Tobacco control – An integral component of the national action plan on non communicable diseases in Pakistan

Abstract

Pakistan is currently implementing a national programme for the prevention and control of non-communicable diseases (NCD) – the NAP-NCD program. As an integrated approach to addressing the multidisciplinary range of issues across the broad range of NCDs, this strategy has been modeled to impact a set of indicators through the combination of a range of actions capitalizing on the strengths of a public-private partnership, which is led by the NGO Heartfile and constituted additionally by the Ministry of Health, Government of Pakistan and WHO. Focused on institutional, community and public policy level change, this strategy factors integration through its Integrated Framework for Action at four levels: grouping NCDs so that they can be targeted through a set of actions, harmonizing actions, integrating actions with existing public health systems and incorporating contemporary evidence-based concepts with this approach. A range of policy and environmental strategies are part of the tobacco control component of the plan. These involve regulating access and limiting demand through restrictions on advertising, marketing, promotion and through price control and taxation; community and school interventions; cessation programmes; mass media counter-marketing campaigns for both prevention and cessation; surveillance and evaluation of efforts and operational research around tobacco and building capacity in the health system in support of tobacco control. NAP-NCD also stresses the need to develop and enforce legislation on smuggling contrabands and counterfeiting along with legislation to subject tobacco to stringent regulations as those governing pharmaceutical products. The adoption of measures to discourage tobacco cultivation and assist with crop diversification; integration of guidance on tobacco use cessation into health services and ensuing the availability and access to nicotine replacement therapy are also part of NAP-NCD.