Driving down any street in Karachi, it’s hard to miss the glow of neon signs advertising vaping products and e-cigarettes, one shop after another, lined up like restaurants on a busy food street.

Walk into one of those shops and you’re immediately hit by a whiff of synthetic strawberry and mint, and see a sign taped to the counter bearing a bold: “18+ ONLY.” Most residents of the city would say these shops are fairly new, so I ask the vendor how and when he got into the trade in the first place and who his average customer is.

He tells me he mostly sells to adults. As he recalls a friend’s AliExpress order of an e-cigarette with a ‘weird’ filter that sparked their venture into the business a few years back, a boy no older than 14 strolls in and pops open a sleek pod. He asks for a refill of his favourite Tokyo juice flavour in pineapple, and without a second glance, the vendor pulls out a bottle from under the counter and tops it up. The boy clicks the device shut and walks out, inhaling it deeply and leaving thick clouds of syrupy vapour in his wake.

special notice when they dealt with a case. It wasn’t until 1964 that the first report by the Surgeon General of the United States on the harmful health effects of smoking was published, making the issue less about consumer choice and more about epidemiology and public health.

Within a year, a law was passed in the US that required cigarette packages to be labelled with health warnings. Before long, cigarette advertisements on television and radio weren’t normal anymore.

Decades of public health efforts like indoor smoking restrictions and support to help people quit have led to smoking rates seeing a sharp decline globally. Now, newer technologies like vapes and nicotine pouches have reshaped the smoking landscape.

But it isn’t exactly nicotine itself that does the most damage — it’s actually the arsenal of carcinogenic substances it’s paired with in conventional cigarettes. Research scientist and harm reduction pioneer Michael Russell said in 1976 that people smoke for nicotine, but they die from the tar. And so people continue to seek healthier ways to deliver that fix.

Since vapes and nicotine pouches don’t “burn” tobacco or produce tar or carbon monoxide, they’re widely claimed to be safer than regular cigarettes.

A vape shop in Karachi. Photo: Author

Big tobacco firms like British American Tobacco (BAT) and Philip Morris International (PMI) have made substantial efforts to shift to new nicotine products and away from conventional cigarettes. As one person working for a big tobacco company in Pakistan told me in earnest defence of nicotine, “You can’t kill human curiosity.”

In London in September 2024, BAT launched ‘The Omni’, a summary of the company’s efforts to promote Tobacco Harm Reduction (THR) by encouraging smokers to switch to less risky alternatives. According to the company’s chief executive, Tadeu Marroco, the goal is to ensure that at least 50 per cent of its revenue comes from smokeless products by 2035.

While PMI maintains that the best choice for a smoker is to quit altogether, it describes THR as an alternative for adults who would otherwise continue to smoke.

The THR narrative has health experts divided on its legitimacy, but the general consensus seems to be that effective government regulation is crucial if we’re to maximise its potential benefits.

bans on the sale of e-cigarettes, while 73 have enforced sale restrictions and regulations.

In Pakistan, however, the market has thrived pretty much free from regulatory pressures seen elsewhere. Data obtained from the Pakistan Bureau of Statistics indicates that between July 2023 and June 2024, Pakistan imported a total of 750,590 e-cigarettes or vaporisers, with major imports coming from China, Hong Kong, Malaysia, the United Kingdom, and Russia. These figures, however, only reflect legal imports — it is believed that a significant number of vapes are smuggled into the country, particularly from China.

Earlier this year, Lahore held a vape exhibition at the city’s Expo Centre, which, according to the event’s website, was designed for industry enthusiasts to connect and explore the “future of vaping” in the country. A similar exhibition was scheduled to be held in Karachi on May 31; however, it was cancelled on the day of the event for unspecified reasons.

BAT entered the Pakistani vaping market through its subsidiary Pakistan Tobacco Company about a year and a half ago, initially offering disposable vapes in three variants — 700, 1,500, and 5,000 puffs. However, it exited the vape market at the start of this year due to heavy taxation on smokeless products and the inability to compete with smuggled products.

Large companies like BAT are compelled to pay government duties and taxes, which meant the retail price of their vaping product, Vuse, was much higher than products that got away with not paying duties. Although vaping has gained popularity in Pakistan, the high price of legal products made it difficult for BAT to compete in the market. An employee at BAT told me on the condition of anonymity that their disposable devices sold for around Rs3,000 and offer approximately 5,000 puffs. In contrast, cheaper alternatives offered 8,000 to 9,000 puffs for as little as Rs1,500. The vast difference in price and usage made these options far more appealing to the average consumer.

Pakistan Tobacco Company did not respond to a request for comment.

help treat symptoms of attention-deficit/hyperactivity disorder (ADHD). As a 19-year-old from Karachi told me of his need to vape, “Just like when you wake up in the morning and have a cup of coffee. Suddenly, everything feels brighter, more colourful, and focusing becomes so much easier.”

But there’s a downside. When vapes are sold in every colour of the rainbow and flavours like pink lemonade, cotton candy, and bubblegum, kids inevitably get drawn in more than an adult smoker looking to quit.

According to pulmonologist Dr Saima Saeed from The Indus Hospital, vaping products are marketed in a way that specifically seem to target young people.

“If you go to any grocery store or corner shop, you’ll see behind the counter where cigarettes used to be, there will be a nice flashy advertisement for this chewable tobacco. The advertising is very flashy, and it has bright colours, and it’s saying you can use these products without smelling of cigarettes, and you won’t need to show anything in your hand because it’s like just a piece of gum in your mouth,” she said.

Rather than acting as a safer alternative, vaping and nicotine pouches are increasingly acting as gateways, according to Dr Saeed. Young people get hooked on nicotine through these products and may later transition to smoking cigarettes rather than avoiding them altogether. From a medical standpoint, nicotine is a drug. “It affects brain development, especially in adolescents whose brains continue developing into their early twenties,” Dr Saeed added.

Even though the first documented reference of an electronic cigarette is a patent granted to Joseph Robinson in 1930, the device never really became commercially successful until 2003 when 52-year-old pharmacist Hon Lik came up with the idea of an e-cigarette as a way to cure his own smoking addiction following his father’s death from lung cancer. Since most of these products are still relatively new, there’s no long-term research available to fully assess their actual impact.

The first documented reference of an e-cigarette, 1930. Photo: United States Patent and Trademark Office

“In Pakistan, systematic tracking of vaping-related injuries is nearly nonexistent. We’re simply overwhelmed with other respiratory issues; cigarette smoking itself still affects 12 to 15 per cent of the population, and that alone is a major burden,” Dr Saeed said.

She went on to explain the regulatory gap, with laws focusing specifically on cigarettes and “smoking”. This language allows the tobacco industry to exploit loopholes. In Pakistan, which is 14 on the list of top tobacco producers in the world and where industry players hold sway across sectors, regulation around new nicotine products is weak or absent. While advertising for cigarettes is banned, that’s not the case for vapes or chewable tobacco.

Pakistan is a signatory to the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), which calls for banning advertisement, promotion, and sponsorship of tobacco products. But while the FCTC uses the word “tobacco,” Pakistan’s laws mostly say “cigarettes,” which leaves out products like vapes and nicotine pouches.

Although a Tobacco Control Cell existed under the Ministry of National Health Services Regulations and Coordination, it was disbanded in 2021. And as many Pakistanis know, there’s a vast difference between having legislation and enforcing it. For instance, there’s already a law that bans tobacco sales within 50 metres of a school, and yet, you’ll find tobacco products being sold right outside schools in many areas.

Recently, some headway has been made and Punjab Chief Minister Maryam Nawaz has directed the relevant departments to impose a ban on vaping in the province. The decision drew mixed reactions, with actor Iffat Omar criticising the move, arguing that such bans are ineffective and only fuel the black market rather than curbing access.

On the subject of harm reduction, Dr Saeed said, “Everything is relative. Some doctors will say that if you’re a smoker, it’s better to vape because there’s less immediate harm.” However, as she pointed out, even though that works in countries with better resources for people looking to quit, that’s hardly the case in Pakistan.

Instead, people may turn to vaping in an effort to quit nicotine, without realising that it requires a gradual reduction, and often without the professional support needed to taper off or quit entirely. “And at the same time, you have all this aggressive advertising to young people to encourage them to start using new tobacco products, clearly understanding that they’re gonna become lifelong addicts of nicotine.”

In a world steadily pushing cigarettes off the shelves, the tobacco industry is reinventing itself, not by backing down, but by pivoting and doubling down on newer nicotine-based products, all marketed as ‘safer’ alternatives to smoking, and all rapidly gaining popularity among young Pakistanis.

According to Dr Javaid A Khan, Professor of Respiratory Medicine at Aga Khan University, this growing trend is far from harmless. It’s alarmingly under-regulated and possibly setting up the next major public health crisis. “Cigarette smoking has become stigmatised; everyone knows it causes cancer and heart disease. But vaping? It’s seen as trendy, modern, even safe,” he said. “The truth is, it still contains nicotine, it’s highly addictive, and there are no long-term safety studies yet.” It’s essentially like repeating history.

Dr Khan believes that nicotine chewing gums are a good way to manage withdrawal symptoms for those looking to quit smoking. But, as he pointed out, famous actors promoting nicotine pouches as anything other than a crutch on television defeats the purpose. It’s hard to believe these products are supposed to be marketed as anything but gateways to nicotine use when you see them advertised by bright and bubbly Syra Yousuf, or Osman Khalid Butt hanging out on a beach.

Dr Waseem Iftikhar Janjua, consultant and advisor at the Sustainable Development Policy Institute in Islamabad, has been working on tobacco control for a few years, focusing on areas such as graphic health warnings, emerging nicotine products like vapes and heated tobacco, tobacco industry interference, and taxation policies.

He explained that while Pakistan has regulations in place when it comes to the demand, like bans on sales to minors, single-stick sales, and mandatory health warnings, there is a regulatory vacuum on the supply side, particularly around new products, such as vapes. These products, often flavoured to appeal to younger users, have rapidly proliferated in the absence of legislation.

He warned that the addictive nature of nicotine and the absence of long-term clinical studies make these products a serious public health risk. The global tobacco industry, he noted, is shifting from cigarettes to electronic nicotine delivery systems under the guise of tobacco harm reduction, a narrative he’s critical of. With Pakistan’s delayed policy response, regulating rather than banning these products is now the only practical solution, according to him.

While cigarette smoke has long been recognised for its harmful first-hand, second-hand, and even third-hand effects — which refers to the smoke lingering on surfaces like sofas and doorknobs — Dr Janjua noted that vaping introduces a new, less understood layer of concern, a phenomenon he dubbed “fourth-hand smoke”: the visual appeal and fascination with vaping, especially among youth, who are drawn in by thick vapour clouds and tricks like smoke rings.

“These devices, often no larger than a USB stick, are discreet and go unnoticed by parents or teachers. They don’t burn tobacco but use a coil to heat liquid nicotine, which gives off a sweet smell and can be used throughout the day,” he said. “Initially expensive, the local market is now saturated with cheaper Chinese products.”

ban on shisha in public spaces caused vaping to gain attention. Unlike cigarettes, which contain a fixed nicotine strength of about 15 to 20mg per stick along with harmful substances such as tar, vapes allow users to control their nicotine intake from zero up to 50mg, or 5pc strength. So, according to him, it’s a healthier alternative for those looking to quit smoking.

Early vape devices were large and lacked the refined pod systems available today. While vaping is supposed to help users quit cigarettes, many customers continue to use both, which defeats the purpose. “If someone really wants to quit, they can quit directly too,” said the shop owner, adding that when new customers come in, he inquires about their smoking history to suggest a suitable device.

Daniyal, another vape store owner in Karachi who has been working in the industry for the past four years and running his own brand and shop for the last two, described the sector as rapidly evolving. Initially employed at another vape shop, his curiosity about the origins, side effects, and benefits of vaping led him to start his own business. He said that all vape hardware and liquids are manufactured abroad, with no manufacturing currently taking place in Pakistan.

He observed a major shift in social attitudes towards vapes. “In the past, people got in trouble for smoking cigarettes. Now, if someone aged 18 to 22 uses a pod vape, no one at home objects because there’s no smell,” he said. “Even when you sit with others, you don’t feel awkward because there’s no tobacco odour.”

A picture of Colombian drug lord Pablo Escobar at a vape shop in Karachi. Photo: Author

The idea that vaping and smoking differ comes mainly from how nicotine is delivered and the chemicals inhaled. Since battery-powered vaping devices heat nicotine, flavourings, and other chemicals into an aerosol that is inhaled, it isn’t technically “smoking.” But for those exposed to the aerosol fumes, the difference can feel minimal. Recently, actor Hina Khwaja Bayat spoke about her annoyance with vaping, saying that she does mind if someone vapes in the same room as her.

Peshawar-based non-profit organisation Blue Veins, which works on gender-based violence and non-communicable diseases, has recently expanded its advocacy to include the regulation of e-cigarettes and vapes. Operating under the Khyber Pakhtunkhwa Alliance for Sustainable Tobacco Control, a civil society collective comprising doctors, lawyers, and journalists, the group is attempting to raise awareness about the absence of a legal framework governing the sale, marketing, or storage of vaping products.

“There’s no regulation. No signage, no age restriction, no health warnings,” Qamar Naseem, a representative of Blue Veins, said, stressing how easily accessible vapes are to younger people. He said there’s a widespread misconception that vaping is safer than smoking. “Nicotine is globally recognised as a poison. If it’s a drug, it should fall under drug laws,” he argued, adding that multiple countries have already banned or strictly regulated vaping due to its health risks.

fastest-growing solid waste streams in the world.

In Pakistan, informal e-waste recycling activities generate organic flame retardants, chemicals added to materials like plastics, textiles, and coatings to make them more resistant to fire. While these flame retardants are ordinarily crucial for safety in certain products, their generation by improper disposal of e-waste can be deadly for labourers working in these areas.

A study conducted on four recycling sites in Karachi — Jacob Lines, Surjani Town, Lyari, and Shershah — revealed that the environment from Shershah and Lyari was highly contaminated with flame retardants. This can have severe health effects like endocrine and thyroid disruption, immunotoxicity, reproductive toxicity, cancer, and harmful effects on foetal and child development. As Jabir Hussain Syed, one of the study’s authors and an e-waste researcher, pointed out, the plastic pods and cartridges inside vapes and e-cigarettes can be particularly problematic for both the environment and health.

Around the world, countries are waking up to the risks of vaping by tightening regulations or imposing outright bans. As more young Pakistanis turn to brightly advertised vapes in fun, fruity flavours, will the government take proactive steps or wait for a full-blown crisis to do something?

*Names changed to protect privacy





Source link