With tobacco use continuing to claim an estimated 164,000 lives annually in Pakistan, health and policy experts have called for urgent action to strengthen the country’s tobacco control strategy by introducing a regulated, evidence-based framework for Tobacco Harm Reduction (THR).
While Pakistan has recorded a 15.7% decline in tobacco consumption between 2014 and 2024, experts caution that the pace of decline remains inadequate against the scale of tobacco-related mortality. They stressed that alongside prevention and cessation efforts, adult smokers who are unable to quit should have access to scientifically evaluated, regulated alternatives to combustible cigarettes, supported by accurate information and appropriate medical guidance.
Mirza M. Abeer, Founder of the Association for Smoking Alternatives in Pakistan (ASAP), said, “A decline in tobacco consumption is encouraging, but when approximately 164,000 lives are still being lost every year, progress cannot be measured by prevalence alone. Pakistan needs a regulatory framework that gives adult smokers access to credible information and scientifically evaluated alternatives while enforcing strict standards for quality, marketing and age restrictions. Regulation is essential to ensure harm reduction is responsible, informed and accessible.”
The burden of smoking also extends far beyond individual health, placing pressure on Pakistan’s healthcare system, household finances and the wider economy. Experts highlighted that this burden disproportionately affects lower-income communities, which often have less access to specialist healthcare, cessation support and reliable information.
Dr. Saima Zahoor, Clinical Oncologist, said, “The safest outcome for every smoker is complete cessation. However, when patients are unable to quit despite repeated attempts, the medical conversation cannot simply end there. Healthcare professionals should be equipped to discuss evidence-based harm-reduction approaches, explain relative risk clearly and help patients move away from continued exposure to combustible tobacco.”
Dr. Aftab Ahmed Khan, Family Physician & Public Health Expert, added, “Smoking remains a major preventable contributor to cardiovascular disease and every additional year of exposure matters. Complete cessation must remain the goal, but for smokers who struggle to quit, reducing exposure to the toxic products of combustion can be an important step. Physicians need clear, evidence-based guidance to support these patients responsibly.”
Experts urged policymakers to establish a science-based THR framework with stringent product standards, safeguards against youth access and clear guidance for healthcare professionals. They stressed that access to smoking cessation and harm reduction should not depend on income or an individual’s ability to navigate complex health information and that every adult smoker should have access to credible guidance and appropriate interventions.
With tobacco continuing to impose a significant human, healthcare and economic burden on Pakistan, experts called for THR to be considered as part of a comprehensive national strategy that accelerates the transition away from combustible tobacco while keeping complete cessation as the ultimate goal.
