March 12, 2025 – Pakistan risks missing a historic opportunity to curb its smoking epidemic that claims 164,000 lives a year, according to a major report released today by international health experts.

The landmark study, Tale of Two Nations: Pakistan vs. Sweden, presents a stark contrast between the two countries’ approaches to smoking cessation and tobacco harm reduction. While Sweden is on track to become the world’s first ‘smoke-free’ nation - defined as reducing smoking prevalence below 5% - Pakistan’s traditional tobacco control policies have resulted in smoking rates up to four times higher than Sweden’s.

Report author Dr. Delon Human, global harm reduction expert and of Smoke Free Sweden, said: “Pakistan stands at a crossroads. Sweden has demonstrated that embracing safer nicotine alternatives - such as snus, nicotine pouches and vaping - while maintaining strong public health policies can drastically cut smoking rates and save lives.

“By contrast, Pakistan’s current regulatory trajectory risks keeping millions of smokers trapped in a cycle of preventable disease and premature death.”

The report highlights that smoking prevalence among men in Pakistan remains at 22.2%, more than four times higher than Sweden’s 4.9%.

The Swedish model, built on harm reduction principles, has resulted in the lowest smoking-related disease rates in Europe, with cancer incidence 41% lower than the EU average.

Despite this compelling evidence, Pakistan has yet to integrate harm reduction strategies into its tobacco control framework. Instead, restrictive policies on lower-risk alternatives continue to limit their accessibility, affordability and acceptance among smokers seeking to quit.

The report urges Pakistani lawmakers to take decisive action by adopting harm reduction measures that have proven successful in Sweden. Key recommendations include:

• Establishing a clear regulatory framework for nicotine pouches and vaping products to ensure affordability and accessibility for adults.
• Shifting public health messaging to educate consumers and healthcare professionals on the reduced risks of smoke-free alternatives.
• Implementing tax policies that make safer nicotine products more attractive than cigarettes.
• Establishing and enforcing minimum-age restrictions on all nicotine products to prevent youth uptake.

“Pakistan can no longer afford to ignore the overwhelming global evidence on tobacco harm reduction,” added Dr. Human. “Following Sweden’s lead could prevent thousands of unnecessary deaths and create a healthier future for millions of Pakistanis.”

Download The Report