Helping adult smokers to quit

Adult smokers in Pakistan need support, especially those who have been unable to quit despite multiple attempts. The Global Adult Tobacco Survey Pakistan 2024 found that 24.1% of current tobacco smokers had tried to quit in the preceding 12 months. The survey figure records attempts, not the share who permanently quit.

According to WHO cessation index, Pakistan offers nicotine replacement therapy and/or some cessation services with at least one cost covered. However, the primary tobacco law in Pakistan - the Prohibition of Smoking in Enclosed Places and Protection of Non-smokers Health Ordinance, 2002 – does not talk about smoking cessation.

According to the Global Adult Tobacco Survey Pakistan 2024, approximately 22.7 million adults in Pakistan currently use tobacco. Greater access to cessation services, including counselling and medicines, could help people who want to stop smoking.

Smoking contributes to cancer, cardiovascular disease and respiratory illnesses such as COPD. According to the WHO, tobacco use causes more than 7 million deaths worldwide each year, while secondhand smoke exposure is estimated to cause over 1.6 million deaths annually. These are global estimates, not Pakistan-specific death rates.

On the other hand, the rest of the world realizes the importance of access to effective cessation services. According to the US National Cancer Institute, "Smoking cessation lowers the risk of cancer and other serious health problems. Counseling, behavior therapy, medicines, and nicotine-containing products, such as nicotine patches, gum, lozenges, inhalers, and nasal sprays, may be used to help a person quit smoking."

Every smoker, at some point in life, wants to quit smoking. At this occasion, a smoker should have knowledge and access to smoking cessation programs at the local levels. There is a lack of structured quit programs, counseling services, and accessible nicotine replacement therapies (NRTs). Public hospitals rarely offer dedicated smoking cessation programs, and private healthcare options are often expensive. Additionally, low awareness of cessation methods and limited government funding exacerbate the issue. The absence of evidence-based quit-lines and professional counseling further reduces quit success rates.

There is a need to establish accessible quit-smoking programs at the federal, provincial and local levels, which should be backed by counselling and nicotine replacement therapies for those struggling to quit. In this regard, the role of healthcare providers is critical. Unfortunately, up till now, they are not part of the efforts to help the adult smokers quit smoking.

The role of health professionals, mainly doctors, is critical in helping the adult smokers quit. However, doctors seem to be aloof from the initiatives on decreasing the burden of tobacco use and seldom actively engage in supporting smokers to quit the habit. It is essential that doctors are sensitized on tobacco harm reduction and made part of the efforts to highlight this concept and how it can assist in reducing smoking prevalence.