The Tobacco Paradox

The Tobacco Paradox: Economic Myths versus Health Realities in Pakistan

In Pakistan, the narrative spun by the tobacco industry is one of significant economic contribution. This claim, however, stands on shaky ground when scrutinized against the backdrop of health and environmental concerns.

The industry boasts of generating substantial revenue through taxation, with figures reaching 120 billion PKR in 2019. Yet, this is starkly contrasted by the overwhelming economic cost of tobacco-induced non-communicable diseases (NCDs), which amounted to a staggering 615 billion PKR in the same year.

This glaring disparity underscores the heavy economic burden that tobacco places on healthcare systems and the national economy, far overshadowing the benefits touted by the industry.

The supposed prosperity offered by tobacco farming is another facet of the industry’s narrative. It’s often portrayed as a lucrative and viable livelihood for farmers, but the reality is fraught with economic difficulties, labor exploitation, child labor environmental degradation, and significant health risks for farmers and their families. The high labor and resource demand of tobacco cultivation often trap farmers in a cycle of debt and poverty, and the environmental toll, including soil depletion and deforestation, raises serious sustainability concerns.

The World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) recognizes these challenges. Article 17 of the WHO FCTC recommends promoting sustainable alternatives to tobacco farming, suggesting diversification programs tailored to local needs to improve farmers’ livelihoods. This approach aims to shift farmers away from tobacco to more sustainable and health-friendly crops.

Over 22 million people (20% of adults) in Pakistan smoke tobacco. 32% of men and 6% of women smoke. However, smokeless forms of tobacco, such as paan, ghutka and naswar, are also popular. More than 1 in four young people (aged 13-15) are exposed to second-hand smoke in their homes. 15% of male deaths and 1% of female deaths are related to tobacco use and exposure. Around 110,000 people die annually from tobacco-related diseases in Pakistan.

Pakistan is among the high-burden countries with respect to the prevalence of tobacco use and its implications for public health. According to Global Adult Tobacco Survey 2014, 19.1% of adults in Pakistan used tobacco in any form, which translates into a population of about 24 million adults. Consequently, the prevalence of tobacco-related diseases is also high and various estimates indicate that tobacco use is associated with more than 108 800 deaths every year in the country.

Despite a global decrease in tobacco consumption and leaf production from 2000 to 2020, tobacco remains a preferred cash-crop in low- and middle-income countries like Pakistan. This preference, largely driven by the industry’s narratives, overlooks the broader economic and health implications of tobacco cultivation and consumption.

It’s essential to debunk the economic myths propagated by the tobacco industry. A closer examination using macroeconomic indicators such as unemployment, inflation, and GDP growth paints a different picture. The industry’s economic contribution claims often ignore the extensive costs associated with healthcare, loss of productivity due to tobacco-related illnesses, and the environmental impact of tobacco farming.

Pakistan faces a critical choice between cultivating tobacco and growing food. With a burgeoning population and rising food security concerns, prioritizing food production over tobacco is essential. Tobacco cultivation, while economically tempting, brings with it health risks, environmental degradation, and does not address the pressing need for food.

By shifting focus to agricultural diversification and boosting food crops, Pakistan can tackle hunger, improve public health, and ensure a sustainable future for its people. The shift from tobacco to food crops is not just an economic decision but a vital step towards national well-being and resilience.

The tobacco industry’s narrative in Pakistan, focusing on its economic contribution, is significantly flawed when weighed against the comprehensive costs associated with tobacco.

The health, environmental, and economic burdens far outweigh the benefits. Policymakers and the public must recognize these realities and support initiatives for sustainable alternatives and reduced tobacco consumption. Addressing the challenges posed by tobacco is crucial for Pakistan’s economic growth and the health and well-being of its populace, paving the way for a healthier and more sustainable future.