Promoting Misguided/Unevidenced Narratives – Is there a violation of the Framework Convention on Tobacco Control in Pakistan?

By Qamar Nasim and Dr. Waseem Janjua

Pakistan has been a signatory to the Framework Convention on Tobacco Control (FCTC) since 2005. Article 13 of the Framework Convention on Tobacco Control (FCTC) focuses on tobacco advertising, promotion, and sponsorship, aiming to restrict the ability of the tobacco industry to promote its products. The measures outlined in Article 13 are designed to reduce the appeal of tobacco products, limit exposure to tobacco advertising, and counteract the industry’s promotional efforts. Many key elements of Article 13 help prevent tobacco promotion.

Through this article, parties to FCTC (including Pakistan) are encouraged to implement comprehensive bans on direct and indirect advertising, promotion, and sponsorship of tobacco products. This includes a range of promotional activities, such as print media, radio, television, and the internet, as well as sponsorship of events and activities. However, it has been observed with grave concern that the tobacco industry affiliates are busy promoting e-cigarettes and other tobacco and nicotine devices across the country and more lately in KP.

Parties are encouraged to adopt measures to restrict or prohibit tobacco product displays and promotional activities at points of sale, including retail outlets. This helps minimize the visibility and attractiveness of tobacco products. Tobacco control advocates and whistle-blowers have been active in pointing out these anomalies and continue to engage with the competent authorities to eliminate tobacco industry promotional activities in the province.

An important guiding principle of the FCTC demands that the parties are required to ban or restrict tobacco sponsorship of international and national events, activities, or individuals that could be associated with tobacco promotion.

Prohibition of misleading descriptions and unevidenced narratives such as “tobacco harm reduction” and “exonerating nicotine” of all evils attracting all tobacco users to smoking is yet another noteworthy aspect. The tobacco industry has a long history of misleading the public for profits. For example, in 1955 “filtered cigarettes” were popularized as safer products – the claim proved frivolous as the 1964 US Surgeon General’s report issued the most damning report against the industry.

Similarly, during the 1970s, the narrative of “light” (and later “ultra-light”) cigarettes were promoted as “safe alternatives” to regular smoking. However, after the turn of the century major tobacco industry shifted the focus to buying, manufacturing, and promoting electronic devices such as e-cigarettes, e-hookahs, vapes, heated tobacco products, and other misguided innovations. The narrative supported spreading these deadly devices to the brink when in 2019 (just before COVID-19) scores of American youths died of EVALI (e-cigarette or vaping use-associated lung injury). The matter got buried due to the global spread of Coronavirus. This also provided an urgently needed respite to the tobacco industry. Capitalizing on the opportunity, the tobacco industry not only spread (unregulated) electronic devices and nicotine products in Pakistan but also started spreading misguided narratives with a reinvigorated zeal.

Political instability and slacked enforcement of the existing laws increased the space for industry’s manipulative interjections happening with impunity. Creating erroneous perceptions in the minds of the public not only strains the already stressed and overburdened health systems but also directly infringes upon the health of youth and children. One of the top guiding principles of Article 5.3 of FCTC states, “There is a fundamental and irreconcilable difference between the public health and tobacco industry interests”.

KP has a long history of developing laws and regulations promoting provincial health that need to be replicated in other provinces. KP can rightly pride itself in developing state-of-the-art hospitals and healthcare facilities around the province. However, false-narrative promotional activities by the promoters of electronic devices continue to stress the monitoring and enforcement mechanisms.

In this regard, Article 13 also encourages parties to promote and strengthen public awareness and education programs regarding the health risks associated with tobacco consumption and exposure to tobacco promotion. This includes informing the public about the deceptive nature of tobacco advertising.

By implementing these measures, FCTC aims to create a comprehensive framework that limits the promotional activities of the tobacco industry. This helps reduce the attractiveness of tobacco products, decrease overall tobacco consumption, and protect public health by preventing the industry from using narratology, to promote misguided knowledge and electronic tobacco and nicotine products.

Despite the widespread promotion of e-cigarettes as a supposedly less harmful alternative to traditional cigarettes, there is no conclusive evidence that the commercialization of these products has yielded any net benefit to public health in Pakistan. On the contrary, the mounting evidence points towards alarming adverse health effects on the population.

Immediate and decisive measures are imperative to thwart the uptake of e-cigarettes and combat the burgeoning nicotine addiction crisis in the Pakistani context. These actions must be part of a comprehensive tobacco control strategy tailored to the specific national circumstances. The urgency of the situation demands swift and effective interventions to safeguard the health and well-being of the Pakistani population, especially the vulnerable younger demographic.

Finally, it is important to note that nicotine has been declared a “hazardous substance, and poison” in Australia. Anyone seeking to consume this poison needs a doctor’s prescription before purchasing poisonous devices and chemical liquids used as refills. Replicating the global best practices in Pakistan, it would be an interesting idea to regulate nicotine as a poison/ hazardous substance. Anyone willfully aspiring to die using this substance, should seek a doctor’s prescription.