Tobacco control: Bridging the gap from awareness to action

Despite decades of tobacco control, smoking remains one of the most persistent public health threats in Pakistan. While awareness campaigns have succeeded in highlighting the dangers of tobacco use, the country continues to grapple with disturbingly high prevalence rates, weak policy enforcement, and a glaring omission—smoking cessation services.

Pakistan ranks among the 15 countries with the highest tobacco consumption, with over 31 million users. Alarmingly, nearly 40% of adults and 55% of children are routinely exposed to secondhand smoke. The toll on health is immense: smoking is a leading contributor to cancer, cardiovascular disease, diabetes, and respiratory illnesses such as COPD and tuberculosis. According to the WHO, tobacco causes over 8 million deaths globally each year—including 1.2 million from secondhand smoke. Within Pakistan, the annual smoking-related death rate stands at 91.1 per 100,000 people—higher than both the South Asian and global averages.

Pakistan's journey in tobacco control began earnestly in 1997 with the banning of tobacco advertisements on electronic media. The country ratified the Framework Convention on Tobacco Control (FCTC) and introduced regulations including graphic health warnings on cigarette packs, tax hikes on tobacco products, and bans on smoking in public places and near educational institutions.

Yet, enforcement is patchy at best. Illicit trade flourishes, pictorial warnings have not met their intended visibility targets, and despite bans, loose cigarette sales remain rampant. Increased prices have only pushed consumers toward cheaper brands—undermining intended deterrent effects.

The most critical void in Pakistan’s tobacco control strategy is the absence of structured smoking cessation support. Without national cessation clinics, subsidized therapies, or trained health professionals, most tobacco users are left to quit without guidance—if they attempt at all. Public campaigns rarely mention quitting as a viable path, and healthcare consultations seldom include cessation counseling or pharmacological intervention. Societal stigma and cultural perceptions further discourage smokers from seeking help.

A future free from combustible smoking is within reach—but it demands systemic reform. Pakistan needs a comprehensive cessation strategy including:

• Establishing smoking cessation clinics across all districts and provinces.
• Training healthcare providers in behavioral therapies and pharmacological interventions.
• Subsidizing nicotine replacement therapy and prescription medications.
• Integrating cessation support into routine medical consultations.
• Enhancing public messaging around quitting and recovery—not just harm.

Tobacco use is not merely a lifestyle choice—it is a complex addiction that requires supportive infrastructure and compassionate policy. By shifting focus from punitive regulation to evidence-based cessation, Pakistan can dramatically reduce tobacco-related morbidity and mortality.

The time to act is now. Smoking cessation must move from the margins of policy conversations to the center of public health strategy—making “quitting” not just possible, but probable.