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Press Room

Delay in Pakistan’s Implementation of Large Graphic Warnings Will Cost Lives

Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”

(Islamabad, Pakistan, and New York, USA) – At an event in Islamabad today, World Lung Foundation joined with a number of national and international health experts in commending Pakistan’s Ministry for National Health Services, Regulations and Coordination for pressing forward with regulations to introduce graphic health warnings covering 85% of cigarette packs. This would make graphic pack warnings in Pakistan among the largest in the world alongside Thailand, which has already adopted graphic warnings that cover 85% of cigarette packs. The experts also condemned tobacco industry lobbying and interference designed to derail and delay the legislation, pointing out that any such delay would cost lives and increase tobacco-related harm to Pakistan’s economy.

The impact of tobacco packaging is well known: attractively branded tobacco packs play a major role in influencing young people to initiate smoking. In contrast, large graphic pack warnings are proven to help deter youth from initiating smoking and to encourage quitting and reduced consumption among current smokers. In Pakistan’s proposed law, the new warning will be more impactful in clearly communicating the danger of tobacco use because it is more attention-grabbing – at more than double the size of the current warning – and because of the powerful, real-life image of throat cancer selected. To date, there have been no national mass-media campaigns in Pakistan to warn people about the harms of tobacco, so graphic pack warnings play an even more important role in raising awareness.

There are health and economic arguments for reducing overall smoking prevalence in Pakistan through proven tobacco control measures, including large graphic pack warnings. According to The Tobacco Atlas, more than 20 million Pakistani adults – approximately 27.9% of adult men and 5.4% of adult women – smoke tobacco. In 2010, 12.2% of male deaths – 1,645 men every week – and 4.5% of female deaths – 442 women every week – were caused by tobacco. The need to deter youth initiation of smoking in Pakistan is particularly urgent. Approximately 555,000 Pakistani children use tobacco every day and 9.9% of boys (ranging from 6.1% of boys in Lahore to 14.1% in Karachi) smoke tobacco – more than the average in other middle-income countries. The increasing incidence and cost of tobacco-related disease and premature death is a growing drain on Pakistan’s economy.

Dr. Tahir Turk, Senior Technical Advisor, World Lung Foundation commented: “The combined revenues of the world’s six largest tobacco companies in 2013 were USD342 Billion, 28% larger than the Gross National Income of Pakistan, yet the tobacco industry has been counting on economic growth and increasing tobacco use in countries like Pakistan to bolster these already massive profits. It is so determined to stop large graphic warnings – not just in Pakistan – precisely because they are so effective in warning people, particularly vulnerable populations like youth, about the real harms of tobacco and therefore in reducing smoking. Where we see lives saved, the tobacco industry sees only lost profit, so it spreads misinformation and attempts to influence government to block progress.

“The coming weeks and months are critical. We applaud the Ministry for National Health Services, Regulations and Coordination for its determination to protect Pakistan’s citizens – particularly its youth – by putting the country at the forefront of global tobacco control in passing this legislation. Further, we stand with the international health community and the Ministry in encouraging government to ignore the threats and lies of the tobacco industry, which is interested only in its own profits rather than the health of Pakistan’s people and economy. Every day of delay is another the tobacco industry gets hundreds of children addicted to its product, so we urge Pakistan to implement the new 85% graphic pack warnings as proposed, with full compliance by the industry by May 30th.”

According to The Tobacco Atlas, more than 108,800 people die each year in Pakistan from tobacco-related diseases such as heart disease, stroke and emphysema. The country is also ranked 6th in the world in terms of TB, a burden made worse by the high prevalence of smoking.

Dr. Fouad Aslam, The International Union Against Tuberculosis and Lung Disease, said: “The eyes of the world – and the tobacco industry – are on Pakistan with this proposal for 85% graphic pack warnings. The proposed pack warning is a proven, low-cost way to save thousands of lives and reduce the massive health care costs arising from smoking-related disease in Pakistan. For the health of Pakistan’s people and its economy, we support the Ministry’s intention to become a global leader in using pack warnings to warn the public of tobacco’s harms. International experience has shown that in every country, the industry will do everything in its power to keep graphic pack warnings from coming to light: lobbying, threatening lawsuits and delaying implementation. While the tobacco industry has been successful in watering down or delaying similar proposal in other countries, let us stand firm and put the health of Pakistan’s people over the industry’s profits. We trust that implementation of the new pack warnings will begin at the end of this month – March 30th – with full compliance from the industry by May 30th.”

Tobacco use is the leading preventable cause of mortality in the world today, and is responsible for more than five million deaths each year – one in ten preventable deaths worldwide. Research has shown graphic warnings are one of the most effective means to prompt people to quit tobacco. It is one of the World Health Organization’s M-P-O-W-E-R (W=Warn) strategies to reduce tobacco consumption.