Civil society in Pakistan surges in response to government inertia in the fight against tobacco

Many of Pakistan's tobacco control measures remain unenforced due to a lack of political will. Illicit trade practices are on the rise in some regions, according to a study by the Voices Against Tobacco coalition.

Ban on smoking in public places and private establishments for collective use, ban on tobacco advertising including at points of sale and obligation to hide tobacco stalls... These various measures to combat smoking have been adopted in recent years by the Pakistani government, but seem to have remained a dead letter.

Unbridled commercial offensives by cigarette manufacturers

A study conducted by the Voices Against Tobacco (VAT) coalition indicates that these provisions appear to be poorly followed.[1]VAT has reportedly observed loyalty schemes, price reductions, and promotional offers on tobacco products that may include the giving of gifts. These promotional schemes are aimed either at customers or at sellers. Two unnamed tobacco companies are reportedly using these schemes in Sindh province to launch new brands. In Punjab province, "illicit" cigarette brands, meaning those not registered in Pakistan, are also reportedly offering discount schemes to launch their products.

Illegal advertising campaigns have also been identified, in the form of posters and the insertion of incentives into cigarette packets and advertising at points of sale. These campaigns also concern new tobacco and nicotine products.

Authorities pay little attention to tobacco-related offenses

"Tobacco control regulations are being openly violated and the authorities, despite having the power, show no interest in stopping illegal cigarette sales.", said Dr. Nadeem Rizvi, a renowned pulmonologist. The inaction of the Pakistani authorities had already been highlighted in 2020[2], in a country with 31 million smokers and more than 163,000 deaths each year due to tobacco[3].

At the end of 2020, Pakistan was also recognized as a nerve center for tobacco products by British American Tobacco (BAT), which was then transferring one of its operational units from Malaysia.[4]BAT and Philip Morris International have also invested heavily in this country for the development of their new heated tobacco products, electronic cigarettes and Velo brand nicotine lozenges (pastilles).[5].

Voice Against Tobacco, a new civil society initiative

A citizen health initiative, however, has recently led to the emergence of a new coalition around the fight against smoking, under the name of Voices Against Tobacco.[6]This group acts on several fronts to counter the actions of the tobacco and nicotine industry, based on the MPOWER program.[7] developed by the World Health Organization (WHO). It relies on a network of student "ambassadors," responsible for promoting peer prevention activities and collecting evidence of violations of tobacco legislation. It mobilizes personalities, such as a famous local sportswoman, who act as spokespersons for its demands. It collects and disseminates, particularly via social networks, testimonies from smokers and information on tobacco and the proposed measures. It deploys advocacy, for example in favor of an increase of 30% of taxes on tobacco products, which are currently only taxed at 45% of the sale price, one of the lowest rates in the world. Their objective is to reach a level of 75% of taxes, recommended by the WHO in the implementation of the fiscal policies of the Framework Convention on Tobacco Control, FCTC. This group finally carries out studies; The first of these, conducted among 1,200 households in the fall of 2021, revealed that 48% of the smokers surveyed were not aware of the serious health dangers they face when smoking.[8]. So many actions that can contribute to changing the perception of tobacco-related problems, whether among the population or among public authorities.

Keywords: Pakistan, advertising, discount, BAT, PMI, VAT, MPOWER

©Generation Without Tobacco

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[1] Tobacco firms promoting cigarettes through ads despite ban: survey, Dawn, published April 19, 2022, accessed April 22, 2022.

[2] In Pakistan, inertia over proposed new tobacco tax disappoints and raises questions, Generation Without Tobacco, published November 19, 202, consulted April 22, 2022.

[3] Raising Tobacco Tax Rates to Promote Public Health and Increase Revenue:

Policy Options for Budget 2022-23, Pakistan: Tobacco Fact Sheet 2022, Tobacconomics, 2022, 3 p.

[4] British American Tobacco shifting key business to Pakistan, The News, published December 23, 2020, accessed April 22, 2022.

[5] Pakistan: Tobacco industry took advantage of pandemic to promote new products, Generation Without Tobacco, published June 29, 2021, accessed April 22, 2022.

[6] Saeed S, Shahroz IM, Khan SU, Agha AA. Voice against tobacco: A call for integrated action for effective change. Pak J Med Sci. 2022;38(2):436-437.

[7] MPOWER: Monitor tobacco use and interventions, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, and Raise tobacco taxes and develop sustainable alternatives to tobacco growing.

[8] Voices Against Tobacco Ambassadors conduct community research survey on tobacco use in Islamabad, Indus Hospital & Health Network, published December 9, 2021, accessed April 22, 2022.