By: Anwar Kashif Mumtaz
For decades, tobacco control has pursued a clear objective – reducing smoking and the devastating health consequences that follow. Few public health policies have been more successful. Through higher excise taxes, comprehensive advertising restrictions, smoke-free public spaces, prominent health warnings and expanded smoking cessation support, governments have significantly reduced smoking rates and reshaped public attitudes towards tobacco use. These measures remain the foundation of effective tobacco control and should continue to be strengthened.
Success, however, brings its own challenge. As markets evolve, technologies change and scientific understanding advances, policymakers must decide whether existing regulatory frameworks continue to deliver the best possible outcomes. One question increasingly sits at the centre of that discussion – should every nicotine product be regulated as though it presents the same level of risk?
For decades, combustible cigarettes dominated the tobacco landscape, making a largely uniform regulatory approach both practical and appropriate. Today, that landscape is more diverse. Scientific research increasingly distinguishes between the risks associated with combustible tobacco and those associated with smoke-free alternatives, largely because the overwhelming majority of smoking-related disease is linked to the toxic by-products created when tobacco burns. That distinction has prompted policymakers in many countries to examine whether regulation should continue treating all nicotine products identically or become more proportionate to the risks they present.
This is not just a scientific debate but fundamentally a question of regulatory philosophy. Effective regulation is not designed to eliminate complexity. It is designed to manage it in ways that best protect the public interest. Across sectors, governments routinely distinguish between products according to the risks they present, applying different standards, requirements and safeguards where appropriate. Tobacco policy should be evaluated through the same lens.
From an economic perspective, regulation succeeds when it changes behaviour in ways that improve public welfare. That requires more than good intentions. It requires policies that are practical, enforceable and capable of adapting as markets evolve. Treating products that present different levels of risk in exactly the same way may appear administratively straightforward, but simplicity does not always produce the most effective outcomes. The objective should not be uniform regulation. It should be effective regulation.
This principle is particularly relevant in Pakistan, where regulatory effectiveness is already challenged by a large illicit economy. According to a recent study by the Policy Research Institute of Market Economy (PRIME) and the Transnational Alliance to Combat Illicit Trade (TRACIT), illicit trade across sectors including tobacco, fuel, pharmaceuticals, tyres and tea is estimated to cost the national exchequer approximately Rs. 751 billion in lost tax revenue each year. Tobacco remains one of the sectors most affected. The consequences extend well beyond fiscal losses. Illicit markets weaken legitimate businesses, reduce regulatory oversight, limit consumer protections and undermine the effectiveness of public policy itself.
That reality reinforces an important lesson. Regulation cannot be judged solely by the laws that are enacted. It must also be judged by how effectively those laws function in practice. Strong enforcement, robust product standards, age verification, manufacturing oversight and action against illicit trade are not separate policy objectives. They are all essential components of a regulatory framework that seeks to protect public health.
It is within this broader context that tobacco harm reduction has become an increasingly important policy discussion. The issue is not whether smoking is harmful, that question was settled decades ago. Nor is it about replacing smoking cessation, which remains the best possible outcome for every smoker. The question is whether adult smokers who are unable or unwilling to quit despite repeated attempts should have access to regulated alternatives that may reduce their exposure to the harmful effects of combustion, while remaining subject to strict regulatory oversight.
Different countries have reached different conclusions, reflecting their own legal frameworks, healthcare priorities and regulatory capacities. That diversity should not be viewed as a weakness. Comparative policymaking has never been about copying another country’s approach. It is about understanding how different regulatory models perform, learning from their outcomes and adapting relevant lessons to local circumstances.
Public policy has always evolved by asking difficult questions and evaluating whether existing approaches continue to serve their intended purpose. Tobacco control should be no different. The objective remains exactly as it has always been: reducing smoking-related harm and protecting public health. If that is the outcome policymakers seek, then every regulatory assumption should remain open to thoughtful evaluation. Effective regulation is not measured by how consistently it treats every product. It is measured by how successfully it reduces risk, protects the public and delivers better outcomes for society.
The writer is a corporate lawyer and president of the Pakistan Tax Bar Association.
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