Tobacco in Transition: Global Practices, Regional Insights, and Pakistan's Policy Imperative

Executive Summary Tobacco use in Pakistan continues to pose a serious challenge to public health and the national economy. While Pakistan ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004 and later launched the National Tobacco Control Strategy (2022–2030) (Ministry of National Health Services, Regulations and Coordination, 2022), the implementation of these measures has been inconsistent. This brief examines the current status of tobacco control efforts in the country, evaluates them in light of global and regional practices, and offers realistic, evidence-based policy suggestions. Findings highlight persistent issues such as weak enforcement, a complicated tax system, an unregulated smokeless tobacco market, and insufficient cessation programs. To lessen the country's growing health and economic burden from tobacco, it is vital to streamline the tax framework, strengthen and align regulations, and adopt a harm reduction strategy built on scientific evidence. 1. Introduction: The Burden of Tobacco in Pakistan Tobacco use has been a serious problem in Pakistan for a long time. Every year, it takes thousands of lives and adds more pressure to a healthcare system that's already struggling to keep up. The World Health Organization (2023) reports that around 164,000 people in Pakistan die each year because of tobacco-related diseases. But the harm isn't just to people's health it's hitting the economy hard too. Pakistan loses almost PKR 700 billion every year, roughly 1 percent of its GDP, through medical costs and lower work productivity (PIDE, 2022). Over the past decade, these losses have gone up by about 31 percent, showing how weak and inconsistent policies have failed to tackle the issue. Just imagine if even a small part of that money went toward improving schools, hospitals, or social programs it could make a huge difference in people's lives. Although the government has tried to control tobacco use, progress has been slow. Without stronger action, Pakistan will continue to struggle in reaching its bigger goals better health, less poverty, and a stronger, more developed society.