One in five adults in Pakistan use tobacco on a regular basis. This leads to serious consequences for the country’s public health and its economy: just over 160,000 deaths and an economic loss of 143,208 million rupees occur every year due to tobacco-related illnesses. In recent years, Pakistan has taken important steps towards protecting people from tobacco smoke, warning them about the dangers of tobacco and enforcing bans on tobacco advertising. However, on raising tobacco taxes— the most effective intervention to reduce demand— Pakistan lags far behind the minimum benchmark set by the World Health Organisation. There is also very little support available to tobacco users who wish to quit.

A nationwide survey of adult smokers was conducted between September 2019 and March 2020. More than 6000 regular smokers from 10 of the most populous cities in Pakistan were asked about their smoking habits and their views on tobacco control policies. Researchers also collected cigarette packs from smokers and from paper recycling markets to identify packs bearing the hallmarks of illicit trade.

The survey found that smokers were relatively young with almost a third below the age of 35 years. On average, a smoker would consume 13 cigarettes a day and spend just under 2000 rupees (10% of their income) per month. Two-thirds of smokers wanted to quit, and over a quarter had made a quit attempt within the previous year. Only a small minority were able to access any support for quitting. On the other hand, the vast majority of smokers (>80%) were in favor of raising tobacco taxes, increasing the legal age for tobacco selling to 21 years, banning smoking in cars with minors and bringing in a complete tobacco ban within 10 years. Contrary to the tobacco industry’s claims of high levels of illicit trade, the survey found only 16% of total cigarette packs were illicit.

The survey findings provide additional support for efforts to increase tobacco taxes in Pakistan, bringing these in line with minimum international standards. Other international studies also suggest that increasing taxes does not increase illicit tobacco trade. The survey also indicates an urgent need to offer tobacco cessation support. Most smokers are willing to quit and with the right support many can turn their quit attempts into success. The survey also highlights support for expanding smoking bans to private vehicles with minors and increasing the minimum age for cigarette sales to 21 years.

Download the fact sheet here.

By Kamran Siddiqi, York University (UK)