Experts Urge Pakistan to Develop Regulated Tobacco Harm Reduction Framework

Health and policy experts are calling for Pakistan to strengthen tobacco control by developing a regulated, evidence-based framework for tobacco harm reduction, while keeping complete cessation as the safest outcome for smokers.

Pakistan has recorded a 15.7 percent decline in tobacco consumption between 2014 and 2024. However, experts say the pace of progress remains inadequate given that tobacco use is estimated to claim 164,000 lives in the country each year.

Experts seek regulated alternatives for adult smokers

Experts said prevention and quitting support should remain central to tobacco control. They also argued that adult smokers who are unable to quit should have access to scientifically evaluated, regulated alternatives to combustible cigarettes, backed by accurate information and appropriate medical guidance.

Mirza M Abeer, founder of the Association for Smoking Alternatives in Pakistan, said the country needed a regulatory framework that provides adult smokers with credible information and scientifically evaluated alternatives while enforcing standards for quality, marketing and age restrictions.

“Regulation is essential to ensure harm reduction is responsible, informed and accessible,” he said.

Health and financial pressures

Experts said the impact of smoking extends beyond individual health. Tobacco use also places pressure on Pakistan’s healthcare system, household finances and the wider economy. They noted that lower-income communities can face greater difficulties in accessing specialist healthcare, cessation support and reliable information.

Dr Saima Zahoor, a clinical oncologist, said complete cessation was the safest outcome for every smoker. But when patients cannot quit despite repeated attempts, she said healthcare professionals should be able to discuss evidence-based harm-reduction approaches, explain relative risk clearly and help patients move away from continued exposure to combustible tobacco.

Dr Aftab Ahmed Khan, a family physician and public health expert, said smoking remained a major preventable contributor to cardiovascular disease and that every additional year of exposure mattered. He said complete cessation should remain the goal, while physicians also needed clear, evidence-based guidance to support smokers who struggled to quit.

Calls for a science-based framework

Experts urged policymakers to establish a science-based tobacco harm reduction framework with stringent product standards, safeguards against youth access and clear guidance for healthcare professionals.