Tobacco Use and Trends
- In 2022, an estimated 25.4 million people (20.7 million males and 4.6 million females) aged 15 years and older were tobacco product users in Pakistan. This positions the country as the 7th globally and the 1st in the WHO Eastern Mediterranean Region in terms of number of tobacco users.1,2
- Between 2017-2018, 14.6% of males and 3.4% of females aged 15+ years were current smokeless tobacco users.
- In 2013, 10.7% of youths (13.3% boys and 6.6% girls) aged 13-15 years were current tobacco users.
- In 2013, 5,3% of youths (6.4% boys and 3.7% girls) aged 13-15 years were current smokeless tobacco users.
- It is estimated that the demand for cigarettes per capita reduced by 28% from 16.7 packs in 2010 to 12 packs in 2022. (Euromonitor [accessed November 2023])
Nicotine Alternatives
- There is no available data on prevalence of other nicotine alternatives in Pakistan.
Health and Economic Burden From Tobacco Use
- In 2021, it was estimated that tobacco was the 5th highest risk factor driving the most deaths and disability combined in Pakistan.
- Tobacco was responsible for an estimated 130.6 thousand deaths, which is about 15.9% of total deaths.
- Of tobacco-related deaths, 101.3 thousand or 77.5% were due to smoking, and 29.3 thousand or 22.5% were due to secondhand smoke.
- In 2021, the top 10 causes of the most deaths in Pakistan included Ischemic Heart Disease (IHD) ranking 3rd, Stroke ranking 4th, and Chronic Obstructive Pulmonary Disease (COPD) ranking 6th.
- Tobacco was responsible for an estimated 37.6 thousand or 20.5% of all IHD deaths, 13.7 thousand or 15.7% of all Stroke deaths, 9.8 thousand or 75.6% of all Lung Cancer deaths, and 26.8 thousand or 48.3% of all COPD deaths.
- In 2019, tobacco use caused an estimated loss of 4.3 million disability-adjusted life years (DALYs), which was about 9.3% of total DALYs. Tobacco accounted for 1.2 million DALYs for IHD, 422.6 thousand DALYs for Stroke, 265.5 thousand DALYs for Lung Cancer, and 644.9 thousand DALYs for COPD.
- Tobacco causes a substantial economic impact. In 2019, the total cost of all smoking-attributable diseases and deaths amounted to an estimated USD 3.85 billion.
Regulatory Environment and Economics
Public Health Commitment
- Pakistan ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004 and the WHO Illicit Trade Protocol in 2018.
- Pakistan adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2010, covering 60% of the front and 60% of the back of the packages.
Diverse Tobacco Market
- Heated Tobacco Products (HTPs) are allowed and legal to market in Pakistan. E‑cigarettes with and without nicotine content are classified as “consumer products”, without any regulations imposed on them.
Taxation Policy
- The total tax rate on the retail price of a pack of cigarettes was 51.8% in 2022.
- As of 2023, the excise tax value of CCs is PKR 330.00/pack, reflecting a share of 66% of the retail price of PKR 500.00/pack.
- HTPs are not classified in the tax code and are currently not subject to excise taxes, while e-cigarettes, irrespective of their nicotine content, are subject to a specific excise tax of PKR 10.00 (USD 0.043)/ml since 2020.
Smoking and Advertising Bans4
- Complete smoking bans with unknown level of compliance, and moderate advertising bans with unknown level of compliance were enforced in Pakistan in 2022.
Age Restrictions
- Tobacco products cannot be sold to individuals younger than 18 years of age.
Illicit Cigarette Trade
- Estimated figures indicate that illicit cigarette trade in Pakistan fluctuates at higher rates, with 18.0% in 2008 and since then consistently increasing to reach its peak at 36.0% in 2020, then slightly declining to 33.1% in 2022. (Euromonitor [accessed November 2023])
Tobacco Production and Diversification
- In 2022, Pakistan produced about 133.6 thousand tons of unmanufactured tobacco, accounting for approximately 2.3% of the global production of 5.8 million tons. This positioned Pakistan as the 7th largest tobacco producer in the world.
- Compared to 2010, when Pakistan produced about 119.3 thousand tons of unmanufactured tobacco, there was a 11.9% increase by 2022.
- In 2022, Pakistan utilized approximately 62.4 thousand hectares of land for tobacco cultivation, reflecting a 11.8% increase compared to 2010. (FAOSTAT [accessed January 2024])
