Civil society surges in Pakistan in the face of government inertia in the fight against tobacco

Many of Pakistan's tobacco control measures are not being implemented due to lack of political will. Illicit trade practices are on the rise in some areas, 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 is said to have observed loyalty operations, price reductions and promotional offers on tobacco products that may include the giving of gifts. These promotional operations are aimed either at customers or at sellers. Two tobacco companies, which have not been revealed, are said to be using these methods in the province of Sindh to launch new brands. In the province of Punjab, "illicit" cigarette brands, therefore not declared in Pakistan, are also said to be offering discount operations to launch their products.

Illegal communication operations were also noted, in the form of posters, the insertion of incentive proposals slipped into cigarette packets and advertising in points of sale. These operations also concern new tobacco and nicotine products.

Authorities pay little attention to tobacco-related offences

"The anti-smoking regulations are 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].

In late 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 has, however, recently allowed 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, in particular 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 tax 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

©Tobacco Free Generation

M.F.

[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 on November 19, 202, consulted on 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, consulted 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.