ISLAMABAD: The government has neither increased the size of graphic health warning (GHW) on cigarette packets nor replaced the picture of cancer patient which were expected to be done by June 2020.

The file suggesting both the changes has been dumped in the Ministry of National Health Services (NHS).

Anti-tobacco advocates believe that because of enormous pressure from the tobacco industry the government has not been able to make the changes. World Health Organisation (WHO) has urged the government to move for plain packaging, enhancement of taxation and implementation of smoke free laws.

When contacted, Special Assistant to Prime Minister (SAPM) on Health Dr Faisal Sultan said he was fully in favour of GHW and would do all possible efforts to implement it.

“Though there are some challenges, we have been working on it and a decision will be made soon,” he said.

GHW was introduced in Pakistan in 2010 and the picture on the packets had to be changed in 2011. In January 2015, the government issued a statutory regulatory order (SRO) to increase the size of GHW on the packets of cigarettes from 40pc to 85pc and to replace the picture within five months. The then minister NHS Saira Afzal Tarar of the PML-N had made the announcement at a press conference for which WHO gave her an award. However, the decision could not be implemented even after six years.

Warning sign had to be increased from 60pc to 70pc by June last year, says official

An official of the ministry of NHS, requesting not to be quoted, said during the last six years GHW was increased to just 60pc of the cigarette packets.

“Increase in the size of GHW was due from 60pc to 70pc in June 2020 along with replacement of the picture, but the file has been dumped in the ministry,” he said.

A public health expert, Dr Ziauddin Islam, told Dawn that it was a fact that people could be sensitised by changing GHW.

“According to a recent study by Pakistan Institute of Development Economics, the cost of treatment of tobacco related diseases is Rs615 billion compared to less than Rs150 billion revenue collected through taxation on tobacco related products in Pakistan,” he said.

Advocate Malik Imran, who approached the Islamabad High Court in 2016 for the implementation of GHW, said the size of the GHW could not be increased despite efforts made by anti-tobacco advocates.Representative of Society for the Protection of the Rights of Child (Sparc), Khalil Ahmed, said children were the main target of the tobacco industry as they become potential clients for next four to five decades.

“We were far ahead of India in terms of GHW but now India has introduced 85pc GHW but Pakistan is still reluctant to increase it to 70pc. On the other hand, Saudi Arabia has introduced plain packaging of cigarettes,” he said.

Former chief of Human Development Foundation Azhar Saleem alleged that GHW was delayed due to influence of the tobacco industry.

“There is also interest of some politicians due to which even the health ministry remains reluctant to implement it. However, I believe Prime Minister Imran Khan will ensure its implementation as he has been working on human development,” he said.

WHO’s national professional officer on tobacco control Shahzad Alam said his organisation had suggested to the health ministry to move for the plain packaging, enhancement of taxation and implementation of smoke free laws.

WHO representative in Pakistan Dr Palitha Mahipala had said it was high time for people to encourage smokers in their homes, workplaces and communities to quit smoking. He had said smoked tobacco products, including water pipes, contain over 7,000 toxic chemicals, including at least 250 chemicals that caused cancer.

He had said tobacco was the most common risk of non-communicable diseases which was causing around 58pc mortality in Pakistan.

Published in Dawn, April 25th, 2021