Becoming smokefree in 2035

Pakistan has the tools, policies, and international support to become smoke-free within the next decade. The challenge, however, lies in consistent enforcement of the tobacco control laws, political will, and mobilizing communities to embrace a healthier, tobacco-free future.

A number of developed countries have started their journeys towards becoming smokefree – that is smoking prevalence drops below 5%. Though Pakistan has not started this journey, it can over the next ten years become smokefree provided it comes up with a plan and implements it strictly.

Currently, 31.6 million or 19.9% of the population over the age of 15 years uses tobacco in some form. Smoking related illnesses consume 1.4% of the country’s GDP every year. That’s a huge cost. After two decades of campaigns against smoking, Pakistan has reported an annual death rate from smoking of 91.1 per 100,000 people, notably higher than the averages for South Asia (78.1) and the rest of the world (72.6).

If we briefly look at the benefits of becoming smokefree, we will understand how crucial this journey is for Pakistan. In terms of health, the current impact of smoking is high rates of cancer, cardiovascular disease, and of course, respiratory illness. A smokefree Pakistan will witness a dramatic reduction in preventable deaths. Pakistan loses billions annually in healthcare costs and productivity. If saved, these can be redirected to development. Currently, Pakistan’s youth is the main client of the tobacco industry. If the laws and policies regarding tobacco control are effectively implemented, we are looking at healthier and more productive generations.

First, the country needs to have a smokefree vision for 2035. Under this vision, smoking prevalence will drop below 5%, aligning with global smoke-free benchmarks. This will help to direct healthcare savings to education, infrastructure, and poverty reduction. Once achieved, this vision will lead to a new social norm where tobacco use is stigmatized, and healthier lifestyles are celebrated.

However, we should not lose sight of hurdles. The first hurdle is weak enforcement of existing tobacco control laws. Weak implementation dilutes impact of the laws. There is a cultural acceptance of tobacco and its various uses. This acceptance is hiding the lifelong adverse effects of smoking.

What Pakistan needs to do to bring down the smoking prevalence? First things first, find out the exact number of tobacco users in the country. Since the GATS in 2014, Pakistan has shown little interest in knowing if the number of tobacco users has increased or decreased. Second ensure that smoking cessation services are available across the country at the district, tehsil and union council level. In this regard, the role of the provincial governments is critical, along with the local governments. Adult smokers who have been unable to quit smoking are the largest chunk of tobacco users. Unless Pakistan helps to come off this habit, the number will continue to increase despite all the successes.

The lack of adequate smoking cessation services in Pakistan is a critical gap in the country’s tobacco control efforts. Addressing this issue through targeted interventions and resource allocation can significantly reduce tobacco-related morbidity and mortality while improving public health outcomes.