Pakistan faces a severe smoking crisis, with one of the highest smoking-related death rates in South Asia – 91.1 per 100,000 people – far exceeding the regional (78.1) and global (72.6) averages, according to a Gallup survey. Over 30 million smokers contribute to a growing public health emergency, with diseases such as cancer, respiratory illnesses, and heart disease costing the country billions annually in healthcare expenses and lost productivity. This persistent health burden demands urgent intervention.
A potential solution lies in a recent landmark decision by the U.S. Food and Drug Administration (FDA), which authorized the marketing of ZYN oral nicotine pouches as a better alternative to smoking. Unlike smoking, nicotine pouches deliver nicotine without combustion – the primary cause of smoking-related diseases.
In 2019, smoking-attributable diseases and deaths cost Pakistan an estimated USD 3.85 billion. The country’s economic instability, political uncertainty, and social pressures have fueled widespread nicotine dependence, highlighting the urgent need for smoke-free alternatives.
Nicotine pouches are already available in Pakistan, but they exist in a regulatory gray area. Unlike in the U.S., where the FDA ensures quality control, safety standards, and responsible marketing, Pakistan lacks a formal regulatory framework for these products. This regulatory gap prevents authorities from ensuring that nicotine pouches meet safety standards and are marketed responsibly. Without proper oversight, consumers may be exposed to unregulated products, potentially undermining public health efforts.
The experiences of countries that have successfully integrated harm reduction into their tobacco control policies highlight the importance of regulation. The FDA’s approval of ZYN nicotine pouches as a better alternative serves as a guiding example for Pakistan.
Hence, Pakistan must take proactive steps to regulate oral nicotine pouches, ensuring they are properly labeled and accessible to adult smokers. Instead of debating whether these alternatives should be available, the focus should be on how to regulate them effectively to maximize public well-being.
