Islamabad: Global tobacco use has dropped to its lowest level in modern history, falling from 33 percent in 2000 to 19.5 percent in 2024, but Pakistan remains far behind in meeting international targets to cut smoking and other forms of tobacco use, according to the World Health Organization’s latest global report released this week.
The WHO Global Report on Trends in Tobacco Use 2000–2024 and Projections 2025–2030 shows that while 61 countries are on track to meet the 30 percent reduction target by 2025, Pakistan and most nations in the Eastern Mediterranean region are not. Weak enforcement of anti-smoking laws, poor taxation, and the growing influence of the tobacco industry continue to stall progress.
The report estimates that over 1.2 billion people aged 15 and older still use tobacco worldwide, with 83 percent of them being men. In Pakistan, around 30 million adults are tobacco users, including smokers, naswar users, and those consuming chewing tobacco. Nearly 160,000 Pakistanis die each year from diseases linked to smoking and smokeless tobacco such as lung cancer, chronic obstructive pulmonary disease, heart disease, and stroke.
Health experts say Pakistan’s male smoking prevalence remains among the highest in South Asia, with more than 31 percent of men using tobacco products, compared to less than 5 percent of women. The gap between male and female smokers continues to widen as awareness among women improves but male smoking remains deeply ingrained in social habits, workplaces, and urban youth culture.
The WHO report warns that the rapid rise of vaping and electronic nicotine delivery systems poses a new challenge, especially among adolescents. Global use of e-cigarettes has increased sharply among teenagers aged 13 to 15, with the highest growth reported in low and middle income countries. Pakistan, which currently lacks a regulatory framework for e-cigarettes and heated tobacco devices, has seen a visible surge in vaping among students in urban centers such as Karachi, Lahore, and Islamabad.
Health officials say the absence of clear laws allows nicotine-laced vaping products to be sold freely in markets, often in flavors attractive to teenagers. Pakistan’s 2022 Global Youth Tobacco Survey found that nearly 10 percent of schoolchildren between ages 13 and 15 had used some form of tobacco, including e-cigarettes, at least once. Doctors warn that this trend could reverse earlier gains in reducing youth smoking.
“Tobacco is not only a health threat but also an environmental hazard,” said Dr Saima Saeed, Head of Pulmonology and Director of the Lung Health Program at Indus Hospital and Health Network. “Farming and processing tobacco contributes to air pollution through deforestation and release of polluting substances, while smoking pollutes the air around the smoker and bystanders. For a holistic approach, we need to promote safer agricultural practices to protect both Pakistan’s health and environment.”
Pakistan ratified the WHO Framework Convention on Tobacco Control more than 20 years ago but continues to lag behind in implementing its core provisions. The country still lacks uniform taxation across cigarette brands, plain packaging, and effective enforcement of bans on advertising and sponsorship. Despite repeated pledges, tobacco taxes remain among the lowest in the region, making cigarettes cheaper and easily accessible to youth.
The tobacco industry, estimated to be worth over Rs 600 billion annually, remains a powerful lobbying force. Its marketing tactics, use of misleading packaging, and sponsorship of public events continue to weaken tobacco control efforts. Experts say claims of rising illicit trade are often used to resist price increases, even though WHO studies show that such claims are exaggerated and largely unsubstantiated.
According to the Ministry of Health, more than 40 percent of hospital admissions for respiratory illness are directly linked to tobacco use. Lung cancer cases in Pakistan have nearly doubled over the past two decades, and heart disease remains the country’s leading cause of death. The economic cost of tobacco use, including healthcare spending and productivity losses, is estimated at over Rs 600 billion annually, far exceeding the revenue collected from cigarette taxes.
The WHO report also highlights the growing burden of smokeless tobacco in South Asia, including products like gutka, naswar, and mainpuri, which are widely used in Pakistan’s rural and low income populations. Smokeless tobacco is strongly associated with oral cancer, which remains among the top five cancers in the country.
Public health experts say Pakistan’s anti-tobacco drive has suffered from fragmented governance and lack of political will. Most anti-smoking campaigns are donor funded and sporadic, while enforcement of smoke-free laws is weak. Few hospitals and clinics offer cessation services, and awareness about quitting support remains low.
Globally, tobacco use among women has declined much faster than among men, with female prevalence now below 7 percent. In South-East Asia, countries such as India, Bangladesh, and Thailand have achieved sharp declines through aggressive tax reforms, graphic warnings, and restrictions on tobacco farming. Pakistan, however, has yet to implement comparable measures.
Experts say without urgent reforms and consistent enforcement, Pakistan will continue to bear a growing burden of tobacco-related disease and premature deaths. “Tobacco control must be treated as a national priority,” Dr Saima said. “Every cigarette smoked and every packet sold is a cost to the country’s health and the planet’s future.”
If current trends continue, Pakistan will remain among the world’s slowest countries to reduce tobacco use, undermining not just its health targets but also its environmental and economic sustainability.
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