KARACHI, Oct 9: Smoking is the only cause behind 40 per cent of all cancer cases in the country.

A study, Bhurgry et al in 2000, has estimated that 65,000 persons were suffering from cancers of all kind in the country, out of which at least 40% (26,000) were attributable directly to cigarette-smoking.

In another study, which was conducted by Alam in 1998, Pakistan was found to have around 28 million smokers at any given time amongst the estimated 1.1. billion smokers around the world. An estimated amount of tobacco worth Rs562 million is consumed daily.

It is further estimated that while at least 27.4% of males and 4.4% of females smoke in Pakistan, the tobacco revenue in 1990 constituted 0.7% of the GNP of the country.

During the past 20 years, adult per capita consumption of manufactured cigarettes has fluctuated between 650 and 700 cigarettes per annum.

In Pakistan 108,000 tons of tobacco were produced in 1992 (1.3% of the world total) up from 68,000 tons in 1990. Furthermore during 1992, 54,626 hectares were harvested for tobacco.

An annual average of 31,000 million cigarettes were produced in the period 1990-92, which increased to 36,644 million in 1994. At around the same time the tar content in the cigarettes and bidis sold was estimated between 16.3-66mg, while the nicotine content ranged from 1.2 14.2mg.

Several types of tobacco are grown in the country including dark tobaccos for bidis, hookah smoking, snuff, and chewing, with around 50% of the tobacco grown used for cigarette production.

A regional consultation of the World Health Organization held in Malta recently has recognized the use of tobacco as one of the greatest threats to public health in the Mediterranean region and called upon all member states and governments to protect the health of their citizens, particularly children and other vulnerable groups, from the negative health, economic and social impacts of tobacco use. The meeting noted that tobacco remains an important component of economic activity in countries of the region and reaffirmed the need for developing national plans of action to combat the tobacco epidemic in countries where such plans have not been developed so far.

The meeting also called for extensive collaboration between the ministries of health, finance, education and agriculture in order to change the existing social and economic norms.

The Malta declaration adopted by the World Health Organisation at that meeting is quite relevant and pertinent in the context of Pakistan.

The declaration urged all member states to identify tobacco control as a national priority, establish intra-governmental mechanisms, explore the impact of taxation policies on tobacco consumption, smuggling, revenue generation and initiation of the habit in children.

The member states were further urged to undertake economic studies that would enhance knowledge on revenue generation through tobacco taxation as well as the financial implications of tobacco-related disability, morbidity and mortality.

The declaration called upon all countries to mobilize technical support for tobacco surveillance activities, which will provide the evidence-base for tobacco control in the future.

The countries were further requested to develop cooperation and regional partnership with each other in order to address issues such as cigarette smuggling and making coordinated efforts against the tobacco epidemic.

The declaration also called on international agencies to strengthen their collaborative activities aimed at assisting governments in national tobacco-control efforts.