Muhammad Omer was sitting at a dhaba in Islamabad to enjoy fresh air and a cup of tea when two sales representatives of a cigarette company approached him to advertise a brand of light-cigarettes by a tobacco company. Knowing that marketing of cigarettes is banned in Pakistan, he was shocked.

The young people of Pakistan are being targeted by the tobacco industry through different means, despite the fact that tobacco use is the single largest cause of death in the world. In Pakistan, there are around 110,000 deaths every year and almost 300 die every day due to tobacco use. According to figures of the ministry of national health regulations of Pakistan, as many as 1,200 children between 6-15 years of age start smoking every day. Smoking causes cancer while non-smokers become victim of cardiovascular disease because of passive smoking.

According to Global Adult Tobacco Survey (GATS) 2014, almost 24 million (19.1 per cent) adults currently use tobacco. That accounts for 15.6 million (12.4 per cent) adults who currently smoke tobacco, including 3.7 million adults using hookah or sheesha and another 9.6 million (7.7 per cent) adults who use smokeless tobacco. Most of the addicted people are exposed to tobacco smoke at workplace.

The GATS is a global standard for systematically monitoring adult tobacco use and tracking tobacco control indicators.

Pakistan, according to the tobacco industry claims, produces 82 billion cigarettes in a country where almost one fourth of population inhales tobacco. The average amount spent on a pack of 20 cigarettes is around Rs40.9. Out of 82 billion sticks, as many as 18 billion are counterfeit and one billion smuggled or non-duty paid.

"Controlling tobacco under the national laws and international treaties is the issue of enforcement rather than awareness," says Nadeem Iqbal, Executive Coordinator, The Network, a non-government organisation working on consumer rights and tobacco control.

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He says Pakistan is among the top 40 countries that signed international treaties to take measures to control tobacco production and sale. "Over the years we have seen the campaign to control tobacco progress in Pakistan. Though the strategies are slow, they are gradually showing results," he says, giving the example of Islamabad city where it is difficult to find cigarettes in shops within 50 metres radius of schools.

Iqbal adds, "There is no proper policy in the country to control tobacco. Though there have been some efforts in the past. Following the 18th amendment, with the devolving of health ministry, Islamabad has a role in policy making but enforcement is purely a provincial subject. The federal government has the exclusive domain to bring laws in accordance with signed international treaties."

The first law on tobacco selling in Pakistan was passed in 1958, called the Pakistan Vendors Act. In 1979, Pakistan introduced Cigarette (Printing of Warning) Ordinance. And in 2002, the government came up with the Prohibition of Smoking and Protection of Non-smokers Health Ordinance, 2002. It signed the Framework Convention on Tobacco Control (FCTC) in 2004 and ratified it the same year.

The government also created the National Tobacco Control Cell in 2007. The FCTC is the first international treaty to provide a framework (and attendant obligations) for tobacco regulations. Under Article 5.2 of the FCTC, the parties to the said treaty are mandated to put in place proper and effective national coordination mechanism for multi-sectoral coordination of tobacco control efforts.

"There have been many steps to control tobacco after the FCTC for which Pakistan submits a bi-annual report to the World Health Organisation (WHO)," says Muhammad Javed, a senior official working in the tobacco control cell of the federal government.

"There are many steps to stop promotion and selling of tobacco and creating awareness. However, there are issues regarding the taxation," he informs.

According to the FCTC, he says, "there should be 75 per cent Federal Excise Duty (FED) on a pack of cigarettes which is around 50 per cent at the moment. The government and the tobacco industry are in talks on the issue and the matter has been taken to the court by the NGOs working on tobacco control issue," he adds.

According to a survey of The Network conducted in 50 districts of Pakistan, it is observed that most of the shopkeepers are selling cigarettes without getting a No Objection Certificate (NOC) from the government, which is mandatory as per rules defined under the FCTC. The Network has also moved the court regarding slow implementation of rules and less FED on cigarettes despite international commitments.

Nadeem Iqbal says, "It requires more than political will to take speedy steps to control and fulfill global commitments. It is a big issue: it claims generating Rs135 billions in revenue every year."

And this is why the issue is handled by the Ministry of Commerce and Trade and not the national health regulations ministry, Iqbal says, continuing, "The debate is whether the right to trade is more important than the right to life. That is why we have urged the government to focus on enforcement and better coordination with the civil society."

Currently, a law is under consideration in the parliament to broaden rules regarding promotion and advertisement of tobacco on public places but the draft might face opposition because some political stalwarts in the committee are involved in tobacco business.