Islamabad:Despite a steady global decline in smoking, Pakistan remains far from meeting international tobacco reduction targets as weak taxation, poor enforcement of laws, and at times the apparent connivance of officials with tobacco companies continue to undermine national control efforts, public health experts said on Monday.
Global tobacco use has fallen sharply over the past two decades, but Pakistan’s smoking rates have barely moved. The country is still not on track to meet the global goal of cutting tobacco use by 30 percent by 2025, largely due to policy inconsistency, industry influence, and institutional complacency.
Public health experts warn that without stronger political commitment, Pakistan will continue to face growing health and economic costs linked to smoking. “Whenever serious tax measures are proposed, they are softened or delayed under pressure,” said Dr. Khurram Shahzad, a senior public health official. “This gives the industry the space it needs to thrive while the health system bears the burden.”
Pakistan, which ratified the WHO Framework Convention on Tobacco Control in 2004, still has one of the region’s weakest taxation systems. Excise duty covers only about 60 percent of the retail price of cigarettes, far below the 75 percent benchmark recommended internationally. A pack of 20 cigarettes can still be bought for less than Rs200 in most cities, keeping tobacco easily affordable and widely accessible.
Health authorities estimate that more than 25 million adults in Pakistan use tobacco regularly and around 160,000 people die each year from smoking-related diseases such as heart disease, cancer, and chronic respiratory illness. The annual economic cost of tobacco use exceeds Rs 600 billion, several times higher than the revenue collected from tobacco taxes.
“Tobacco is also an environmental hazard. Farming and processing tobacco contributes to air pollution through deforestation and release of polluting substances, whilst smoking pollutes the air around the smoker and bystanders,” said Dr Saima Saeed, Head of Pulmonology and Director of the Lung Health Program at the Indus Hospital and Health Network.
“For a holistic approach to tobacco control, we need to incentivise safer agricultural practices to protect both Pakistan’s health and environment.” Tobacco use remains particularly high among men in South and Southeast Asia, including Pakistan, India, and Bangladesh, where nearly half of all adult males still smoke or use tobacco in some form. Despite gradual declines, population growth and poor enforcement have prevented significant overall progress.
In contrast, countries in Africa and the Americas are close to meeting or surpassing their targets through higher taxes, strict advertising bans, and strong implementation of anti-smoking laws.
While Pakistan has laws banning smoking in public places and restricting tobacco advertising, enforcement remains lax. Cigarette vendors frequently sell to minors, and promotional displays remain common in shops across the country. Health officials concede that limited monitoring capacity and industry interference have allowed widespread violations.
The growing use of e-cigarettes and smokeless tobacco among teenagers has further complicated the problem. Surveys show that more than one in ten adolescents aged 13 to 15 now use some form of tobacco, reflecting a serious failure in youth-focused regulation and awareness.
“Tobacco control cannot work without political ownership,” said Dr. Shahzad. “Raising prices, stopping industry interference, and enforcing existing laws are the only ways forward.” Globally, the number of tobacco users has declined from about 1.36 billion in 2000 to 1.24 billion in 2022, but more than 80 percent of smokers still live in low and middle income countries, including Pakistan. Unless decisive steps are taken soon, experts fear that tobacco use among Pakistani men will remain close to 30 percent by 2030, far above global averages and well short of national health targets.
