Make Smoking Cessation Central to Tobacco Control Strategy

Despite decades of tobacco control campaigns, graphic warnings, bans on advertising, and tax hikes, Pakistan remains trapped in a cycle of tobacco dependency. Over 31 million Pakistanis use tobacco in some form, and smoking-related illnesses claim over 160,000 lives annually. However, the smoking cessation remains ignored and almost forgotten, leaving the adult smokers who want to quit without any assistance. 

According to the World Health Organization (WHO), Pakistan’s healthcare system lacks adequate smoking cessation support, resulting in low quit rates. If people decide to give up smoking, they do not know where they should seek assistance. That is why only 25% of smokers attempt to quit annually, with a success rate of less than 3%. 

Smoking cessation is not just a public health ideal—it's the most immediate and cost-effective way to reduce tobacco-related harm. Unlike preventive campaigns that target future smokers, cessation directly addresses the millions already addicted. Studies show that even brief counseling interventions can significantly increase quit rates, while pharmacological aids like Nicotine Replacement Therapy (NRT) and varenicline multiply the odds of success.

In countries like the UK, Australia, and Thailand, cessation services are integrated into primary healthcare, supported by national quitlines, subsidized medications, and public awareness campaigns. Pakistan, however, has yet to institutionalize cessation as a core component of its tobacco control strategy.

Despite ratifying the WHO Framework Convention on Tobacco Control (FCTC) in 2004, Pakistan has made little headway in implementing Article 14, which calls for accessible cessation services. The reasons are manifold. Tobacco control efforts have focused heavily on taxation and packaging, with cessation relegated to the margins. Most doctors receive no formal training in tobacco cessation, and cessation clinics are virtually nonexistent. The widespread misconception that nicotine directly causes diseases like cancer and heart disease complicates advice given to patients about smoking cessation services. Moreover, most smokers are unaware that quitting is possible with support—and that help even exists. Pakistan also lacks a toll-free quitline, a basic infrastructure in most countries with serious cessation programs.

To reverse the tide, Pakistan needs a national cessation strategy anchored in evidence and empathy, one that involves listening to smokers and making them part of efforts for a smoke-free future. Their participation in cessation efforts at the policy level will provide a critical link for understanding what help they need to quit. There is a need to establish a national quitline with trained counselors and multilingual support. A quitline was established in 2017 but it is no longer working. Similarly, smoking cessation should be integrated into primary healthcare. This integration should be backed by training for doctors and nurses. In a country like Pakistan, cessation medications should be subsidized. Unless the cessation medications are affordable and accessible, poor adult smokers will not use them.

In the past, tobacco control campaigns were launched regularly. Surprisingly, when social media platforms have become a source of instant contact, no tobacco control campaigns have been planned and launched. There is a desperate need to normalize quitting for adult smokers.  

Another critical aspect missing is the involvement of the communities. Smoking is perceived as an individual problem. However, to address this problem, collective efforts are a must. When communities get together, they are able to see smoking as everyone’s problem and make collective efforts to address it.
 
Pakistan’s tobacco control narrative must evolve-from punitive measures to supportive interventions. Cessation is not a luxury; it’s a public health imperative. Until Pakistan invests in helping smokers quit, the cycle of addiction, disease, and death will persist. The question is no longer whether Pakistan can afford to prioritize cessation. It’s whether it can afford not to.