EDITORIAL: In grim news for public health in Pakistan, it has emerged that the country’s annual smoking-related death toll is the highest in South Asia and above the global average.
Gallup Pakistan’s analysis of the Global Burden of Disease report 2024 shows that Pakistan records an annual death rate from smoking of 91.1 per 100,000 people, far exceeding South Asia’s average (78.1) and the world’s (72.6).
Additionally, while Pakistan’s smoking-related death rate dropped 35 percent between 1990 and 2021, it still lagged behind reductions in India, South Asia and the global average.
With over 30 million smokers in the country, it is clear that we have a public health crisis on our hands requiring urgent, comprehensive interventions to reduce tobacco consumption and its deadly impact.
An already overburdened health sector has perennially struggled to cope with the rising incidence of tobacco-related diseases – from cancer and respiratory illnesses to heart disease and stroke – further straining limited resources and impeding efforts to address other critical health challenges.
The response of the various authorities to this crisis, however, has largely been incoherent, insufficient and languid, ensuring that cigarettes remain easily accessible and affordable, perpetuating a pernicious cycle of addiction and its devastating health consequences.
According to the World Health Organisation, purchasing 100 packs of the most-sold cigarette brand in Pakistan requires a mere 3.7 percent of the GDP per capita, compared to 9.8 percent in India.
At the same time, Gallup Pakistan’s findings show that the share of GDP per capita required to purchase 100 packs in Pakistan actually increased by 38 percent between 2012 and 2022, worryingly demonstrating that rising prices alone have not sufficiently curbed demand.
While evidence suggests that higher cigarette taxes deter cigarette consumption, the fact is that tax authorities have utterly failed to bring the majority of cigarette manufacturers as well as much of the tobacco supply chain – from cultivation to the point it reaches the manufacturer – into the tax net, nullifying any positive impact that increasing tobacco taxes could have had.
As has been noted in this space before, the increasing incidence of taxes on the regulated tobacco sector has fuelled demand for cheaper, smuggled alternatives, with the illicit cigarette segment occupying around 56 percent of the market by June last year.
Apart from the incompetence of the tax authorities, the abject inability of the law enforcement apparatus to halt the widespread smuggling, coupled with the ineffectiveness of the highly publicised Track-and-Trace System (TTS) to tackle the counterfeit tobacco trade has contributed to a critical crisis.
Despite approximately 80 percent of smokers wanting to quit, the easy affordability of cigarettes and weak enforcement against smuggling have made them readily accessible — even to minors. Consequently, around 1,200 Pakistani children aged six to 15 take up the habit every day.
The mere enactment of laws restricting tobacco marketing and criminalising the sale of cigarettes to minors has clearly failed to have the desired impact not only due to poor implementation, but also owing to a lack of coordinated strategies that address the various factors that make cigarettes so easily accessible.
The impact on our already creaking health infrastructure and the economy at large has been profound, running into billions of rupees. It is clear that an urgent crackdown is needed on the illicit cigarette trade while measures that ensure all tobacco manufacturers and the entire tobacco supply chain are appropriately taxed are also a must.
Moreover, public health campaigns to raise awareness regarding tobacco’s harms, particularly among youth, and the wide availability of programmes aimed at helping smokers quit have increasingly become essential. A decisive action is now vital to curbing this public health crisis and saving lives.
Copyright Business Recorder, 2025
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