BACKGROUND AND IMPLEMENTATION CHALLENGES: Tobacco use is the leading preventable cause of NCDs, including cardiovascular disease, cancer, chronic respiratory illness, and mental health disorders. In Pakistan, 17.53% of NCD-related deaths were attributable to tobacco, as reported by the Global Burden of Disease Study (2019). Recognizing the growing prevalence and associated health burden of tobacco use, a robust, multi-sectoral policy response was essential. The National Tobacco Control Strategy (NTCS), developed by the National Tobacco Control Cell under the Ministry of NHSR&C, serves as a comprehensive framework to address this challenge.
INTERVENTION OR RESPONSE: The NTCS was formulated through an evidence-based and participatory process, engaging provincial governments, development partners, health groups, community-based organizations, and academia. Guided by the WHO Framework Convention on Tobacco Control (FCTC) and aligned with its MPOWER strategies, the NTCS incorporates population-level tobacco interventions within the National and Provincial Essential Package of Health Services, advancing Pakistan’s UHC Reform Agenda. The strategy’s objectives include:

1. Reducing all forms of tobacco use prevalence by 30% by 2030.
2. Decreasing the availability and accessibility of tobacco products, including novel items.
3. Strengthening cross-sectoral coordination for sustainable tobacco control initiatives.
4. Establishing robust monitoring mechanisms to ensure compliance with national TCLs.

RESULTS AND IMPACT: The NTCS provides a systematic approach to meeting SDGs 3.a: strengthening the implementation of the WHO FCTC. It fosters enhanced provincial and national alignment, policy coherence, and accountability mechanisms to achieve impactful and sustainable outcomes. After adoption of NTCS, this guided many national level consultation including related to tobacco taxation. It also served as guiding framework for various Provincial Implementation and Monitoring committees’ meetings’ agenda advancing tobacco control initiative in KP, Punjab and Sindh provinces.
CONCLUSIONS: Anchored in global best practices and SDG targets, the NTCS provides a replicable framework for countries aiming to reduce tobacco prevalence and its associated health burden while advancing universal health coverage and sustainable development objectives.