Islamabad – Pakistan is grappling with a severe public health emergency, with increasing calls to impose a comprehensive ban on smoking cigarettes. The health toll from tobacco use is catastrophic, with the country recording the highest rate of smoking-related deaths in South Asia, surpassing even the global average.
According to Gallup Pakistan’s analysis of the Global Burden of Disease report 2024, Pakistan experiences a staggering 91.1 smoking-related deaths per 100,000 people annually. This figure far exceeds South Asia’s average of 78.1 and the global average of 72.6. While the country’s smoking-related death rate decreased by 35% between 1990 and 2021, it still lags behind the reductions achieved by India and other South Asian nations. With over 30 million cigarette smokers in Pakistan, this public health crisis demands immediate, decisive action.
The accessibility and affordability of cigarettes remain key drivers of this epidemic. The World Health Organization notes that purchasing 100 packs of the most-sold cigarette brand in Pakistan requires just 3.7% of the GDP per capita, compared to 9.8% in India. Even though the share of GDP per capita required to buy cigarettes increased by 38% from 2012 to 2022, rising prices alone have not deterred consumption. Alarmingly, 1,200 children aged six to 15 start smoking every day in Pakistan, perpetuating the cycle of addiction.
Efforts to curb cigarette consumption through taxation have largely failed due to systemic issues. The majority of cigarette manufacturers and much of the tobacco supply chain remain outside the tax net, nullifying the potential benefits of higher cigarette taxes. Compounding this failure, the illicit cigarette trade now dominates 56% of the market, fueled by widespread smuggling and the ineffectiveness of the much-touted Track-and-Trace System (TTS). This black market thrives on the inaction of law enforcement and poor regulatory oversight, making cigarettes readily available even to minors.
Beyond taxation, weak enforcement of existing laws—such as those banning the sale of cigarettes to minors and restricting tobacco marketing—has done little to curb smoking. Pakistan’s crumbling health infrastructure bears the brunt of tobacco-related illnesses, costing the economy billions annually.
A comprehensive strategy is essential to combat this crisis. A robust crackdown on the illicit cigarette trade, coupled with measures to tax all tobacco manufacturers and the entire supply chain, is critical. Public health campaigns must also raise awareness of the dangers of smoking, particularly among youth, while cessation programs must be widely accessible.
Decisive action to restrict cigarette availability and promote public health is no longer optional—it is a moral and economic imperative.