Pakistan alerted to tobacco industry-led measures for derailment of landmark decision

Islamabad
The Regional Director of the Eastern Mediterranean Office of the World Health Organization (WHO), Dr. Ala Alwan, has alerted Pakistan to the strong possibility of the tobacco industry taking measures to derail the new pictorial health warnings in a bid to undermine the government’s decision to adopt 85% pictorial health warnings on both sides of cigarette packs.
In a letter addressed to Prime Minister Nawaz Sharif, Dr. Alwan has said, “We expect the tobacco industry to take all possible measures to derail these new pictorial warnings. However, we are certain of the government’s commitment to tobacco control, and to protecting the lives of Pakistani citizens from the devastating consequences of tobacco use.” He has then assured WHO’s commitment to support Pakistan in implementation of the “commendable decision.”
Dr. Alwan’s letter comes at an opportune time because the government is already under immense pressure, both from the tobacco industry as well as the taxation authorities, to make relaxations in its decision.
Dr. Alwan opens the letter by congratulating Pakistan for its decision to increase the size of pictorial health warnings to the highest in the region and one of the largest worldwide. “This step reinforces Pakistan’s leadership in the area of tobacco control,” he has stated in the letter, a copy of which is available with this scribe.
Dr. Alwan has termed pictorial health warnings as an essential part of the demand reduction measures as adopted by the WHO Framework Convention on Tobacco Control (FCTC), to which Pakistan became a party in 2004. “WHO reconfirmed the importance of pictorial health earnings by launching the technical package of MPOWER, in 2008, through which all countries were encouraged to adopt six policies that are the key to reducing the tobacco epidemic,” he mentions in the letter.
The six policies propounded by MPOWER are: monitor the tobacco epidemic; protect people from

secondhand smoke and enforce 100% tobacco-free public places with no designated areas; offer help to smokers to quit smoking; warn people of the consequences of tobacco use through pictorial health warnings and plain packaging; enforce comprehensive ban on advertising, promotion and sponsorship; and raise taxation.
Dr. Alwan believes that the adoption of this second major step in a year by Pakistan, which was preceded by implementation of the Global Adults Tobacco Survey (GATS), demonstrates the country’s high political commitment to tobacco control.
GATS is a nationally representative household survey that was launched in February 2007 as a new component of the ongoing Global Tobacco Surveillance System (GTSS). This Survey enables countries to collect data on adult tobacco use and key tobacco control measures. Results from GATS assist countries in the formulation, tracking and implementation of effective tobacco control interventions, and countries are able to compare results of their survey with results from other countries. In Pakistan, field work (data collection) for the Survey has been completed. The next steps included data analysis and preparation of the final country report.
Some of the topics covered in GATS are: tobacco use prevalence (smoking and smokeless tobacco products); secondhand tobacco smoke exposure and policies; cessation; knowledge, attitudes and perceptions; exposure to media; and economics.
The printing of pictorial health warnings on 85% of the front and back of cigarette packs will become mandatory with effect from March 30, 2014. After March 30, a grace period of 60 days, ending of May 31, 2015 may be allowed to the tobacco industry clear old and existing stocks.
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly 6 million people a year. More than 5 million of those deaths are the result of direct tobacco use while more than 600,000 are a result of non-smokers being exposed to secondhand smoke. Approximately, one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths.
In Pakistan too, the use of tobacco is on the rise. According to the National Health Behaviour Survey 2012, approximately 36% men and 7% women aged 15-64 years currently use tobacco products. Tobacco use is more common in rural (21%) than urban settings (16%).
Pakistan is one of the main tobacco-producing countries. During 2011-12, Pakistan produced 97.88 million kilograms of tobacco and around 8.39% was exported during the same period.