Islamabad
515-respondent study finds most current tobacco and nicotine users trust their own families on health information more than they trust the government
A new national survey finds that most of Pakistan’s current tobacco and nicotine users want smoke-free alternatives such as vapes and nicotine pouches brought under strict government regulation rather than banned outright. 87% back a regulated, legal framework over prohibition, according to the Tobacco Harm Reduction Perception Survey, Pakistan, released today by the Endit Foundation.
The survey was fielded among 515 adult daily and weekly tobacco or nicotine users across Pakistan by Prodege, a global research and consumer-insights company, in technical coordination with the Endit Foundation, Islamabad.
Respondents were surveyed online between 16 June and 2 July 2025, and all were screened to be current regular users of at least one tobacco or nicotine product.
The findings point to a consumer already ahead of policy. 86% say alternative nicotine products considered less harmful than cigarettes should be regulated differently; 89% want strong enforcement to keep them away from minors; and 86% believe an outright ban would push people toward illegal markets rather than toward quitting. 79% support taxing smoke-free alternatives at a lower rate than cigarettes.
We found high awareness of these products in survey, 87% know of vapes and e-cigarettes, 83% know of nicotine pouches, but a critical misconception persists. 69% of respondents still believe nicotine itself is the main cause of smoking-related cancer, even though 82% separately agree that most of the harm from smoking comes from inhaling smoke, not from nicotine.
“This gap has direct implications for how harm reduction messaging is designed and delivered,” the report states.
The survey also exposes a trust gap. Friends and family are the most trusted source of information on tobacco and nicotine, at 93%, followed by doctors and public health experts (80%). Government policymakers rank lowest, at 40%, behind the media (43%).
“Any public health messaging on tobacco harm reduction is likely to travel further through personal networks and clinicians than through official or media channels alone,” the report notes.
“The findings show that many of Pakistan’s current tobacco and nicotine users are looking to move toward products they perceive as less harmful, expecting these to be regulated,” said Dr Ziauddin Islam, CEO of the Endit Foundation.
“Turning that readiness into a real public health gain means Pakistan needs firm regulation that protects youth, holds any legal products to strict safety and quality standards, and gives adult smokers accurate, evidence-based information to help them move away from cigarettes.”
The report recommends four steps for regulators: risk-proportionate rules that treat smoke-free nicotine products differently from combustible cigarettes; mandatory product standards and youth-access enforcement; and a coordinated public education campaign, led by the Ministry of Health, to close the nicotine-cancer knowledge gap.
About the Endit Foundation The Endit Foundation is an Islamabad-based public health organisation that raises awareness of tobacco’s health hazards, advocates for tobacco-policy reform, and runs harm-reduction and cessation support programmes for vulnerable groups, including youth and low-income communities.
