World No Tobacco Day was observed on May 31.

n Pakistan the prevalence of tobacco use among the youth is alarmingly high. This year’s theme, focusing on protecting children from tobacco industry interference, holds particular significance for a nation where around 1,200 children between the ages of six and 15 start smoking every day. Urgent action is imperative to secure the health and well-being of the future generations.

Pakistan faces many challenges in combating tobacco use among its youth. The efforts to implement tobacco control measures are often frustrated by the influential tobacco industry. Aggressive marketing tactics, coupled with the availability of cheap and easily accessible tobacco products, continually expose children to influences that normalise and encourage tobacco use.

Campaign for Tobacco Free Kids says that nearly 40 per cent of the youth in Pakistan who have ever smoked cigarettes first tried them before the age of 10. This early initiation into tobacco use significantly increases the risk of addiction and long-term health consequences, underscoring the importance of early prevention efforts.

Interference by the tobacco industry extends beyond conventional advertising campaigns. It encompassed efforts to undermine tobacco control policies and manipulate public perception and particularly targets vulnerable populations like children.

Tobacco companies invest significant sums in marketing, employing increasingly sophisticated tactics to target youth. These efforts associate tobacco products especially cigarettes with success, fun and glamour.

Raising taxes on tobacco products has emerged as the most effective and cost-efficient method endorsed by the World Health Organisation to reduce tobacco use. By making tobacco less affordable, this reduces consumption and prevents youth initiation. “Youth and low-income groups are particularly responsive to price hikes,” the WHO notes.

Despite a raise in the federal excise duty in 2023, cigarettes remain cheaper in Pakistan than India, Sri Lanka and Bangladesh. Premium cigarettes in Pakistan cost around $1.50 per pack, significantly lower than the $3.00+ prices in the region. The affordability, coupled with the pervasive nature of tobacco advertising and easy access to tobacco products, contributes to the rising number of young smokers.

According to a paper published in the Pakistan Journal of Medical Sciences in November last year, 70 per cent of students in Karachi and Islamabad agreed that low tobacco prices make it accessible to the youth. 87.5 per cent of students who used tobacco products obtained cigarettes from stores, shops, street vendors or kiosks. This highlights the need for stricter regulations on tobacco sales and enforcement measures to restrict youth access to tobacco products. “In Islamabad, 73 per cent of respondents reported seeing tobacco advertisements. In Karachi, the figure stood at 55 per cent. A majority of these advertisements were seen in shops, markets and point-of-sale displays.”

Pakistan must re-commit to the fight against tobacco use. Increasing taxes on cigarettes, strengthening tobacco control policies, investing in comprehensive tobacco cessation programs and empowering the youth with knowledge and resilience are crucial steps towards building a tobacco-free future for Pakistan.

The cost of tobacco use is staggering. First, healthcare expenses due to tobacco-related diseases are estimated at Rs 615 billion. This figure dwarfs the Rs 140 billion taxes paid by the tobacco companies. Second, smoking-related illnesses and premature deaths lead to a significant loss in productivity. This loss has a profound impact on the economy, affecting the workforce and diminishing economic output. Third, the environmental damage caused by tobacco cultivation and production is immense. It contributes to deforestation, soil degradation, water pollution and air pollution. These environmental impacts have long-term consequences that require substantial resources to mitigate and rectify.

A World Health Organisation report titled, “Hooking the next generation: how the tobacco industry captures young customers” released on May 26 in connection with World No Tobacco Day says that the tobacco industry targets the youth for a lifetime of profits, creating a new wave of addiction. Globally, an estimated 37 million people aged 13–15 years use tobacco. “While these products are aggressively marketed to young people, the industry continues to claim that these products are intended for adults. But the industry’s goal is clear: replace tobacco users lost to death and disease with a fresh wave of users trapped in addiction,” says the report.

Recently British American Tobacco, a global tobacco giant, has threatened to withdraw its investment from Pakistan if further taxes are imposed on cigarettes. A BAT delegation reportedly met with Prime Minister Shahbaz Sharif and the Special Investment Facilitation Council national coordinator Lt Gen Sarfraz Hussain. Pakistan Tobacco Company is a subsidiary of the BAT.

While the UK is a smaller market (65 million people) than Pakistan (225 million people), last year, the tobacco industry paid £8.8 billion in taxes in the UK (~Rs 3,000 billion).

The cigarette industry in Pakistan argues that higher taxes drive illicit trade. Some PTC officials claimed in recent media interaction that the illicit cigarettes trade in Pakistan has increased from 22 per cent to 58 per cent. However, the link between taxes on cigarettes and illicit trade has not been supported by independent research.

Recent studies by reputed organisations using various methods have estimated the share of illicit trade market, as a percentage of the total cigarette market in Pakistan, between 9 and 17 percent.

Former caretaker minister Murtaza Solangi said last week that Pakistani youth were being exploited by the tobacco industry due to the lenient tobacco control in Pakistan. “Tobacco addiction is a gateway to many other forms of substance abuse and may cause serious health and mental health issues among the youth,” he said.

Pakistan must re-commit to the fight against tobacco use and industry interference. Increasing taxes on cigarettes, strengthening tobacco control policies, investing in comprehensive tobacco cessation programmes and empowering the youth with knowledge and resilience are crucial steps towards building a tobacco-free future for Pakistan.

Solangi warns, “If the attempts of the tobacco industry to attract young customers are not kept in check through proper mechanisms and higher prices, they will grow more powerful and keep being the cause of deaths and diseases in the country.” The time to act is now. The health and prosperity of Pakistan’s youth depend on it.

The writer is an Islamabad-based researcher and journalist with an interest in health and taxation