ISLAMABAD – Health experts and anti-tobacco activists urge the government to harmonize cigarette taxes with WHO guidelines to protect the country’s youth from falling victim to smoking, a consequence of the current affordability of cigarettes*.
The imposition of low taxes on cigarettes in Pakistan makes them cheaper, which not only increases the number of smokers every year but also increases smoking-related diseases and health bills for the government.
Dr Maleek Haider has an unending number of patients with smoking-induced ailments.
“Most of my patients are poor and breadwinners in their families. I have observed that they start smoking at an early age and fall sick by the time they cross 30,” he said.
His observation strikes a chord with the findings of one of the latest studies on smoking in Pakistan conducted by the Pakistan Institute of Development Economics.
It says that 86 percent of the cost of smoking-induced diseases is borne by individuals in 35–64 age group.
Alarmingly, it also states that the total cost of mortality and morbidity caused by smoking accounts for 1.6 per cent of the GDP of a country that spends less than 1 per cent of its GDP on healthcare.
Shedding light on why cigarettes are cheap, the study says that it is due to overlooking at the guidelines set by the World Health Organization (WHO).
The WHO guidelines state that a “threshold of 70 per cent of the retail price or the level required to cover the costs tobacco makes the country incur. In the latter case, the increase would be four to five times the tax rate. In the short run, the rates on the two tax tiers should be increased with a higher increase for the second tier to minimise the gap between them. In the long run, however, the two-tier system should be abolished to have a single-tier system. This would help in bringing the poor out of the vicious cycle of poverty in addition to reducing the smoking-related disease burden.”
The total revenue from cigarette taxation in 2021-22 was Rs 150 billion. Hence, the economic and health cost imposed by smoking on society is 3.65 times higher than the overall tax collected from the tobacco industry.
Similarly, the smoking-attributable direct cost is 8.3 percent of the total health expenditures, which is significantly high. Likewise, the total economic cost of smoking is almost equal (1.03 times) to the public sector health spending (both federal and provincial), according to the PIDE report.
Anti-tobacco activists have called for increasing cigarette taxes instead of utilities such as electricity and gas.
Malik Imran Ahmad, Country Head of the Campaign for Tobacco-Free Kids (CTFK), also pointed out the high prevalence of tobacco use in the country, with 31.9 million adults (15 years and above) consuming tobacco products, accounting for about 19.7% of the adult population.
It is estimated that smoking-induced illnesses, such as cancer, diabetes, and heart disease, contribute to over 160,000 deaths annually in Pakistan.
Dr. Aman Khan, director of the Waseela Foundation, says that multi-national cigarette manufacturers know how to manipulate media to mislead the masses into smoking.
He said research has shown that hardly 16 per cent of cigarettes are illicit, but the companies propagate that they account for 40 per cent. He added that these multinational companies are influential enough to stifle voices of sanity in media.
He said the government needs to build a narrative on modern lines, keeping in view the changing nature of media to counter smoking.
