vape. Brightly coloured, disposable or reusable vape devices featuring both high and low nicotine concentrations make the ‘hit’ both potent and psychologically appealing.
In Lahore alone, vape stores have popped up in every major market, with online retailers accommodating many customers, including schoolchildren, with the claim that vaping reduces anxiety and improves focus. Unfortunately, this narrative is deeply flawed and misleading.
Global health authorities such as the World Health Organisation concur that vaping is not a safe alternative to smoking. Vaping aerosols contain substances such as formaldehyde, acetaldehyde and acrolein, besides other volatile organic compounds of which many are classified as carcinogenic by the International Agency for Research on Cancer. Besides, these substances often match or exceed levels found in cigarette smoke. Studies have detected heavy metals such as nickel, cadmium and lead in vaping emissions, all of which are extremely harmful for the human body.
Beyond inhaled toxins, biomedical research has confirmed DNA damage from vaping, including chromosomal breaks and strand mutations. Nicotine itself, although not classified as a direct carcinogen by the IARC, disrupts DNA repair mechanisms, promotes tumor growth in animal subjects, and increases angiogenesis, potentially accelerating cancer progression.
Mixing vaping with other pollutants poses added risks, especially in urban environments like Lahore where air quality is already compromised.
Clinical evidence reinforces these concerns. The severe EVALI outbreak in 2019-2020 triggered over 2,800 hospitalisations and multiple deaths in the US due to contaminated vaping products. Epidemiological research shows increased lung cancer incidence among dual users — those smoking both cigarettes and e-cigarettes.
Some people argue that vaping is less harmful than smoking. While true in the narrow sense of avoiding combustion which creates toxins like tar and carbon monoxide, it is dangerously reductive. At high-voltage settings, formaldehyde and other toxicants can surpass levels found in conventional cigarettes. Moreover, flavoured nicotine pods appeal to the youth. Once ensnared by nicotine addiction, many young users inevitably transition to stronger forms of nicotine (such as cigarettes).
The government’s intent to protect the youth is commendable, but the policy’s structure raises some questions. A blanket prohibition forgoes legitimate control options, forcing many users either into the underground vaping market — with even higher health risks — or back to combustible tobacco, arguably more harmful for public health.
Meanwhile, online stores in Pakistan continue to operate, offering easy access and undermining enforcement. A ban without robust coordination can inadvertently shift the problem rather than solving it.
In regulatory policy worldwide, effective vape control has often followed a phased model. New Zealand, in 2020, implemented a staged programme: limiting flavours, mandating strict packaging rules, enforcing age checks and regulating nicotine strength. Within two years, youth vaping had dropped by over 50 percent. Singapore adopted a similar path — beginning with heavy regulation and culminating in a nicotine e-liquid ban in 2020 — backed by penalties that significantly curbed youth use.
These models show that a rights-based, evidence-informed regulatory approach can reduce youth vaping while preserving harm reduction options for adults seeking smoking alternatives.
A similarly phased ban, including restricting flavoured and sweet e-liquids; capping nicotine concentrations; mandating transparent labelling of ingredients; and licensing vendors could have a more sustainable and effective impact. A multi-year transition period could allow smokers using vaping as a cessation tool to shift gradually, while youth-targeted products were phased out. Simultaneously, public education campaigns — drawing on the successful anti-sheesha playbook — must inform young users and their parents about the risks of vaping, nicotine dependence and long-term health consequences.
The continued operation of online stores in Pakistan suggests enforcement gaps. The law must explicitly cover electronic commerce, with penalties proportional to the public health threat. National legislation can reinforce provincial efforts and ensure broad consistency. Without such a layered framework, enforcement at the point-of-sale alone could falter.
| D |
Despite its flaws, the ban offers an opportunity. Health authorities should set up systems to monitor trends in both vaping and cigarette use among the youth. If cigarette smoking rises among former vapers, the ban may need adjustment to prevent replacing one health hazard with another.
The health system should invest in cessation support: expanding access to nicotine replacement therapy, counselling and mental health services. Moreover, to evaluate vaping’s long-term effects, the ban should be accompanied by strengthened epidemiological surveillance. Linking vape exposure histories with disease data will inform future regulations and health campaigns.
The complexity of nicotine addiction requires an agile public health response. A rigid enforcement-only approach runs the risk of unwanted trade-offs. A nuanced policy that embraces harm reduction science where evidence supports it, while reserving strong restrictions for products likely to harm young people can prove more effective.
Over time, the goal should be a complete phase-out across all age groups — but only when viable cessation support and regulatory pathways are well established.
Success will require more than closure orders: it demands a bridge from prohibition to prevention and cessation, supported by sustained public education, regulatory vigilance and longitudinal research. If we can adopt lessons from New Zealand and Singapore, harness legal tools to shut down online access and balance harm reduction with youth protection, this ban could protect young lungs without sparking a black market rebellion or pushing more teens towards cigarettes.
Ahmed Ahsan is a development sector professional with nearly a decade of experience in communications and reporting.He has supported the implementation of The World Bank’s Disaster and Climate Resilience Improvement Project and ADB’s Flood Emergency Reconstruction andResilience Project in Pakistan