By Maria Tabassum
PESHAWAR: Leaves of nicotiana are used in various ways for smoking, snuffing, chewing, and extracting nicotine. Originally indigenous to the Americas, today’s cultivated tobacco has been highly engineered for consumption and nicotine extraction.
Prior to the 15th century, tobacco plant was grown and used in the Americas. From the 16th to 18th century, tobacco was smoked primarily in pipes and cigars, chewed and snuffed. In the 19th century, cigarettes were introduced and became the most commonly used tobacco product globally.
In the 21st century, the tobacco products landscape continued to expand to include little flavoured cigars and cigarillos, e-cigarettes, heated tobacco products (HTPs), and synthetic nicotine products.
Nowadays, tobacco is being used in oral nicotine products, smokeless tobacco products, combustible tobacco products, HTPs, hybrid devices, and e-cigarettes.
E-cigarettes come in disposable and refillable forms and with prefilled cartridges and pods. These are called e-cigs, vapes and electronic nicotine delivery systems or ENDS. These are battery-operated devices that heat a liquid to produce an inhaled aerosol. The liquids in e-cigarettes usually contain nicotine as well as flavouring and other chemicals. E-cigarettes come in a variety of shapes and sizes.
In this digital age, the landscape of nicotine consumption is undergoing a profound transformation and Pakistan is a prime example of this global trend. The integration of technology and widespread use of social media have significantly influenced consumer behaviour and the tobacco industry’s marketing strategies.
Traditional cigarette smoking, once the norm, is gradually being eclipsed by modern alternatives such as e-cigarettes, vaping devices, heated tobacco products and heat-not-burn products. These new methods of nicotine delivery are gaining popularity in Pakistan, particularly in urban areas where global influences are stronger and access to technology is more widespread. Marketed as less harmful and more socially acceptable, these alternatives are increasingly appealing to the youth, signifying a major shift in traditional smoking habits.
In the year 2020, up to 22.3 per cent of the world population, including 36.7 per cent of men and 7.8 pc of women, consumed tobacco. About 8.7 million people around the world die of tobacco consumption every year, including 1.3 million those who are exposed to second-hand smoke.
Pakistan is one of the largest tobacco-consuming countries in the world. The country is second to India with the highest use of smokeless tobacco.
According to the Ministry of National Health Services 2018, almost 23.9 million adults currently use tobacco in any form in the country. As per the Pakistan Household Integrated Economic Survey 2015-2016, 45 per cent of the households in Pakistan were tobacco consumers. A total of 6.2 per cent of the population uses vaping or e-cigarettes while 15.9 million (12.4 percent) use smokeless tobacco. On global level, there were 82 million vapers worldwide in 2021.
Tobacco consumption kills over 164,000 people each year in the country. Almost 31,000 of these deaths are due to exposure to second-hand smoke. Overall, 10.9 percent of all fatalities are caused by tobacco. The total economic cost of tobacco-induced diseases in Pakistan in 2019 was 615 billion while revenue from tobacco taxation 2018-19 was 120 billion.
A visiting researcher at the Sustainable Policy Development Institute Waseem Iftikhar Janjua points out that the World Health Organisation (WHO) Framework Convention on Tobacco Control (WHO FCTC) is the first international treaty negotiated under the auspices of the WHO. It was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February 2005.
Pakistan became a party to the convention on February 27, 2005 and ratified the FCTC Protocol to Eliminate Illicit Trade in Tobacco Products on June 29, 2018.
There are 182 Parties to the WHO FCTC 2021, covering more than 90 per cent of the world population.
Talking about our country, Janjua said, a ban on tobacco advertising, promotion, and sponsorship is in place.
Tobacco packaging and labeling regulations have been imposed. Regulations on smoke-free places and sales restrictions are in place while there are no regulations on e-cigarettes and new tobacco products. Cigarette (Printing of Warning) Ordinance 1979 is in place but there is no rule on warning on smokeless tobacco products, he added.
The advent of the internet and the explosion of social media platforms have been game-changers for tobacco industry’s marketing. In Pakistan, with its significant increase in social media usage, tobacco companies are leveraging these platforms for targeted advertising.
These campaigns often depict new nicotine delivery devices as trendy and aligned with a tech-forward lifestyle, specifically targeting a younger, tech-savvy demographic. This strategy, effective in increasing sales, raises considerable public health concerns, particularly about its potential influence on non-smokers and younger individuals.
The health implications of these novel nicotine delivery systems are currently a subject of global debate, leading to a variety of regulatory responses. In Pakistan, the regulatory framework is in a state of flux, with authorities trying to strike a balance between public health interests and the economic benefits brought by the tobacco industry. The long-term health effects of these new devices are still being studied, presenting a significant challenge for regulators and policymakers alike.
This shift towards new methods of nicotine consumption reflects a broader change in consumer behaviour in Pakistan. An increased emphasis on health concerns, coupled with the appeal of modern technology, is driving many away from traditional cigarettes. This trend is particularly pronounced among younger populations in urban areas, indicating a significant cultural shift in the country’s approach to smoking.
However, Pakistan, like many other countries, faces challenges in addressing the long-term health impacts and potential risks associated with these new nicotine delivery systems. The lack of extensive research and the concern that these devices could potentially lead to traditional smoking habits, especially among the youth, are pressing issues. Moreover, the ease of access to these products through online platforms raises questions about effective regulation and control.
In addition to health concerns, there are economic implications to consider. The tobacco industry is a significant contributor to Pakistan’s economy and the shift towards alternative nicotine delivery systems could have financial repercussions. Policymakers must navigate these economic considerations while prioritizing public health.
The role of education and public awareness campaigns in this evolving landscape cannot be overstated. There is a need for comprehensive educational initiatives to inform the public, particularly the youth, about the potential risks associated with these new devices. Such campaigns could play a crucial role in mitigating the attraction of targeted marketing by tobacco companies and in promoting healthier lifestyle choices.
The transformation in the way nicotine is consumed in Pakistan, driven by technological advances and innovative marketing strategies, presents a complex array of challenges and opportunities. The country’s journey through this new era of nicotine consumption necessitates informed decision-making, proactive policy-making, and a balanced approach that considers both public health and economic factors. As Pakistan continues to navigate these changes, the ultimate goal remains the promotion of a healthier future for its citizens.
Now talking about the challenges faced by the country, there is no federal and provincial policy framework available regulating e-cigarettes. Regulations are needed on sale, advertisement and promotion of e-cigarettes specially regulations on age restriction for their sale. There is a dire need for sub-national regulations that are stricter than the national laws. The country must ban e-cigarettes like Australia, Brazil, Thailand, Singapore, Cambodia, Brunei Darussalam, Qatar, Iran, Syrian Arab Republic, Ethiopia, Mexico and Lebanon.
