Cessation services essential to reduce smoking prevalence

• Smoking cessation should be a key part of tobacco control in Pakistan.
• Only 25% of smokers make a quit attempt each year, while fewer than 3% successfully quit.
• Pakistan does not have a comprehensive government-supported national cessation programme.
• Many smokers are unaware of available quitting support and do not know where to seek help.
• Public hospitals should provide smoking cessation services across provinces and districts.
• Healthcare professionals should receive training in cessation techniques and counselling.
• Affordable or free nicotine replacement therapy and cessation medicines should be available.
• Smokers’ needs and opinions should be considered when developing cessation policies.

Many adult smokers in Pakistan want to quit but may not know where to get reliable help. Making cessation support easier to find can give them a practical path away from smoking.

Better smoking cessation services can help reduce smoking-related disease and secondhand smoke exposure and can support healthier families and communities across Pakistan.

The article supports a national cessation strategy, public-sector cessation clinics, trained healthcare workers, affordable treatment, and implementation of Article 14 of the FCTC.

This explainer is based on the supplied internal article. The complete article text is kept as provided in the document, while the summaries and key points are written in simple language for general readers in Pakistan.

Smoking is one of the leading causes of preventable deaths worldwide. Despite widespread awareness of its harmful effects, tobacco use remains a significant public health challenge, particularly in countries like Pakistan.

According to the World Health Organization, tobacco kills more than 8 million people each year, including 1.2 million non-smokers exposed to secondhand smoke. Smoking is a major risk factor for numerous diseases, including cancer, cardiovascular diseases, respiratory illnesses, and diabetes. It is estimated that half of all long-term smokers die from tobacco-related diseases. Smoking adversely affects almost the whole body. Globally smoking cessation is an essential part of tobacco control efforts. Access to smoking cessation services is now considered a human right.

Almost two decades after ratifying Framework Convention on Tobacco Control (FCTC), access to smoking cessation services in Pakistan remains low. Only 25% of smokers make a quit attempt every year. The success rate of quitting smoking is less than 3%.

After ratifying the FCTC, Pakistan focused on disrupting the access of smokers to cigarettes – a task in which it failed miserably. Pakistan introduced pictorial health warnings (PHWs) on cigarette packs in 2009. These warnings are periodically updated and currently cover 60% of the front and back of cigarette packs. However, the target is to cover 80% of the pack with the PHWs.

Similarly, to discourage tobacco consumption, the government increased taxes on cigarettes and other tobacco products. Pakistani substantially increased the Federal Excise Duty (FED) on cigarettes during the fiscal year 2022- 23. However, because of the increase in the prices of premium to economy brands, smokers switched to cheaper brands and bought loose cigarettes. This is despite the fact that the sale of loose cigarettes is banned. There is also a ban on sale of tobacco products within a 50-meter radius of educational institutions, though its implementation remains an issue.

However, one area that Pakistan has ignored completely is the provision of smoking cessation services. Pakistan lacks a comprehensive, government-supported national smoking cessation program.

By and large smokers are unaware of the availability or importance of cessation support. Public awareness campaigns rarely emphasize smoking cessation as a viable option, focusing more on the harms of tobacco use. This limits demand for such services and leaves smokers without motivation or knowledge about how to quit.

A smoke-free Pakistan is possible. However, for this we have to listen to smokers’ voices. They should be part of efforts for a smoke-free future, since their participation in smoking cessation efforts at policy level will provide the critical link for knowing what help they need to quit or switch. All policies formed by governments must ensure the opinion and needs of smokers are valued in line with article 14 of FCTC.

Article 14 requires countries to take effective measures to promote tobacco cessation and provide adequate treatment for tobacco dependence. In short, it obligates governments to develop comprehensive, evidence-based guidelines and integrate cessation support into national health systems.

There is a need to develop and implement a nationwide smoking cessation strategy. This should be backed by establishing smoking cessation clinics in public hospitals across all provinces and districts, training healthcare professionals in cessation techniques and counseling, and providing affordable or free access to NRT and cessation medications. There is also a need to include cessation counseling in routine health check-ups.