BACKGROUND AND IMPLEMENTATION CHALLENGES: In Pakistan, an estimated 19.1% of adults use tobacco (GATS-2014). Whereas, in Punjab 29.1% male and 3.6% female are tobacco users (PDHS 2017-18). Tobacco consumption kills almost 163000 persons in Pakistan per year, 31000 of these deaths are due to secondhand smoke (GBD-2019), indicating a margin to enhance compliance on tobacco control laws.
The economic cost of smoking in Pakistan is Rs.615.07 billion (US$3.85 billion), equal to 1.6% of Pakistan's GDP, which is about five times greater than the revenue from the tobacco industry (PIDE-2021).
In Punjab, there was no dedicated tobacco control program. Rather tobacco control was part of NCD program and was confined to mass awareness events. There was no Provincial or District Focal persons to work exclusively for tobacco control. No mechanism was in place for enforcement of Tobacco Control Laws.
INTERVENTION OR RESPONSE: The project has pursued the initiative for advancing Sustainable Tobacco Control in Pakistan to counter the sustainability challenges at sub-national level. It demonstrates innovative strategies for combating tobacco-related public health challenges.
RESULTS AND IMPACT: ABP facilitated the development of sustainable tobacco control policy framework, integrating cross-sectoral efforts to strengthen governance and legislative enforcement. As a result, first-ever provincial and eight district focal-persons have been nominated to ensure dedicated leadership and localized implementation of tobacco control policies.
As an innovative approach, the project facilitated integration of tobacco control with the TB control program, leveraging existing healthcare infrastructure to enhance sustainability, efficiency and outreach.
Issuance of tobacco vendor licenses in 8 partner districts marked a significant policy innovation, regulating the sale of tobacco products and ensuring compliance on laws at point of sale. Complementing this was the deployment of mobile application that enables citizens to report violations of tobacco control laws in real-time.
CONCLUSIONS: The program achieved significant milestones that establish a sustainable, replicable and scalable foundation for tobacco control in Pakistan.