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Vital Stories

Countdown to Large Graphic Warnings on Tobacco in Pakistan

Tahir Turk, Senior Technical Advisor, Vital Strategies, and local advocacy groups, address the media in Pakistan.

Pakistan is a cultural and geographic crossroads and, from the tobacco control perspective, it unfortunately shows it by showcasing a lot of challenges. Like its neighbor India, Pakistan has a high number of smokers of both manufactured cigarettes and hand-rolled bidis – 27.9% of men and 5.4% of women – and a growing smokeless tobacco trend, with 13.7% of adults. But also, like its neighbors from the Middle East region, Shisha, or water pipe, usage seems to be continuing to grow. All in all, more than 108,800 people die each year from tobacco related disease, according the Tobacco Atlas.

Fortunately, facing the challenging context there is a dedicated group of civil servants and civil society groups who have managed to make significant gains over the last few years. Now, Vital Strategies is working with this coalition of groups and individuals to warn the public of the dangers of tobacco use – or the “W” in World Health Organization’s MPOWER framework.

In February, Pakistan’s Minister of National Health Services, Regulations and Coordination announced a significant new measure – increasing graphic pack warnings on cigarettes to 85% on both sides of the pack and changing the picture to an effective and disturbing throat cancer picture. Vital Strategies will also work to team with the Ministry to air a television ad with similar themes – gaining even greater impact for the warning and also reaching tend of millions of nonsmokers.

The Minister’s announcement got significant pushback from the tobacco industry who, working from a playbook we have seen used time and again, argued that this would be too difficult to implement, too costly, and cost them profits. The industry worked through allies inside and outside government including, controversially, a visit from British American Tobacco and the British High Commissioner to Pakistan, which allegedly worked to dissuade adoption of larger warnings.

Vital Strategies Senior Techinical Advisor Dr. Tahir Turk, in Pakistan to lay the groundwork for a new national mass media campaign on tobacco’s harms, worked to counter this influence. Calling a press meeting with other advocates, Dr. Turk emphasized that pack warnings are a life-saving initiative, and one that works preventively to prevent children from initiating. As kids see the large graphic warnings on the pack, they often will give a second thought to starting. Coverage of the event was fantastic, helping to counter the tobacco industry’s bogus claims and reiterate the importance of graphic warnings.

Ultimately, the Minister has given the tobacco industry an extra 60 days to comply, but Vital Strategies and other advocates will stay strong in asking that government choose children and people’s health over industry profits.

In the meantime, we look forward to continuing to work with our partners in Pakistan on creating a mass media campaign with the potential to reach millions of Pakistanis and warn them about the dangers of tobacco use.