• Factsheet

    In 2007 ,Five million people died in the world as a direct result of tobacco.

  • In World

    In 20th Century, tobacco epidemic killed 100 million people world-wide.

  • In Pakistan

    About 100,000 people die annually due to tobacco use.

  • Health effects

    Tobacco use is a risk factor for six out of eight leading causes of death in the world.

Significant Initiatives/Achievements of Tobacco Control Cell

Tobacco Control cell has taken follwing significant initiatives regarding tobacco control in Pakistan:

Introduction of Pictorial Health Warning
Pakistan introduced Pictorial Health Warning on cigarette packs and outers from 31st May, 2010. The pictorial warning covers 40% on both front and back of cigarette packs. This warning will be rotated on yearly basis.

Inclusion of Tobacco Control Messages in Curriculum
In corporation of tobacco control messages in the curriculum and other health programs was one of the major activities of the Project. During meetings held with Ministry of Education, requests were made to give them compact, condensed material based on scientific evidence, for inclusion in the curriculum or the reading materials for school going children of primary and secondary schools. In response to this request a comprehensive set of material was provided by the Project which was handed over to Ministry of Education. This material was circulated to Provincial Text Book Boards for reflecting it in the necessary readings. Punjab Text Book Board had included tobacco control messages in the curriculum. Other provinces are expected to do the same.

Creation of Tobacco Control Cell at KPK

TCC has managed for development and notification of Provincial Tobacco Control Cell at KPK. Officers were placed in Provincial Tobacco Control Cell. Similarly, in meeting of PIC Sindh, Secretary Health Department Sindh announced for the development of Provincial Tobacco Control Cell in Sindh as well as announces the development of Divisional Tobacco Control.

Basic Tobacco Control Infrastructure / Institutional Strengthening
The basic tobacco control infrastructure had been developed at federal, provincial and district levels. Tobacco Control Cell at federal level had been strengthened by providing technical human resource and equipped them with computers. Focal points for tobacco control at provincial and district level had been nominated. In the No-cost extension of the project, district governments were strengthened by placing District Coordinators for Tobacco Control in 8 model districts.
For institutional strengthening, Technical Advisory Group on tobacco control formed and notified. Technical Advisory Group notified on a permanent basis to steer the project technically. An Inter-Ministerial Committee on tobacco control formed and notified. Partnership made with Journalists by forming Journalist Health Forum.

Provincial / District Interface
The Tobacco Control Cell's priority was to reach out to the Provincial and District governments for enhancing tobacco control efforts and facilitating them in initiating provincial tobacco control activities. Following were major steps taken in this regard:

  1. Formation of Provincial Implementation Committees in 4 provinces
  2. Formation District Implementation Committees in 20 model districts
  3. Activation of Provincial and District Implementation Committees
  4. Development of Plans of Actions by 20 model districts
  5. Dissemination of advocacy materials on tobacco control to authorized persons to take action under the law.

Situation Analysis of Illicit Tobacco Trade in Pakistan
First time in the history of Tobacco Control in Pakistan, Tobacco Control Cell prepared Situation analysis of Illicit Tobacco Trade in Pakistan and country status report generated in consultation with FBR.

Strengthening Legislative Contours
The Government of Pakistan started process of revision of tobacco control laws in accordance with FCTC provisions. Draft Revised Tobacco Control Laws prepared in in consultation with WHO, The Union, Provincial and District Governments and Civil Society. Draft Revised laws will be sent to Parliament for approval.

Basic Tobacco Control Infrastructure / Institutional Strengthening
The basic tobacco control infrastructure had been developed at federal, provincial and district levels. Tobacco Control Cell at federal level had been strengthened by providing technical human resource and equipped them with computers. Focal points for tobacco control at provincial and district level had been nominated. In the No-cost extension of the project, district governments were strengthened by placing District Coordinators for Tobacco Control in 8 model districts.
For institutional strengthening, Technical Advisory Group on tobacco control formed and notified. Technical Advisory Group notified on a permanent basis to steer the project technically. An Inter-Ministerial Committee on tobacco control formed and notified. Partnership made with Journalists by forming Journalist Health Forum.

Provincial / District Interface
The Tobacco Control Cell’s priority was to reach out to the Provincial and District governments for enhancing tobacco control efforts and facilitating them in initiating provincial tobacco control activities. Following were major steps taken in this regard:

  1. Formation of Provincial Implementation Committees in 4 provinces
  2. Formation District Implementation Committees in 20 model districts
  3. Activation of Provincial and District Implementation Committees
  4. Development of Plans of Actions by 20 model districts
  5. Dissemination of advocacy materials on tobacco control to authorized persons to take action under the law.

Development of Provincial PC-1s
The Project provided support to Provincial Implementation Committees headed by Secretaries of Departments of Health in tobacco control activities. “Support to Provinces for Developing Provincial PC-1s” was one the major activities marked in the work-plan of the Project. Consequently, four Provincial PC-1’s for Provincial Tobacco Control Programs, in consultation with four Provincial Departments of Health, were developed. These “Provincial Tobacco Control Programs” were to replicate successfully implemented interventions already made by the Project The provincial PC-1’s will be submitted by the provincial health departments to their respective Provincial Departmental Development Working Party, for approval.

Strengthening Legislative Contours
The Government of Pakistan started process of revision of tobacco control laws in accordance with FCTC provisions.  Draft Revised Tobacco Control Laws prepared in in consultation with WHO, The Union, Provincial and District Governments and Civil Society. Draft Revised laws will be sent to Parliament for approval.

Development and Dissemination of Advocacy Materials on Tobacco Control
The Project, in consultation with a group of experts on health, education and communication, developed information materials on tobacco control laws for “authorized persons” under the law i.e. Law enforcement officers, managers of hotels/restaurants, public transport vehicle drivers and conductors, heads of the educational institutions, heads of health care establishments. Moreover, facts sheets on   Second-hand and Third-hand Smoke , Smoking and Women’s Health, Sheesha and kids developed. These materials translated in Urdu and disseminated among general public of all age-group. Total 661,000 units of information’s materials disseminated among Law enforcement officers, managers of hotels/restaurants, public transport vehicle drivers and conductors, heads of the educational institutions, heads of health care establishments, representatives of Bazaar Unions etc.
The Project fostered an extremely productive partnership with the health journalists, who took up the tobacco control epidemic and its growth as a major public health threat in Pakistan. Dissemination of scientific and evidenced based materials to the media regularly had significant result on the effectiveness of tobacco control programs. To disseminate the evidence based information to media and advocate them on tobacco control, The Project developed and disseminated a Media Resource Kit among journalists. This kit contained facts on situation of tobacco use in Pakistan, hazards of tobacco use (Smoking cigarette, sheesha , Pan, Naswar etc.), second hand smoke, Law, increasing taxes on tobacco products, comprehensive ban on advertisement, Pictorial Health Warnings and Role of Media in Tobacco Control.  An advocacy kit for parliamentarians and policy makers was developed and sent to 1100 members of Senate, National Assembly and Provincial Assemblies.
An awareness video on hazards of tobacco use, second hand tobacco smoke and sheesha, based on interviews of the patients affected from diseases caused by tobacco use, had been developed in the Project. This video was aired on national TV channel and disseminated among selected target audience. Following are weblinks to this video:
Part-1: http://www.youtube.com/watch?v=nxdP6du8yKM
Patt-2: http://www.youtube.com/watch?v=iqydDDtlo_s

Development of Training of Trainers (ToT) Module
The Project developed Training of Trainers module. This will result in conducting ToTs and cascade trainings for authorized persons at federal, provincial and district levels, in the reinvestment project. The aim of this module was to raise awareness among persons authorized under the tobacco control laws to take action against violators.

Orientation of Authorized Persons on Tobacco control Laws
The Project conducted orientation sessions on tobacco control laws for authorized persons notified under tobacco control laws from district departments. i.e. Health, Education, Police, Traffic Police, Hotels / Restaurants, Bazaar Unions, Transporters, Media. 317 orientation sessions on tobacco control laws were conducted in 20 model districts of the Project. The authorized persons from district departments were Police Officers, Principals/ Headmasters, Heads of Health Care Facilities, Managers of Restaurants, Drivers and conductors, Representatives from Bazaar Unions, Journalists from District Press Clubs.

Enforcement of Tobacco Control Laws
In November and December 2011, Philip Morris Pakistan Limited advertised Marlboro cigarettes in several newspapers and magazines. The ads exceeded permissible size limitations of not more than one square inch (approximately 2.5 cm), and did not carry health warnings to the required size of not less than one fifth of the total ad. To counter this breach of advertising regulations, the Pakistan Tobacco Control Cell served an explanation notice to Philips Morris Pakistan. It also directed its coordinators in all four provinces of Pakistan to meet with key stakeholders including provincial and district health departments and tobacco control committees, local media, NGOs, and local police officers to clarify actions and seek cooperation to prevent future violations. As a result of the efforts from the Tobacco Control Cell, together with action from provincial government and civil society organisations, the police registered a number of cases in all four provinces of the country. The case was heard in Hyderabad and resulted in the magistrate issuing a bail warrant against the head of marketing Philip Morris Pakistan. In handing down his ruling, the magistrate stated:
“I have considered the submission of the parties and perused the record. No doubt the accused has admitted his guilt while talking the plea that it was done in good faith (sic) and he never intended to violate the law. No matter what the intention of accused was whether it was good or bad but one thing is clear that the accused has violated the law and ignorance of law is no excuse. While the resulting fine was regrettably miniscule (approximately US$50), the case demonstrates the commitment and cooperation that can be generated with a wide range of stakeholders, and sets an important precedent in the region as the first such legal action.”
(Success Story of Tobacco Control Cell litigation published in Tobacco Control Journal; http://www.scribd.com/doc/112158940/PM-Case-Pakistan ).

More than 100 Police cases registered against violators of Tobacco Control Laws in model districts of Pakistan. This includes 05 cases against M/S Pakistan Tobacco Company a giant Tobacco Industry of Pakistan, 05 against M/S Phillips Morris Pakistan ltd on violation of Section 07 of Pakistan Tobacco Control Law. More than 50,000 smuggled cigarette packs confiscated. Continuous Crackdown against Sheesha café in many districts of Pakistan including Islamabad.

Public Private Partnership
One of the main strengths of the Tobacco Control had the partnerships with the NGO’s working in Tobacco Control. NGO’s had many strengths that can complement the functions of the public sector in the health service delivery. Tobacco Control efforts had been augmented by committed anti-tobacco activists. In this connection the role of CTC, and The Network for Consumer Protection, needed to be especially mentioned.

Development of Website for Tobacco Control Cell (www.tcc.gov.pk)
To educate people and raise awareness about hazards of tobacco use through web media, The Project developed a website (www.tcc.gov.pk). This website contained the following useful information:

  1. Factsheet about hazards of tobacco use
  2. Objectives and functions of the Cell
  3. Activities / Achievements of the Cell in tobacco control in Pakistan
  4. Projects being implemented for tobacco control in Pakistan
  5. Information about partners and their activities for tobacco control
  6. Legislations on tobacco control in Pakistan
  7. Access (download) to Tobacco control related documents/reports like Tobacco Control Ordinance LXXIV (2002), Framework Convention on Tobacco Control (FCTC), Fatawas on Smoking, MPOWER, National Health Policy 2002 etc.
  8. Human resources at the Cell
  9. Link to other organizations/departments working on tobacco control
  10. Geographical location and contact of the Cell

Developing Monitoring Tools
The Project developed monitoring tools to monitor the implementation of tobacco control activities and Tobacco Control Ordinance 2002. The objective of first tool “Quarterly Monitoring Tool” was to monitor the implementation of tobacco control activities at federal, provincial and district level mapped in work plan for Tobacco Control. Data were collected against this tool from the focal point of respective province or district.
Another checklist, Ordinance LXXIV (2002)” was to monitor the implementation of the Tobacco Control Ordinance LXXIV (2002), record the violations and take actions on these violations. This checklist was distributed among the members of the provincial/district implementation committee. Each committee member filled this checklist while his/her monitoring visits.