Islamabad: A new national survey finds that most of Pakistan’s current tobacco and nicotine users want smoke-free alternatives, such as vapes and nicotine pouches, brought under strict government regulation rather than banned outright.
According to the Tobacco Harm Reduction Perception Survey, Pakistan, released today by the Endit Foundation, 87% of respondents support a regulated and legal framework over prohibition.
The survey was conducted among 515 adult daily and weekly tobacco or nicotine users across Pakistan by Prodege, a global research and consumer-insights company, in technical coordination with the Endit Foundation, Islamabad. Respondents were surveyed online between 16 June and 2 July 2025. All participants were screened to confirm they were current regular users of at least one tobacco or nicotine product.
The findings point to consumers who may be ahead of current policy discussions. 86% of respondents said alternative nicotine products considered less harmful than cigarettes should be regulated differently, while 89% supported strong enforcement to keep such products away from minors.
Meanwhile, 86% believe an outright ban would push people toward illegal markets rather than encourage them to quit. Another 79% support taxing smoke-free alternatives at a lower rate than cigarettes.
High Awareness, But Major Misconceptions
The survey found high awareness of smoke-free nicotine products among respondents. 87% said they were aware of vapes and e-cigarettes, while 83% were aware of nicotine pouches.
However, a significant knowledge gap remains. 69% of respondents believe nicotine itself is the main cause of smoking-related cancer. At the same time, 82% agree that most of the harm caused by smoking comes from inhaling smoke rather than nicotine.
The report states that this gap has direct implications for how tobacco harm reduction messages should be designed and delivered.
Families More Trusted Than Government
The survey also highlights a significant trust gap when it comes to health information.
Friends and family were the most trusted source of information on tobacco and nicotine, with 93% of respondents expressing trust in them. Doctors and public health experts followed at 80%.
Government policymakers ranked the lowest, with only 40% of respondents saying they trusted them. The media ranked slightly higher at 43%.
The report notes that public health messaging on tobacco harm reduction is likely to reach more people through personal networks and healthcare professionals than through official or media channels alone.
Call for Evidence-Based Regulation
Dr Ziauddin Islam, CEO of the Endit Foundation, said the findings show that many current tobacco and nicotine users in Pakistan are looking toward products they perceive as less harmful and expect these products to be regulated.
“Turning that readiness into a real public health gain means Pakistan needs firm regulation that protects youth, holds any legal products to strict safety and quality standards, and gives adult smokers accurate, evidence-based information to help them move away from cigarettes,” he said.
The report recommends several measures for regulators, including risk-proportionate regulations that treat smoke-free nicotine products differently from combustible cigarettes.
It also calls for mandatory product standards, stronger enforcement to prevent youth access, and a coordinated public education campaign led by the Ministry of Health to address the knowledge gap surrounding nicotine and smoking-related cancer.
About the Endit Foundation
The Endit Foundation is an Islamabad-based public health organisation that raises awareness of tobacco-related health risks, advocates for tobacco-policy reform, and runs harm-reduction and cessation support programmes for vulnerable groups, including youth and low-income communities.
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Endit Foundation
Email: info@enditfoundation.org
Phone: +92 300 2227179
Website: www.enditfoundation.org
