Nearly half of Pakistani adolescents exposed to cigarette smoke: study

Islamabad : An alarming 47.1% of Pakistani adolescents are exposed to cigarette smoke at home, while 63.7% encounter it in their communities, a groundbreaking survey has revealed.

The study, conducted between December 2023 and May 2024 by the Tobacco and Nicotine Use Among Adolescents of Pakistan (TAP) initiative, exposes a troubling picture of tobacco and nicotine abuse among children and teenagers in the country.

The survey was carried out by locally hired research teams, including 35 research assistants, across nine districts in all provinces and the Islamabad Capital Territory. These figures underscore the urgent need for stronger enforcement of regulations and public health interventions to protect the younger generation from the long-term harms of addiction. The study, which surveyed 14,232 adolescents across 10 districts, including Islamabad, Karachi, and Quetta, highlighted the use of various tobacco and nicotine products. Among the respondents, 3.9% reported using e-cigarettes, 3.2% consumed nicotine pouches, 2.4% used smokeless tobacco, and 1.6% smoked cigarettes. Alarmingly, nearly half of the boys (49.1%) and a third of the girls (32.3%) could purchase these products within a five-minute walk from their homes.

Peer influence plays a significant role in tobacco use among adolescents. The study found that 16.2% of respondents had friends who smoked, while 15.5% had peers using smokeless tobacco. Additionally, 6.5% had friends who used e-cigarettes, and 5.8% reported peers using nicotine pouches. This highlights the need for community-driven awareness campaigns targeting peer pressure and social norms.

The widespread availability and marketing of tobacco products exacerbate the problem. Tobacco products are often placed next to snacks and sweets in retail outlets, making them more appealing to children. Furthermore, the study found that plain packaging was perceived as less attractive by 69.9% of respondents, suggesting that mandatory plain packaging could reduce the appeal of such products.

The health consequences of early nicotine addiction are profound. Adolescents who use tobacco and nicotine products are at greater risk of respiratory problems, cardiovascular diseases, and long-term dependency. The economic burden on Pakistan’s healthcare system is equally concerning, with tobacco-related illnesses requiring significant medical resources and increasing healthcare costs. Despite existing laws banning tobacco sales near schools and to minors, enforcement remains inadequate. The study stresses the need for stricter implementation of the 50-meter ban on sales near schools and the prohibition of single cigarette sales. Novel nicotine products such as e-cigarettes and nicotine pouches also require urgent regulatory attention, including advertising restrictions and age limits for purchase.

Prof. Shahzad Ali Khan, a public health expert, and Vice Chancellor of Health Services Academy (HSA) Islamabad emphasised the severe impact of tobacco use on health and the growing disease burden in Pakistan.

“Tobacco use is one of the leading causes of preventable diseases and deaths globally, and Pakistan is no exception. It is linked to a range of chronic conditions, including lung cancer, cardiovascular diseases, and chronic obstructive pulmonary disease (COPD). The alarming rates of tobacco use among our youth not only jeopardize their health but also strain an already burdened healthcare system. The younger generation is particularly vulnerable, as early exposure to tobacco often leads to lifelong addiction and associated health complications.”

Prof. Khan further highlighted the need for comprehensive tobacco control measures. “Strong enforcement of existing regulations, along with targeted awareness campaigns, can go a long way in curbing the tobacco epidemic. Policymakers must also address the growing popularity of novel nicotine products, which pose a new challenge to public health efforts. Investments in prevention and education will yield significant long-term benefits for the health and well-being of our population.”