IN a significant move to safeguard public health, health advocates and organizations from 25 African countries have appealed to Prime Minister Shehbaz Sharif of Pakistan to reject proposals allowing the manufacture and export of 10-stick cigarette packs, colloquially known as “kiddie packs,” to Sudan. This collective plea, undersigned by 54 organizations and 60 advocates, underscores a global concern for protecting children from the dangers of tobacco addiction. The petition underscores that allowing the production of kiddie packs for export, while maintaining stricter regulations domestically, poses significant ethical and health challenges. It implies that it is acceptable to endanger the health of children in another region, which is a morally indefensible stance. The advocates emphasize that if a product is deemed too dangerous for children in one country, it should be considered equally harmful for children everywhere.
The petition further describes that the African continent, particularly Sudan, faces numerous health and socio-economic challenges. The introduction of cheaper and more accessible cigarette packs would exacerbate these issues, increasing the risk of tobacco addiction, diseases, and premature deaths. The argument that these packs would not be sold in Pakistan but only in Africa is a clear example of prioritizing profit over public health. This could lead to a domino effect, where once kiddie packs are introduced in one country, they could proliferate across the continent, undermining efforts to control tobacco use and protect public health.
The petition also underscores the unacceptable nature of BAT’s strategy to exploit regulatory differences across continents to market harmful products to vulnerable populations. It is imperative to recognize that permitting the manufacture of these kiddie packs, even if not sold domestically, contradicts the spirit of our public health goals and intemational obligations. Moreover, it is ethically questionable to facilitate a practice that endangers children in another part of the world, particularly in regions already struggling with numerous public health challenges
The stance against weakening tobacco control laws is not limited to African advocates. The Health Services Academy (HSA) in Islamabad has also raised its voice, warning against the increased accessibility and affordability of smaller cigarette packs. During a recent press conference, HSA Vice Chancellor Prof Dr. Shahzad Ali Khan and other health experts highlighted the severe impact of tobacco on public health in Pakistan. They pointed out that tobacco contributes significantly to the burden of chest and lung diseases, with higher rates of addiction and premature deaths among children being a primary concern.
Dr. Khan emphasized the global consensus against such measures, citing the petition from the coalition of African organizations and health advocates. Prof Dr. Matiur Rehman from HSA underscored the harmful effects of active, passive, second-hand, and third-hand smoking, stressing the need for stringent tobacco control measures. Dr. Madiha Siddiqui, a consultant pulmonologist from Indus Hospital, shared alarming statistics on the rising number of female patients with tobacco-related illnesses, highlighting the widespread impact of tobacco across different demographics.
In a letter addressed to the Tobacco Control Cell (TCC) Ministry of National Health Services, Regulations and Coordination (NHS,R&C), HSA highlights the stringent tobacco control regulations in Pakistan. Currently, these regulations prohibit the sale of cigarette packs containing fewer than 20 sticks. This measure aims to restrict minors’ access to affordable cigarettes, aligning with global standards.
However, a leading cigarette manufacturer in Pakistan is actively lobbying to amend these regulations to allow for the production of 10-stick packs intended for export to Sudan. This proposed change contradicts Article 16 of the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), which emphasizes the prohibition of small cigarette packets to prevent access by minors.
The ethical implications of banning a harmful product domestically while exporting it to another country are stark. It suggests a double standard in health policies and a disregard for the well-being of children in other parts of the world. The HSA is known for its dedication to public health through education, research, and policy advocacy and support the global stance against such practices. In another related and alarming development, the Ministry of National Health Services, Regulations and Coordination (NHS,R&C) has issued a proposed statutory notification, S. R. O. 1065(1) 2024, suggesting amendments to facilitate the export of kiddie packs to Sudan. Whereas civil society organizations in Pakistan working for tobacco control firmly believe that cigarette packs containing fewer than 20 cigarettes should not be manufactured in the country.
Moreover, Coalition for Tobacco Control Pakistan (CTC-Pak), a project of Society for Alternative Media and Research (SAMAR) and a coalition of more than 100 civil society organizations from four provinces of Pakistan working for tobacco control, appeals to the Prime Minister of Pakistan that public health should transcend borders, and the protection of children from tobacco addiction and its related harms is a shared responsibility. Allowing the manufacture and export of kiddie packs not only undermines global tobacco control efforts but also sets a dangerous precedent. It is imperative that Pakistan, as a responsible member of the international community and a signatory to the WHO FCTC, upholds its commitment to protect public health and rejects any measures that could endanger children worldwide. The collective voice of health advocates from Africa and Pakistan should resonate with policymakers, urging them to prioritize health over profit and ensure a healthier future for all children.
—The writer is a Research Associate at the Coalition for Tobacco Control Pakistan (CTC-Pak)/Society for Alternative Media and Research (SAMAR).
