state of smoking and health in Pakistan

This page was last edited on: March 22, 2024 at 10:17 am

smoking rate

9.6% (2022)

tobacco use rate

17% (2022)

Tobacco Use and Trends

In 2022, an estimated 25.4 million adults aged 15 years and over use in Pakistan are tobacco products users. This positions Pakistan, the 7^th globally and the 1^st in the WHO Eastern Mediterranean Region (EMR) in terms of the number of tobacco product users.
It is estimated that the demand for cigarettes per capita reduced by 28% from 16.7 packs in 2010 to 12 packs in 2022.

Health and Economic Burden From Tobacco Use

Tobacco was the 5^th highest risk factor driving the most death and disability combined in 2019. It was estimated that tobacco use accounted for more than 163,672 deaths or 18% of all deaths in the country.
- Of tobacco deaths, 134 thousand or 82% were attributed to smoking, 31 thousand or 19% were second-hand smoking and 6 thousand or 3% were chewing tobacco.
The leading causes of most deaths in Pakistan include ischemic heart disease (IHD) ranking 2^nd, Stroke ranking 3^rd,and COPD ranking 7^th, where tobacco was responsible for:
- 31 thousand or 25% of total IHD deaths, 30 thousand or 64% of all COPD deaths, and 25 thousand or 18% of all Stroke deaths.
In 2019, tobacco use caused an estimated loss of 5.1 million disability-adjusted life years (DALYs) – 10% of total DALYs where tobacco accounts for the loss of 1.5 million DALYs for IHD, 842 thousand DALYs for COPD and 16.9 thousand DALYs for Stroke.
Tobacco has a substantial economic impact. In 2019, the total cost of all smoking-attributable diseases and deaths amounted to an estimated USD 3.85 billion.

regulatory environment & Economics

Public Health Commitment

Pakistan ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004 and the WHO Illicit Trade Protocol in 2018.
Implemented Graphical Health Warnings (GHWs) on combustible cigarettes (CCs) in 2010, occupying 60% of the pack.

Diverse Tobacco Market

Heated Tobacco Products HTPs are not marketed but considered as “tobacco product”. E-cigarettes with and without nicotine content are classified as “consumer products”, without any regulations imposed on them.

Taxation Policy

The total tax rate on retail prices of a pack of cigarettes was 51.8% in 2022.
- As of 2023, the excise value of CCs is PKR330.00/pack and its share (66%) of the retail selling price PKR500.00/pack.
HTPs are not classified by tax code and currently are not subject to excise taxes while e-cigarettes irrespective of nicotine content are subject to a specific excise tax of PKR10/(US$0.06)/ml since 2020.

Smoking & Advertising Bans

Comprehensive smoking bans and slightly less than comprehensive advertising bans are enforced for CCs in 2022 while their compliance levels are not reported. E-cigarettes are not regulated in Pakistan and are not subject to smoking and advertising bans.

Age Restrictions

Tobacco products cannot be sold to individuals younger than 18 years of age.

Illicit Cigarette Trade

Estimated figures indicate that illicit cigarette trade in Pakistan fluctuates at higher rates with 18% in 2008 consistently increasing to reach its peak at 36% in 2020, then slightly declining to 33.1% in 2022.

TOBACCO PRODUCTION AND DIVERSIFICATION

In 2022, Pakistan was the 7^th largest unmanufactured tobacco producer in the globe, producing approximately 133 thousand tons of unmanufactured tobacco. This accounts for about 2.3% of the global production of 5.8 million tons. Compared to 2010, when Pakistan produced 119.3 thousand tons, there has been an increase of 11.9%.
Pakistan utilized an estimated 62.4 thousand hectares of land to harvest tobacco in 2022, which is an increase of 11.8% compared to 2010 (FAOSTAT)

[1] Source: World Health Organization: Non-age-standardized estimates of current tobacco use, tobacco smoking and cigarette smoking (Tobacco control: Monitor) and The World Bank’s Population Estimates and Projections.

Explanation: This estimate is calculated by applying the WHO’s estimated percentage of tobacco smokers for 2023 to the World Bank’s projected population figures of the same year for 15 years and older. These figures should be used with caution, as they do not account for the 95% credible interval around the estimate.