Landmark mixed-methods research across 6 provinces finds that misinformation spread by anti-tobacco organizations regarding smoke-free alternatives, rather than habit or access, is the primary barrier to switching and that the gap is correctable.
Smoking claims around 164,000 lives in Pakistan each year and costs the country a whopping 422 billion rupees in healthcare and lost productivity. It hooks 18.3 million adults, one in five Pakistani men, inside a combustion habit that the scientific world declared preventable decades ago. A landmark new study finds that the single biggest reason Pakistani smokers refuse to consider alternatives has nothing to do with price, access, or habit. It has to do with lies and the organisations spreading them. The Switch Report, Pakistan’s first largest survey on what smokers think about alternatives to regular cigarettes, looked at 1,600 adults across six provinces, including 1,085 confirmed smokers. Between January and May 2026, the WTA compiled the research which included a combination of quantitative data and focus group analysis conducted in Karachi, Lahore, and Islamabad and a global review across eight countries. About 59.3% of the smokers in Pakistan feel that smokeless products, including vapes and nicotine pouches, are more hazardous than cigarettes. .Not equal risks. Greater. That belief rests on a foundational error that the report identifies as the engine driving everything else: 56.6% of smokers attribute smoking-related disease, including cancer, to nicotine not to combustion. This single factual mistake collapses the entire scientific case for harm reduction. A smoker who thinks nicotine causes cancer won’t see any difference between a regular cig and a nicotine pouch. This makes no sense logically. Every alternative looks equally deadly. The report does not dodge accountability. It identifies anti-tobacco organisations and public health campaigns that treat all nicotine products as equivalent making no distinction between combustible cigarettes and smoke-free alternatives as a primary driver of the misinformation environment. Pakistani smokers receive most of their health information from family members (40.5%), social media (34.%) and peers (31.8 %). Only 22.4% cite healthcare professionals despite 78% saying they trust doctors most. The magnitude of misinformation revealed in this research should be a source of worry for the policy makers. In situations where over 50% of all smokers wrongly perceive nicotine as being carcinogenic, one realizes that there is a great failure in educating people against false stories from anti-smoking campaigns. The government must take steps to counter misinformation and create an environment where smokers can access factual, evidence-based information says Shahbaz Khan, CEO WTA The infrastructure of correct information simply does not reach Pakistani smokers. Just 7.8% reported frequent exposure to information about smoke-free alternatives over the previous six months. More than a quarter had encountered none at all. Focus groups in three cities surfaced eight specific myths that function as active psychological barriers to switching and researchers found that participants raised every single one spontaneously, without prompting. Smokers across Karachi, Lahore and Islamabad believe vaping causes an irreversible lung condition called “popcorn lung”, that e-cigarettes contain antifreeze, that nicotine pouches cause oral cancer just like naswar, that heated tobacco products still produce smoke, and that smoke-free alternatives serve as a gateway to harder drugs. The data hides a key point amidst the gloom: 45.6% of smokers stated they’d switch to less harmful alternatives if given solid proof, yet only 8.7% have actually thought about doing it. So while many might jump at the right evidence, few have gotten there yet. The gap between those two numbers 45.6 percent open to switching versus 8.7 percent who ever tried represents millions of Pakistanis making avoidable decisions inside a manufactured information vacuum. The leading obstacles to switching were seen as equivalent harm at 39.8%, insufficient and trustworthy info at 37.1%, and regulatory uncertainty at 33.2%. affordability was way lower at just 22%. Access ranked at 24.7 percent. The report ends with 7 suggestions: public education in Urdu about combustion and nicotine, correcting myths, better guidance for healthcare pros and the media, clearer talks about regulation and risk, and creating Pakistan-specific evidence to monitor perception and smoking habit changes over time.
