The Tobacco Epidemic
Over 22 million people (20% of adults) in Pakistan smoke tobacco. 32% of men and 6% of women smoke. However, smokeless forms of tobacco, such as paan, ghutka and naswar, are also popular. More than 1 in four young people (aged 13-15) are exposed to second-hand smoke in their homes.
15% of male deaths and 1% of female deaths are related to tobacco use and exposure. Around 110,000 people die annually from tobacco-related diseases in Pakistan.
Policies in Place
Pakistan became party to the WHO Framework Convention on Tobacco Control (FCTC) in 2005.
There are two main pieces of tobacco control legislation: the Cigarettes (Printing of Warning) Ordinance, 1979 and the Prohibition of Smoking in Enclosed Places and Protection of Non-smokers Health Ordinance, 2002. Nearly twenty additional ordinances and amendments have been passed since 2002, clarifying and strengthening tobacco control. These national laws:
• Prohibit smoking in all places of public work or use, including public transport and outdoor waiting areas for transport. Smoking is permitted in hotel guest rooms.
• Bans some advertising, including on domestic TV, radio, billboards, and in print media. Most other forms of advertising and promotion are allowed.
• Require a pictorial and text health warning on 85% of smoked tobacco product packaging, with text on the front in Urdu and text on the back in English. Warnings on smokeless tobacco products are not required.
• Allow sub-national regulations that are stricter than the national law.
In 2008, The Union worked with the Ministry of Health in Pakistan to establish a government Tobacco Control Cell responsible for tobacco control nationally. The Union continues to work with the National Tobacco Control Cell and civil society (and with the Ministry of Health at sub-national level) to improve graphic health warnings and expand bans on advertising, promotion and sponsorship. The Union is also supporting a project to implement Smokefree Islamabad.
The Tobacco Control Cell has formed a technical working group on tobacco taxation. It includes representatives from The Union, WHO, World Bank and other stakeholders. The working group has been tasked to review existing tobacco tax structure and devise a mechanism to increase taxes on tobacco products in line with FCTC recommendations including earmarking of tobacco tax revenues for tobacco control measures. Tobacco Control Cell will be focal point for this initiative.