Tobacco control loopholes

Eleven years have passed since Pakistan signed and ratified the World Health Organisations’s Framework Convention on Tobacco Control (FCTC) in 2004 but it is yet to take measures to implement this treaty and amend the existing laws to bring them in conformity with the international best practices, and for the sake of health and wellbeing of its citizens.

Use of tobacco is a global epidemic that kills nearly six million people each year, according to WHO. More than five million of those deaths are the result of direct tobacco use, while more than 600,000 are the result of non-smokers being exposed to second-hand smoke.

In Pakistan, the high prevalence of tobacco consumption remains a leading cause of preventable death and diseases for its citizens. Every day 301 Pakistanis die as a result of tobacco use as per the figures of Pakistan Demographic and Household Survey 2012-13.

Smoking also puts a heavy financial burden on Pakistanis – in 2013 alone, Pakistanis spent Rs250 billion on buying cigarettes. According to the Global Adults Tobacco Survey for Pakistan in 2014, the estimated number of tobacco users in Pakistan is estimated to be 15.6 million and this number is growing rapidly.

An effective way to check tobacco epidemic is to prohibit its use at public places and ban its advertisement and sponsorship. That is why Article 13 of WHO FCTC requires the parties to the convention to implement a comprehensive ban on tobacco advertising, promotion and sponsorship as anything less will allow the tobacco industry to continue to exploit loopholes.

Since Pakistan promulgated a tobacco control law, the Prohibition of Smoking and Protection of Non Smokers’ Health Ordinance in 2002, two years prior to signing and ratifying the WHO treaty, this law does not fulfil all requirements of the international treaty. Several issues are still to be addressed to fully eliminate advertising, promotion and sponsorship (TAPS) of tobacco products in the country.

Tobacco companies in our country have been investing heavily on indirect advertising, promotion and sponsorship and have used a range of sophisticated strategies and tactics to undermine the existing tobacco control measures. There is a need to update the country’s legal regime to counter devious methods of indirect advertisement and promotion of tobacco products.

Most importantly, companies are increasingly using the gimmick of so-called ‘Corporate Social Responsibility’ to indirectly advertise and promote tobacco products. Through sponsorship these companies try to improve their public image and gain social acceptance by hiding the enormous morbidity and mortality caused by their business.

Under the garb of public welfare projects, lavish dinners, musical events and foreign visits are sponsored to entertain senior civil servants and politicians. The slogan of Corporate Social Responsibility is a public relations strategy through which tobacco businesses get access to policymakers and decision-makers and thus enhance their chances of influencing policy decisions. Legislation is required to ban all such sponsorship.

The tobacco industry’s indirect marketing thrives on gaps and loopholes in the existing tobacco control law. Following a ban on advertisements in the media, cigarette packs have become a key advertising medium for the industry. They lure consumers by giving information about their preferences in a glamorous manner on packs and to conceal health hazards of tobacco. Cigarette packs bear misleading and deceptive slogans such as ‘smooth taste’, ‘low tar’, ‘mild, light’, ‘new refreshing taste’, ‘menthol’, ‘new filter’ etc.

The slogans on packs also include catchy phrases targeted to attract youth to smoking such as ‘Wohi Dabang Maza’ (The same audacious taste), ‘Yeh Hai Mera Style’ (This is my style). These practices are in violation of Article 11 of the FCTC that requires the parties to the convention to adopt and implement measures to ensure that tobacco product packaging and labelling do not promote tobacco products in ways that are false, misleading, or deceptive.

Another business technique is promotion of tobacco products through attractive and eye-catching power walls or contracted boards and fascia at retail shops. Companies provide financial incentives to retail shopkeepers in the form of gift items, décor of the retail shops and cash benefits in return for prime display of their products at points of sale. The 2002 ordinance does not prohibit the incentives to retailers.

At present, there are no regulatory restrictions on ingredients in tobacco products, which is in violation of the international treaty. For instance, additives such as menthol numb the throat so the smoker cannot feel the smoke’s aggravating effects. Other additives such a sugar, honey and cocoa are used to enhance the ‘taste’ of tobacco.

Moreover, the 2002 law does not specifically prohibit alternate nicotine delivery systems such as electronic cigarettes. Another omission relates to open public spaces such as bus stations, sports stadiums and parks which are not smoke-free under the existing regulations. Smoking needs to be banned in all such open public places.

Use of tobacco can also be curtailed if the easy and widespread availability of tobacco products is prohibited – for example at chemist shops, grocery stores and hospital canteens. The availability of tobacco products like bread and butter generates a misleading notion that they are relatively safe for health. Only licence-holding designated shops should be allowed to sell this addictive substance with considerable health hazards. All such tobacco shops need to display a prominent health warning on smoking tobacco.

In order to close the above-mentioned loopholes in the existing tobacco control law and bring it in conformity with the Article 13 of the FCTC, a new comprehensive law is needed to ban all kinds of tobacco advertising, promotion and sponsorship (TAPS). The federal government needs to coordinate with the provinces to establish a uniform tobacco control regime all over the country – the way it formed the Drug Regulatory Authority under Article 144 of the constitution.

A strict tobacco control regime will help save the tens of billions of rupees that are being spent each year on the cure of diseases caused by tobacco smoking. This is possible only if our rulers can get out of their state of inaction on public health issues.

Email: adnanadilzaidi@gmail.com