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The Context
Pakistan has a population of 168 million (2008), of whom about 22-25 million are smokers. It is the sixth most populous country in the world and most populous country of the WHO Eastern Mediterranean Region. Although its urban population is steadily increasing, Pakistan remains largely a rural country, with only 36% of the total population living in urban settings.

Almost, 40 per cent of the country’s population lives below poverty line. 64 per cent of the total population of the country lives in rural Pakistan which is poor. 50 per cent men and women living in big cities of Pakistan are slum dwellers. The poor are increasingly felling victim of lung disease because of tobacco use. Rural poor use hukka (water pipe) whereas gutka, paan (smokeless tobacco) and cheap cigarettes such as bedi are popular among the urban poor. Excessive use of tobacco is multiplying socio-economic problems of poor families and communities. More than 200,000 people die annually of lung diseases.

Despite the tobacco control efforts, the Tobacco Industry in Pakistan continues its unethical marketing tactics such as offering rewards in various forms and cash rebates etc. The number of male smokers is approximately four times the number of female smokers, with smoking prevalence inversely related to educational access based on data from the Global Youth Tobacco Survey (GYTS).

In Pakistan, tobacco kills 100,000 persons every year. This is 274 deaths per day!

The Policy Perspective
Government of Pakistan ratified FCTC and promulgated laws in 2003 banning cigarettes advertisement on mass media outlets and smoking at public places and in public transports.

To address this major health priority, the “Prohibition of Smoking and Protection of Non Smokers Health Ordinance 2002” focused mainly on protecting the rights of non‐smokers by prohibiting tobacco use in indoor public places. However, it also included provisions to regulate tobacco advertisements, ban underage sales and establish enforcement mechanisms. In addition to the 2002 law, a law from 1979 also regulates the printing of health warnings on cigarettes. This law had been amended twice before 2002. Under this law, the Federal Ministry of Health has the power to define the content and specifications of pictorial health warnings appearing on cigarette packs.

However, enforcement of laws is very weak. Tobacco-consuming illiterate and poor population is a great challenge for tobacco control activists. There is a need to develop links between tobacco control initiatives and poverty reduction programs to assist in moving tobacco control further up in policy agenda.

The Challenges
The youth of Pakistan are being targeted by the tobacco industry so that ‘replacement smokers” could be recruited. This is because 85% of adults, who smoke, started smoking before they became 18 years of age. Sadly, approximately 1200 Pakistani boys and girls take up smoking; cigarettes and shisha (water pipe) every day. Given the percentage of young people (aged 10-19) in the country (42% of the total population), tobacco use is likely to increase enormously. There has been an increase in the use of Shisha in hotels and cafes in the larger cities, which is a cause of great concern.

Growing use of Gutka, mainpuri and Naswar (smokeless tobacco) among youth; both male and female, and household women is also becoming a health concern. The health hazards are very much severe and the number of victims’ cases being reported is increasing.

The lack of awareness on tobacco control law and issues among the government authorities and general public identified to be among the main reasons behind the weak enforcement of tobacco control laws.

Also, the consistent efforts by pro-tobacco elements to find and taking advantages of the loopholes in the laws needs to addressed on urgent basis.

Coalition for Tobacco Control – Pakistan (CTC-Pak)
The Coalition for Tobacco Control – Pakistan (CTC-Pak), is an initiative and project of Society for Alternative Media and Research (SAMAR). CTC-Pak is a coalition for member organizations working for tobacco control throughout Pakistan that also acts as a liaison entity between the policy makers and civil society of Pakistan. The aim of CTC-Pak is to strengthen the development and implementation of policies based on the provisions of Framework Convention for Tobacco Control (FCTC) through its monitoring and advocacy activities and also, acting as a technical resource for the Tobacco Control Cell, Government of Pakistan.

CTC-Pak is first ‘Bloomberg Global Initiative for Tobacco Reduction Program’ grantee in Pakistan that is working towards effective tobacco control and compliance for the relevant laws with support from Campaign for Tobacco Free Kids, USA (CTFK) and The Union, UK.

The objectives are to:
1. Monitor the implementation status of tobacco control laws with support from the coalition members and present suggestions for amendments in the laws based on the findings of results of monitoring.
2. Strengthen the coalition member organizations for providing technical support the government authorities at sub-national levels.


For more information, kindly contact CTC-Pak.

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