Anti-smoking law having little impact

An anti-smoking law passed in Pakistan a year ago has proved inadequate, according to anti-tobacco activists. "The government should boost its tobacco control efforts by strictly enforcing the law. Also, the tobacco industry should be held accountable for its tempting advertisements which target the younger generation", said Dr Ahsan Latif, head of the Pakistan Anti-Tobacco Coalition, an alliance of around 20 health-sector NGOs working for a smoke-free environment. The legislation, which came into force in July 2003, banned smoking in public places and on public transport vehicles as well as curbing the sale of cigarettes to those under 18. The law also outlawed the storage and sale of tobacco products within 50 metres of educational institutions and specified heavy fines and jail terms for violators. "It is no secret that smoking causes severe medical problems such as cancer and many cardiovascular diseases. The health costs due to tobacco-related diseases are far greater than what the government generates in revenues through cigarette sales," Dr Latif said. "Smoking is a bad social habit - not a criminal activity", said Dr Najeeb Ahmed, who heads the Health Education Cell working under the aegis of the Health Ministry. "Although the anti-smoking law exists, its strict enforcement can never work until you change the public's attitude." "We must change this social attitude through awareness campaigns, and not by imposing penalties. Gradually, as people become aware of the hazards of smoking, they will give it up voluntarily." Dr Ahmed said. Pakistan lacks any authentic data on cigarette-related deaths and diseases but rough estimates suggest that tobacco causes around 100,000 deaths annually, according to a report by the Tobacco Free Initiative - Pakistan [TFI-P], a World Health Organization [WHO] funded project of the Islamabad-based NGO, Network for Consumer Protection. Almost 50 percent of the adult population, mostly from amongst the poor, smokes. Smoking not only causes premature deaths but also affects the health of non-smokers at home, in their workplace or when they travel. According to the Pakistan Medical Association, smoking causes approximately 80-85 per cent of lung, laryngeal, mouth and tongue cancers, besides other common cardiac and lung problems. "Everyone knows that smoking is injurious to health. But, how can a smoker give it up in the face of such widespread tobacco advertising, whether it is in a glossy magazine, on the side of a sleek racing car, or on stylish roadside billboards?", asked Kaneez Zehra, project officer of TFI-P. "Our main concern is the young people who usually fall prey to tobacco companies' aggressive advertisements by receiving a clear and constant message that smoking is glamorous, exciting and a desirable way to behave", Zehra added. Anti-tobacco activists have also expressed concern over the absence of facilities to encourage smokers to quit the habit. "We do not have a single [anti-] smoking physician clinic in the country nor are other techniques such as nicotine replacement therapies [NRT] easily available to help smokers to quit", Dr Latif told IRIN. "NRTs are not even registered in Pakistan and whatever comes through smuggling is out of the reach of the common man, as it is available only at specific places in big cities." Pakistan signed the UN Framework Convention on Tobacco Control in May 2004. It binds states to ban tobacco promotion and advertising, as well as initiating projects to provide alternative source of income for tobacco farmers. "There is a realisation in government of the enormous toll in health care costs and lost productivity," Dr Latif said, "but we lack funding for anti-tobacco activities both at the public and private levels, whether for awareness campaigns or alternative projects for tobacco growers." The government has recently approved a five-year National Action Plan (NAP) to address all the factors in the way of a tobacco-free state. NAP, partially funded by international donors, involves stakeholders from both the public and private sectors. Although the anti-tobacco lobbies acknowledge the government's efforts, they maintain that they are quite inadequate as there is a long way to go before Pakistan can become a tobacco-free state.