Pakistan Country Profile

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Pakistani flag

Image source: Imtiaz Ahmed | CC BY-NC-ND 2.0

Key Points

  • Pakistan is a country in South Asia, part of the World Health Organization’s Eastern Mediterranean Region.
  • It is the world’s fifth-most populous country, with a population of 247.5 million in 2023. As of 2021, current tobacco use prevalence was 19.5% amongst those aged 15+.
  • Pakistan ratified the WHO Framework Convention on Tobacco Control in 2004. It ratified the Protocol to Eliminate Illicit Trade in Tobacco Products in 2018.
  • The tobacco market in Pakistan is dominated by the transnational tobacco companies British American Tobacco – via its subsidiary Pakistan Tobacco Company – and Philip Morris International.
  • Recent examples of industry interference in Pakistan include controversial marketing aimed at young people; spreading misleading information, particularly regarding tax and the illicit tobacco trade; and funding third parties to produce research.

While Pakistan has made some gains in tobacco control in recent years, major challenges persist. Tobacco use prevalence remains relatively high, particularly amongst males.1 The industry mobilises strongly against tax increases on tobacco products, and industry arguments on the impact of such measures on the illicit tobacco trade have been widely disseminated by the national media. They have also reportedly been adopted by the Federal Board of Revenue, Pakistan’s tax collection agency.2 Tobacco taxes remain well below the threshold recommended by the WHO and prior to a significant increase in excise tax in February 2023, cigarette prices had not changed significantly since 2019.34 Finally, the market for e-cigarettes is growing rapidly,5 and as of April 2025, these products remain unregulated.67

Tobacco Use in Pakistan

Pakistan had a population of 247.5 million in 2023.8 In 2021, the WHO estimated Pakistani tobacco use based on all national survey data published since 1990. Current (i.e. daily or occasional) prevalence of tobacco use in any form (both smoked and smokeless) was 19.5% amongst those aged 15 and over. Around 32% of males were current tobacco users, compared to 7% of females. The corresponding figure for smoked tobacco (i.e. cigarettes, bidis and waterpipe) was around 17% overall (31% for males; 3% for females).1

In 2022 (the last year for which national level statistics are available), current tobacco use amongst youths aged 13 to 15 was less than 7%, with 8.5% of males in this age group using tobacco products compared to over 4% of females.9

Smokeless tobacco (SLT) is widely used in Pakistan, though less so than in neighbouring India.1011 SLT use is particularly common amongst poorer sections of the population.10 In 2014, the last year for which national level statistics are available, 8% of the population aged 15 and over were current (i.e. daily or occasional) users of SLT (11% of males; 4% of females).12 For youth, current use of SLT (4.4%) was higher than for smoked tobacco (4%). 5.5% of boys were current SLT users, compared to less than 3% of girls.9

As of April 2025, there were no regulations in Pakistan on the use of e-cigarettes.67 Use is increasing rapidly and revenue from these products was estimated at US$74.3 million in 2023.5 A 2023 multi-city study across Pakistan found that over 43% of participants were current e-cigarette users. With the mean age of initiation being 17, the authors suggested that the absence of regulation meant that adolescents and young adults had been targeted with e-cigarette promotion, including by influencers and celebrities, and that e-cigarette stores were selling products without health warnings or age verification. However, the authors acknowledged that their sample may not represent the wider Pakistani population, given that most participants were young (the average age was 19.6 years), educated, urban and relatively wealthy.13 The 2022 Global Youth Tobacco Survey put current e-cigarette use at just over 3% amongst those aged 13-15 (>4% boys; 2% girls).9

There were an estimated 134,000 deaths attributable to smoking in 2019, accounting for nearly 9% of all mortality in Pakistan that year.14 The economic burden of all smoking-related morbidity and mortality in the year 2018-19, for people aged 35 and older, was estimated at more than PKR615 billion (US$3.85 billion) – equivalent to 1.6% of Pakistani GDP.15 This was more than five times greater than the PKR120 billion (US$751 million) in tax revenue collected from the tobacco industry. Smoking is therefore a significant net burden for Pakistan’s public health system, most of which is borne by males, those living in rural areas and those aged between 35 and 64.15

Tobacco in Pakistan

Market share and leading brands

In 2024, market research company Euromonitor International put the value of the Pakistani tobacco market at PKR1,106.2 billion (US$3.9 billion).16

The Pakistani cigarette market is dominated by the Pakistan Tobacco Company (PTC) –  the local subsidiary of British American Tobacco (BAT) – and to a lesser extent Philip Morris International (PMI). In 2024, BAT had a market share of 74%; PMI of over 20%. Imperial Brands had a share of 0.3%. Other, smaller companies – such as Khyber Tobacco Company, Souvenir Tobacco Company Limited and Sarhad Cigarette Industries Ltd – account for the remaining 5% of the market.1718

Nine out of the ten bestselling brands of cigarette in Pakistan belong to either BAT or PMI. The market leader is BAT’s Pall Mall on over 53%, followed by PMI’s Morven Gold on over 13%. In third and fourth place are two more BAT brands, John Player and Gold Flake, with shares of around 10% and 8%, respectively. All other brands have shares of less than 4%.19

Tobacco farming

Tobacco production in Pakistan has increased steadily in recent decades, from nearly 78,000 tonnes in 1980 to around 104,000 tonnes in 2019. Since 2019 this increase has been much more rapid: nearly 133,000 tonnes were declared in 2020 and over 168,000 tonnes in 2021. In 2022 production fell back to 2020 levels, though in 2023 it increased again to over 150,000 tonnes (see Figure 1).20

Figure 1: Tobacco production, 1980 to 2023. Source: UN Food and Agriculture Organization/Our World in Data | CC BY

However, greater crop yield per hectare has meant that the area of agricultural land on which tobacco is grown has fallen, from over 56,000 hectares in 2000 to less than 51,000 in 2020. The percentage of agricultural land on which tobacco is grown has also fallen, from 0.21% in 2000 to 0.14% in 2020.21

Tobacco and the economy

According to UN Comtrade, Pakistan was a net exporter of tobacco leaf in 2023, importing nearly US$9 million compared to over US$66 million in exports.2223

UN Comtrade also reports that Pakistan is a net exporter of cigarettes. In 2023, the country exported over US$10 million in cigarettes, compared to US$414,000 in imports.2425

According to the Pakistan Tobacco Board, a semi-autonomous government department under the Ministry of National Food Security & Research, which oversees and promotes the tobacco industry in the country,26 major export destinations for Pakistani tobacco and cigarettes in the year 2021-22 included Yemen, United Arab Emirates, Indonesia, Saudi Arabia and Bahrain.27

Illicit trade

Euromonitor International put the illicit share of the market at nearly 52% in 2024.28 Euromonitor has received tobacco industry funding since 2019, though the company states that it retains independence over its research outputs and that the projects for which it has accepted industry funding are unconnected to its wider statistical database. However, even prior to its receipt of industry funding, Euromonitor had been criticised for inconsistencies in its annual illicit trade estimates, opaque methodology and sources of data, and a reliance on tobacco industry intelligence.29

Since 2017 there have been at least four independent studies on the dimensions of the illicit tobacco trade in Pakistan, which have generated estimates ranging from 9% to 33% of the market.230 Though the most recent of these studies, published in 2024, produced the higher estimate of 33%, this is still significantly lower than estimates produced by the tobacco industry and associated organisations (see section “Spreading misleading information”).31

The tobacco industry and its associates often argue that higher tobacco taxes result in increased illicit trade, with consumers seeking out illicit products because they are cheaper. However, a 2017 study found that Pakistan was one of six countries (along with Bangladesh, India, Philippines, Thailand and Viet Nam) where the median price of illicit cigarettes was higher than that of legal cigarettes in retail settings. This suggests that consumer desire for cheaper tobacco products is not a cause of illicit trade in these countries. In fact, the study’s authors suggest that taxes should be increased, as low tax rates mean that legal cigarettes in Pakistan are extremely cheap.32

Tobacco and the environment

More than three quarters of Pakistan’s tobacco is grown in the north-western province of Khyber Pakhtunkhwa.18 Large quantities of pesticides have been sprayed on different crops in this region, including tobacco, for many years.33 Research published in 2010 documented a lack of proper training in pesticide handling amongst tobacco farmers in this region, resulting in environmental pollution and health hazards to local communities, as well negative impacts on the farmers themselves.34

A more recent study analysed water from the River Barandu to assess organochloride pesticide pollution associated with tobacco farming in the province. It found four parameters which represented a very high level of ecological risk – i.e. these chemicals represented a very high probability of adverse impact on the river’s ecosystem – as well as one more classified as medium risk.35 Endosulfan, one of the pesticides in the first group, is considered by the European Union to be “very toxic to nearly all kinds of organisms”, which in humans may cause convulsions, neurological disorders and congenital birth defects, among other serious health impacts.36

Roadmap to Tobacco Control

Pakistan signed and ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004.37 In 2018, it ratified the Protocol to Eliminate Illicit Trade in Tobacco Products.38

Pakistan has two principal tobacco control laws: the Cigarettes (Printing of Warning) Ordinance, 1979 and the Prohibition of Smoking in Enclosed Places and Protection of Non-smokers Health Ordinance, 2002.39 The former mandated the printing of health warnings on the packaging of tobacco products, while the latter prohibited smoking in public places, including public transport; imposed restrictions on tobacco advertising, promotion and sponsorship (TAPS); and prohibited the sale of cigarettes to minors. There are several other ordinances and Statutory Regulatory Orders which have built upon these laws and guide implementation.3940

However, some loopholes remain. While health warnings are required on 60% of the surface area of cigarette packs, there is no such requirement for SLT products.39 As of 2023, there were no restrictions on the sale of tobacco products in vending machines or online. Online advertising of tobacco products was also permitted. The ban on sponsorship was incomplete, and there was no restriction on tobacco industry corporate social responsibility (CSR).1 Finally, while tobacco taxes increased significantly in 2022-23, to 48% (for the low price tier) and 68% (for the high price tier) of retail value, they are still short of the 75% recommended by the WHO.4142

For more details, please see the following websites:

Tobacco Industry Interference in Pakistan

Recent tobacco industry tactics in Pakistan include lobbying policy makers, including through diplomats; financing third-party organisations; and targeting youth with marketing for newer nicotine and tobacco products, among others.

Profiting from conflict

In November 2023, British American Tobacco (BAT) sought permission from the Pakistani Ministry of Health to manufacture and export packs of ten cigarettes (often referred to as “kiddie packs” due to their greater affordability to children) to Sudan, a country which has been in a state of civil war since 2023.4344 Manufacture and sale of kiddie packs is banned in Pakistan, in line with Article 16 of the WHO FCTC.43

While the Ministry of Health initially resisted this request, in July 2024 it proposed an amendment to the existing regulation, adding the words “domestic consumption”. The proposed amendment thus read:

“No cigarette manufacturer shall manufacture, sell or offer for sale, any cigarette for domestic consumption unless they are in packets of at least twenty cigarette sticks.”43

Following strong mobilisation by the Pakistani tobacco control community, and a letter to the Pakistani prime minister by health experts across Africa, the proposed amendment did not go ahead – though the request was ultimately granted by Bangladesh.4345

Controversial marketing: targeting youth

In 2019, BAT launched Velo, its brand of nicotine pouches, in Pakistan.46 By 2022, Pakistan had become BAT’s third-largest market for the product.47

A report by the Bureau of Investigative Journalism in 2021 detailed how the appearance of Velo on the Pakistani market was accompanied by marketing campaigns aimed at young people. Social media marketing and the use of influencers was complemented by in-person marketing.4849 BAT also launched a music show called Velo Sound Station on TV and YouTube.5051

The use of music sponsorship to promote Velo is a new iteration of old marketing tactics. In the 1990s, BAT rolled out a campaign in Pakistan to promote the Benson & Hedges brand of cigarettes. The campaign sought to associate the brand with music, sponsoring music-related content on the radio and in print media.52 An internal BAT document from this period stated that “Music is recommended as a potential communications vehicle for B&H” because it allowed BAT to target “the younger consumers – the key to future growth.”5354

In 2023, Pakistan’s health ministry issued notices to at least ten tobacco companies over violation of TAPS regulations. These violations reportedly included the marketing of tobacco products on social media, prize offers, and placement of promotional materials at points of sale.5556 Philip Morris Pakistan was one of the companies notified.56

Spreading misleading information

The tobacco industry and its associates have repeatedly exaggerated the scale of the illicit tobacco trade in Pakistan. Starting from 2014, soon after the introduction of a two-tier excise system, several organisations produced “industry-inspired” reports, which, according to the World Bank, used methods of questionable validity and substantially overestimated the volume of illicit cigarette sales.57

For example, in its 2017 report on the illicit trade in Asia, the industry-linked consultancy Oxford Economics (OE) estimated illicit consumption to account for nearly 42% of the cigarette market, up from 25% in 2012.58 However, this report was funded by Philip Morris International (PMI) and produced according to terms of reference established by PMI – terms which have been strongly criticised by tobacco control advocates.5859

A further OE report, produced for BAT in 2022, stated that illicit consumption accounted for 38% of the cigarette market in 2021.60 Although its findings were widely reported in Pakistani media, this report has not been published online and it is unclear what methodology OE used to arrive at this latest estimate. The research also reportedly emphasised “PTC’s positive association with Pakistan since its inception and its contribution to the country’s GDP, taxation, employment, foreign investment, and corporate social responsibility.”61

These reports have provided the basis for further media outputs. PMI, for example, has provided funding for Stop Illegal Trade, an initiative which describes itself as “a media advocacy forum against illegal consumer goods”.62 In 2020 and 2021, Stop Illegal Trade ran a campaign entitled #44Billion4Pakistan on television, YouTube and social networks, urging the public to sign a pledge and petition policy makers to take action on the PKR44 billion (US$153 million) it stated were lost to the illicit tobacco trade.63 Stop Illegal Trade also stated that “Pakistan is number 1 in Asia for illegal cigarette consumption”, which was a key finding of OE’s 2017 report.6465

The aim appears to be to link the growth of illicit trade in Pakistan to tax increases on tobacco products. For example, in April 2023, it was reported in the Pakistani press that an increase in excise duty introduced in February had led to a 60% reduction in the volume of legal cigarettes and a 50% increase in the illicit trade. These figures were provided to the author of the article by Pakistan Tobacco Company (PTC).6667 Similarly, in August 2023, PTC’s head of external affairs warned that illicit sales could secure more than half the market “in months” unless action was taken.68 The Chief Financial Officer of Philip Morris Pakistan made similar arguments, stating that the rapid growth of the illicit tobacco trade meant that Pakistan was unlikely to achieve its tax collection targets.69

Yet in late 2023 it was reported that the tax hikes in February of that year had in fact reduced cigarette consumption by more than 11 billion sticks. A reported 14% of Pakistan’s smokers quit following introduction of the higher taxes, with a further 10% reducing their consumption.70

Use of diplomats

In 2015, the UK’s top diplomat in Pakistan attended a meeting at which BAT lobbied Pakistani ministers to drop plans for graphic health warnings (GHWs) covering 85% of the front of all cigarette packs.7172 Photos from the meeting show the British High Commissioner sitting alongside BAT executives as they registered their opposition to the policy with the Pakistani finance and health ministers.71 UK health experts called this a “flagrant breach” of the WHO FCTC.73

Pakistan has yet to implement the 85% GHWs. While revisions to the law were passed in 2018 and 2019, the requirement is only for 60% GHWs on both sides of the pack.74

Use of third parties

Global Action to End Smoking (GAES), formerly the Foundation for a Smoke-Free World (FSFW) – which was established by PMI in 2017, and as of 2025, remains solely funded by PMI, apart from dividends and interest deriving from investments made with PMI funding, and a single anonymous donation in 2024 for a trivial amount of its total budget75 – has been very active in Pakistan. As of March 2025, GAES/FSFW has awarded grants to four different organisations based in the country.76 Most of these grants have been for projects focusing on tobacco harm reduction and newer nicotine and tobacco products.

Alternative Research Initiative

The Alternative Research Initiative (ARI) is the principal GAES/FSFW grantee in Pakistan. From 2018 to 2024 it was granted over US$1.4 million.75777879808182 GAES’s 2024 tax return reveals that another US$402,000 has been approved for future payment.75

The funding has mostly supported research on smoking cessation, tobacco harm reduction and the use of newer nicotine and tobacco products in Pakistan, though the stated purpose of the grant ARI received in February 2020 was to “Garner consensus and support for COP9 to consider harm reduction as integral to tobacco control.”83 This was one of several grants awarded worldwide by FSFW in 2020 in an attempt to influence the Conference of the Parties to the WHO FCTC.79

Pakistan Alliance for Nicotine and Tobacco Harm Reduction

The grants FSFW paid to ARI also funded the Pakistan Alliance for Nicotine and Tobacco Harm Reduction (PANTHR). As of September 2023, PANTHR lists three publications which correspond to the stated descriptions of the FSFW grants. It also produced a study on smoking and the use of e-cigarettes during the COVID-19 lockdown.8384

QBAL SMC PVT LTD

QBal describes itself as a “public policy advocacy entity registered with Security and Exchange Commission of Pakistan.”85 From 2018 to 2024, it was granted over US$840,000 by FSFW/GAES.77787980818275 GAES’s 2024 tax return shows that a further $280,000 has been approved for future payment.75

Available for download on the QBal website are a policy brief on “Harm Reduced Products” in both English and Urdu; a scoping study on Pakistan’s tobacco control and tax regulations, with a focus on newer nicotine and tobacco products; and a report on economically sustainable alternatives to tobacco growing. All of these publications were financed by the grants from FSFW.86 One of the recommendations of the policy brief states:

“this is the ideal time to improve the perception of HRPs [Harm Reduced Products] and help enact favorable tax structures and regulations that will keep them affordable and available.”87

Others

FSFW funded the contract research organisation Cyntax Health Projects to carry out a clinical trial “to compare the effectiveness of different tobacco harm reduction products in general adult population in low- and middle-income countries”.88 It also funded the research organisation Innovative Development Solutions to produce a literature review and a report on smoking cessation and tobacco harm reduction amongst marginalised groups in Pakistan.8990 According to GAES’s 2024 tax return, both of these organisations have had further grants approved for future payment.75

Relevant Links

Tobacco Tactics Resources

TCRG Research

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References

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