Some smokers start smoking because it’s cool and an easy way to fit in and impress their peers and co-workers. Others smoke to curb their appetite. Still, others consider smoking as a form of rebelling against the older generation and start in a fit of anger or frustration. Another common cause is because of how easily available and affordable cigarettes are.

Smokers may start smoking because of a multitude of reasons, but almost all continue to smoke because cigarettes are addictive. According to a report released by the State Bank of Pakistan on Sept 11, 15.6 million people in Pakistan smoke tobacco. The most likely smoker in the country is male and between the ages of 15-49.

Waris Hameed, a 34-year-old farmer from the village of Chishtian, started smoking when he was 17. He was on his way to the market to buy household necessities when he found half a still-lit cigarette lying on the ground. By the time he reached the market he had finished the cigarette and liked it enough to decide to forego buying the pulses and salt his mother had sent for, and instead buy a pack of K2.

"Daily life was a grind. Following my parent’s rules never got me anywhere. Smoking was the one thing I could do that made me feel powerful. It made me feel like I wasn’t just another impoverished boy who will never get anywhere in life. It was one thing I had in common with Salman Khan or Shahrukh Khan," says Hameed.

Today, he has two young boys, and he doesn’t shy away from smoking in front of them. "I know it’s bad for my health and they shouldn’t think it’s okay to smoke, but it’s the one release I have. I don’t drink, I don’t smoke hashish, if this is the worst side of me, I don’t care if my children are exposed to it."

Intergenerational relationships between smokers and non-smokers are often complicated. Shireen Mahmood, a 27-year-old woman from Islamabad grew up watching her father smoke. When she was 9-years-old her father had a heart attack. She heard from aunts and uncles that this was because he was a smoker. She spent many years coming up with inventive ways to convince him to quit smoking. By the time he quit, Mahmood herself was smoking a pack a day.

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"I started smoking because everyone else at college was doing it. It was what the cool kids did between classes. And over time I continued because it reduced my anxiety about studying," says Mahmood. Like Hameed, Mahmood knows that smoking is not improving her health to say the least. She, in fact, has seen its effects up close and personal. She often tries to quit, she even succeeds temporarily, but up till now she hasn’t been able to kick the habit to the ground.

Another common reason teenagers on the street and in elite households start (and continue) to smoke is to curb their hunger. Muhammad Afzal is a 15-year-old boy who lives on the streets of Lahore. He spends the day collecting recyclable trash that he sells in the evening. With the money he earns, Afzal buys cigarettes and, occasionally when sales are better, he also buys hashish. He shares all his purchases with his father and three friends who live a similar life on the streets.

"The first time I smoked it was because boys from an elite college came in their flashy cars and they gave me cigarettes and told me to try it. I liked the feeling of smoking. It also made me less hungry and I felt like I needed less food if I smoked, so I continued," says Afzal.

Afzal continued smoking because a cigarette is far cheaper than a meal, and he rarely had money to buy himself and his father a satisfying meal of daal roti, but he almost always could procure a couple of cigarettes.

Similarly, Ashraf Hussain, while he was a student at Aitchison who has been overweight most of his life, began smoking at 16 to curb his appetite. "I was too lazy to exercise and someone told me that cigarettes kill your hunger so I began smoking right before lunch and dinner. Before long I was smoking over a pack a day," says Hussain

At 35 years of age Hussain is still overweight and Afzal is still hungry. The only change in their lives is that they are now addicted to cigarettes.

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While men are far more likely to smoke than women, in the last decade or so women have also started viewing smoking as a form of empowerment. This idea is presented in mainstream media in a complicated form. Women who smoke on media are depicted as bold and brave enough to make their own choices. The downside is that they are either portrayed as ‘vamps’ having Western values, or simply disrespectful daughters who will bring the family name to shame by some action of theirs during the course of the story.

"The reason smoking is empowering for females has nothing to do with the cigarette itself, the empowerment comes from the way society views women who smoke," explains Shelha Qayoom, a Karachi-based lecturer who has been a smoker for almost a decade.

"Smoking is associated with ‘bad’ women, someone who doesn’t have the right values. So a cigarette in a woman’s hands isn’t just a rolled up tobacco, it’s a sign that I am a certain type of woman. And the fact that I know that society is judging me, and I continue to hold the cigarette in public, that’s the empowering bit," explains Qayoom. "It’s a brave bold thing to be a woman and smoke in public in this country."

She adds that the fact that smoking is injurious to our health should take away from all the "empowerment" but by the time most smokers realise the health hazards they are already addicted.

There are some women though who like the ideas attached to women who smoke, may even be addicted but can’t afford the luxury of smoking too often.

Mahnoor Khan works in a beauty salon in Gulberg, Lahore and has been smoking for six years. Mahnoor never smokes alone; it’s always with other women who work at the parlour. "We can’t smoke in front of our boss or our parents," says Khan.

She, along with the other workers, smokes during the time when their boss leaves the parlour and the van that drops them home arrives. That small gap of time gives them a chance "to smoke our menthol cigarettes and feel like the rich customers who come and smoke in the parlour without a care in the world, and then we change our clothes so we don’t smell when we reach home."

Pasting health warnings on cigarette packs is a step in the right direction but clearly it’s not enough to prevent people, especially young adults, from trying it out. In the late 1980s and early 1990s PTV ran an advertisement against smoking which featured a healthy Wasim Akram jogging in Lahore’s Model Town Park. Given that every teenager, at that time, memorised its tag line "Main cigarette nahi peeta," and non-smokers still use it to explain why they aren’t socially smoking, it was a commendable move.

But if the government and society is serious about curtailing smokers in the country, a more concerted effort in making cigarettes less easily available, more expensive, and most importantly to change the ‘cool’ image of smokers, is necessary.

All the names in the story have been changed.