January 2022 Newsletter

This newsletter presents smoking cessation as a complex public-health issue in Pakistan. It explains that tobacco causes serious diseases and deaths worldwide, and Pakistan has millions of tobacco users using products such as cigarettes, hookah, shisha, paan, gutka, and niswar. The newsletter notes that Pakistan has taken some tobacco-control steps, including taxation, warning legislation, bans on public smoking and advertising, and restrictions around educational institutions, but implementation remains weak.

The newsletter argues that cigarette taxation can reduce consumption, but in Pakistan and other low- and middle-income countries, taxes alone are not enough. Low cigarette prices, illicit cigarettes, weak governance, poor-quality local products, and limited cessation infrastructure reduce the effectiveness of taxation. It explains that smoking is addictive and influenced by age, gender, income, peer pressure, family factors, and social environment.

The issue recommends that Pakistan should work on two major fronts: increasing public awareness about the harms of combustible smoking and enforcing tobacco-control laws, while also providing affordable and accessible smoking cessation platforms. It also suggests that tobacco harm reduction and nicotine replacement therapy can support smokers who are unable to quit immediately, but these options remain expensive, limited, poorly understood, and largely unregulated in Pakistan.

The newsletter also discusses international policy and communication issues. It reports that Thailand was considering legalising e-cigarettes to reduce cigarette smoking. It also highlights criticism of the CDC’s handling of EVALI, arguing that poor communication may have discouraged smokers from switching to lower-risk nicotine products. Another article discusses Bloomberg Philanthropies’ refusal to engage with experts seeking a discussion on vaping evidence and tobacco harm reduction.

• Smoking cessation in Pakistan is a public-health challenge that cannot be solved through taxation alone.
• Pakistan has around 25 million tobacco users and many forms of tobacco use, including cigarettes, hookah, shisha, paan, gutka, and niswar.
• Existing tobacco-control steps include taxes, warning legislation, public smoking restrictions, advertising bans, and sale restrictions near educational institutions.
• Implementation of tobacco-control measures remains weak in Pakistan.
• Low cigarette prices and illicit cigarettes reduce the effectiveness of tobacco taxation.
• Smoking is influenced by addiction, income, age, gender, peer pressure, family factors, and social environment.
• Pakistan needs affordable and accessible smoking cessation services across the country.
• Public awareness and strict enforcement of tobacco laws should work together with cessation support.
• Tobacco harm reduction and nicotine replacement therapy can support smokers who cannot quit immediately.
• THR and NRT products are still expensive, limited, and poorly understood in Pakistan.
• Smokers should be included as important stakeholders in tobacco-control policy discussions.
• Thailand was considering legalising e-cigarettes as an alternative for cigarette smokers.
• The CDC’s EVALI communication is criticised for creating confusion about nicotine vaping.
• Bloomberg Philanthropies is criticised for refusing a proposed discussion on vaping evidence.