ISLAMABAD: On World No Tobacco Day (WNTD) 2014, then National Health Services (NHS) state minister Saira Afzal Tarar had announced she would increase the size of the pictorial warning on cigarette packets from 40 to 85pc by the next year.

But four years later, on the eve of WNTD 2018, civil society experts say the government has not done much to reduce the consumption of tobacco in line with international obligations.

At the time of Ms Tarar’s announcement, a tobacco industry delegation led by a high commissioner met with then finance minister Ishaq Dar, and it was decided that the matter would be reconsidered by an inter-ministerial committee.

The committee decided that the size of the pictorial health warning would be increased from 40pc to 50pc, but even that decision was not implemented for over three years.

After a two-year delay, the federal cabinet decided again in 2017 that the pictorial health warning would be enlarged to 50pc, and the new health warning will replace the old one this June.

The national coordinator of the Coalition for Tobacco Control, Khurram Hashmi told Dawn that it was unfortunate that a government decision could not be implemented even after four years.

“If the government would have increased the pictorial health warning by 10pc every year, today we would have almost achieved the 85pc target. Unfortunately, the decision was delayed due to which we have been left behind compared to other neighbouring countries,” Mr Hashmi said.

He added: “The global adult tobacco survey (GATS) and global youth tobacco survey (GYTS) claim that three out of every 10 current smokers thought of quitting smoking because of warning labels so the government should consider it seriously and protect the youth from disease.”

Dr Waseem Khawaja from the Pakistan Institute of Medical Sciences said tobacco was the major reason of cardiovascular disease.

“The WHO is calling on countries around the world to implement plain packaging of tobacco products and help end the deadly tobacco epidemic but we are still debating if the size of the pictorial warning should be increased or not,” he said.

“Tobacco use is the world’s leading cause of preventable death and claims about six million lives each year. More than 80pc of these deaths occur in low and middle income countries,” he said.

He added that smoking can increase risks of asthma, pneumonia and other diseases, while babies whose mothers are chain smokers are at risk of low birth weight.

Dr Khawaja said the department of pulmonology treats 200 to 250 patients a day suffering from lung diseases, of which 125 are found to be smokers.

He said: “125 patients suffering from chronic obstructive pulmonary disease report to the hospital. Five to 10 patients are admitted to the pulmonology ward daily due to smoking complications.”

The Human Development Foundation said in a statement that without urgent action, tobacco use would claim one billion lives this century.

Tobacco use contributes to cardiovascular disease as the second-greatest contributing factor behind high blood pressure and harms some of the world’s most vulnerable populations disproportionately, it said.

Reducing tobacco use would dramatically reduce the death toll from cardiovascular diseases. Proven measures to reduce tobacco use include increasing tobacco taxes, placing large pictorial warnings on tobacco products, restricting tobacco advertising and banning smoking in indoor public places.

Published in Dawn, May 31st, 2018