LAST month, an advertisement thanking Imran Khan appeared in various Pakistani dailies. The ad expressed gratitude to the prime minister for “saving our lives and future generations by imposing health levy on deadly products.…”

The celebrations, however, may have been premature. Soon it emerged that the tax was not included in the proposed budget for 2019-20.

This was a possibility that health advocates had seen coming. In fact, the ad in question had further talked about the need to reject “all sorts of blackmailing attitude by any quarter to undermine the resolve of this government in improving public health”. Presumably, the ‘attitudes’ being referred to here are those of Big Tobacco.

Tobacco companies are some of the biggest taxpayers in Pakistan. “The estimated revenue for the financial year 2018-19 is Rs114bn and, due to withdrawal of lower tier of tax, est­imated revenue for year 2019-20 will be Rs147bn,” Special Assistant to the Prime Min­ister on National Health Services Dr Zaf­ar Mirza told Dawn, while speaking about the FBR’s proposal to drop the levy and withdraw a third tier tax on cigarettes to increase revenue. Dr Mirza was assured that the additional amount of federal excise duty, Rs33 billion, would be diverted towards the health sector.

The back and forth in tobacco-related policies is nothing new.

This back and forth in tobacco-related policies is nothing new. Critics and advocates argue that the tobacco industry’s resources allow it to pull weight in Islamabad’s power corridors and go as far influencing policy.

Of course, these tactics are not specific to Pakistan. Time and again, tobacco giants have dug into their pockets for lobbying and spinning public perception. But in other parts of the world, they are finally being held accountable for past misdeeds. In the US, a federal court ordered four tobacco companies to run ‘corrective statements’ on television, in print and online. The ads included admissions like, “Cigarette companies intentionally designed cigarettes with enough nicotine to create and sustain addiction.”

While this was a landmark ruling, it drag­ged on in the courts for over two decades.

Health advocates in Pakistan are familiar with such delays. In 2011, the health ministry had started talks about enhancing pictorial warnings that occupied 40 per cent of each cigarette pack. Finally, in 2015, the then health minister triumphantly announced that the size of pictorial warnings would be increased to 85pc of the cigarette box. This would be a significant change, making Pakistan one of the countries with the largest health warnings.

But these enhanced warnings were never implemented. After facing hurdles and multiple delays, the size was increased by only 10pc in 2018.

Other countries in our region have had more success. The warnings in India, Hong Kong and Thailand take up 85pc of the cigarette pack. While countries like New Zealand (87.5pc), Nepal (90pc) and Vanuatu (90pc) have even larger warnings. Timor Leste has the largest warning that takes up 92.5pc of the box.

According to media reports, Pakistan was unable to do the same because of extensive lobbying by two large tobacco companies.

Eyebrows were similarly raised earlier this year when in the run-up to the budget, Imran Khan met with representatives from a tob­a­cco company, and accepted a Rs5 million don­ation for the Diamer-Bhasha and Mohm­and dam fund. It was reported that the company also pledged a donation of Rs20m to­wards the prime minister’s shelter home project.

This was particularly worrying for tobacco-control advocates, many of whom were overjoyed when the prime minister took office. They expected things to be drastically different with Imran Khan, the man behind Shaukat Khanum Mem­orial Cancer Hospital, taking charge.

If the government is in fact looking to curb tobacco use in Pakistan, it can learn from looking at countries that have had better success in reducing tobacco use.

According to the Campaign for Tobacco-Free Kids, “Tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids”. The advocacy organisation further sta­tes that in the US, every 10pc increase in cigarette prices reduces youth smoking by about 7pc and total cigarette consumption by about 4pc.

Tax increases aside, the current government has taken various steps to discourage smoking. This includes the much-reported ban on the sale of loose cigarettes. But not much has changed on the ground and there are no barriers to buying loose cigarettes.

Research has shown that measures like increasing tax on tobacco products, stopping the sale of loose cigarettes and introducing larger pictorial health warnings discourage younger people from taking up smoking. Only by implementing these changes can Pakistan stand a chance against this silent killer that claims over 160,000 lives in the country each year.

The writer is a journalist, visual artist and director of the documentary Puff Puff Pak.

Twitter: @FahadNaveed

Published in Dawn, July 1st, 2019