Pakistan is fast becoming one of the most alarming global hotspots for medical care crises. While polio has shockingly resurfaced this year, hepatitis C cases remain staggeringly high, placing the country among the most severely affected nations. Adding to these woes, Pakistan’s lax enforcement of tobacco regulations has made it a leading nation for smoking-related deaths.

According to the Global Burden of Disease report, Pakistan’s annual death rate from smoking significantly exceeds the averages for both South Asia and the rest of the world. Over the past 30 years, Pakistan has seen only a marginal decrease in smoking-related deaths compared to the more substantial declines observed in South Asia and globally. The reasons for this are clearly outlined in the report.

In Pakistan, purchasing 100 packs of the most popular cigarette brand requires only 3.7 percent of the GDP per capita, compared to 9.8 percent in India and 4.2 percent in Bangladesh. In European nations that have successfully reduced smoking rates, the cost of cigarettes is prohibitively high, creating a social deterrent to smoking. Pakistan, however, remains an outlier, where affordability sustains high smoking prevalence. The problem is exacerbated by powerful tobacco lobbies that have kept taxes on tobacco products low and resisted stricter regulations. They have opposed enhanced health warnings and the removal of branding from packaging. Furthermore, smuggling from neighbouring countries introduces cheaper, unregulated tobacco products into the market, targeting unsuspecting consumers.

In rural areas, the issue is even more dire. The minimum mandated price for cigarette packets is routinely flouted, with cigarettes sold at increasingly lower prices to ensure widespread availability. This race to the bottom undermines any efforts to control tobacco use.

A decisive crackdown on low taxes, illegal trade, and regulatory non-compliance is urgently needed to reverse this trend and prevent further harm to public health.