PESHAWAR – Tobacco control in Pakistan has spanned decades, but smoking remains one of the country’s most entrenched public health threats. Despite widespread awareness campaigns, Pakistan continues to report alarmingly high consumption rates, weak policy enforcement, and a major policy gap: the absence of smoking cessation services.
Pakistan ranks among the world’s top 15 countries for tobacco use, with more than 31 million users. Around 40% of adults and 55% of children are routinely exposed to secondhand smoke. Tobacco-related illness accounts for a heavy toll, contributing to cancer, cardiovascular disease, diabetes, and chronic respiratory conditions like COPD and tuberculosis.
According to the World Health Organization, tobacco causes over 8 million deaths annually, including 1.2 million from secondhand smoke. In Pakistan, the annual smoking-related death rate stands at 91.1 per 100,000 people—higher than both the South Asian and global averages.
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The country began its tobacco control efforts in 1997 by banning tobacco advertising on electronic media. It later ratified the WHO Framework Convention on Tobacco Control (FCTC) and enacted a series of laws, including graphic health warnings on cigarette packs, higher excise taxes, and bans on smoking in public spaces and around educational institutions.
But implementation remains inconsistent. Illicit trade in tobacco products is rampant. Graphic warnings have not achieved their intended visibility. Despite legal restrictions, the sale of loose cigarettes is common. Tax increases have shifted consumers to cheaper, unregulated brands, weakening the effectiveness of fiscal deterrents.
What’s missing most in Pakistan’s tobacco control strategy is a national structure for helping people quit. No public system provides cessation clinics, subsidised therapies, or trained healthcare professionals. National campaigns rarely promote quitting as a path forward, and clinical consultations seldom include behavioural or pharmacological intervention. Cultural stigma and social attitudes also discourage smokers from seeking assistance.
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Experts argue that if the country is to reduce tobacco-related illness and death, cessation support must become a central focus. A comprehensive strategy should include:
Establishing smoking cessation clinics in every district and province
Training healthcare workers in counselling and evidence-based treatments
Subsidising nicotine replacement therapies and prescription medication
Making cessation support part of regular medical consultations
Highlighting recovery and quitting in public awareness campaigns—not just harm
Tobacco use is not merely a personal habit—it is a complex addiction. Reducing its grip on society will require infrastructure, trained personnel and compassionate, long-term policy. Without shifting from punishment to support, the country risks losing thousands more lives to preventable disease.
The opportunity to act is now. Tobacco control in Pakistan must evolve from awareness and restriction to a system that makes quitting not only possible, but probable.
The writer works for ending combustible smoking in Pakistan.
