t a time when Pakistan is grappling with economic austerity, tightening import controls and attempting to curb the inflow of non-essential goods such as tobacco products, one question looms unanswered: how are vaping devices and heated tobacco products (HTPs) still flooding markets across the country?

These products (less recreational nicotine pouches) are not manufactured domestically. They are imported, often branded as lifestyle commodities and squarely fall in the category of goods the government has, in principle, sought to restrict. Yet they remain widely available, in shops, online marketplaces and through informal distribution networks that seem far too organised to be dismissed as mere smuggling. This contradiction is not just administrative; it is deeply political and profoundly concerning.

The timing makes this even more troubling. Even as these products circulate freely, a bill is being pushed to “regulate” rather than ban them. Framed as a public health intervention, the proposed legislation would legalise the import, sale and marketing of vapes under a structured regime, introducing age limits, packaging requirements and advertising restrictions. The bill, clearly pushed by the tobacco industry, risks legitimising an already expanding market that has taken root precisely because of weak enforcement and policy ambiguity.

Let us be clear: Pakistan is currently suffering from the pandemic of cigarettes and other traditional tobacco products. It simply cannot afford another similar pandemic. There are no comprehensive federal laws governing the sale, advertising, or import of e-cigarettes and similar products. They are sold openly and unregulated, marketed aggressively and consumed widely.

This is a policy vacuum that has been actively exploited by the tobacco industry. The tobacco and nicotine industry, with its long history of navigating regulatory grey zones, has stepped in to shape the narrative, pushing for regulation on its own terms, at its own pace and in ways that secure market access rather than restrict it.

The central question, however, remains unanswered: if these products are indeed subject to import constraints under austerity measures, how are they entering Pakistan in such volumes? Bootlegging alone cannot explain the scale and visibility of the market.

Vape shops operate openly in major cities. Online platforms deliver products nationwide. Flavoured nicotine products, clearly designed to appeal to younger consumers, are stocked in convenience stores. This is not a shadow economy; this is a parallel, normalised marketplace operating in plain sight.

This raises uncomfortable questions. Are customs authorities unaware of what is entering the country? That seems unlikely. Is enforcement selective, allowing certain import channels to function unchecked? Or, is the industry so well-resourced and strategically positioned that it can circumvent state controls? None of these scenarios inspire confidence. All of them point to a deep governance failure, one that cannot be corrected by passing a bill that formalises the market it should be dismantling. This is concerning especially when the tobacco industry cries “illicit” on the un-taxed cigarettes.

Equally disturbing is the role of certain political actors advocating for the passage of this bill. Elected representatives are entrusted with safeguarding public welfare, not advancing the commercial interests of industries whose products are inherently harmful. The push to regulate rather than ban these devices reflects a troubling alignment with industry narratives, particularly the notion that controlled availability is preferable to prohibition. This argument ignores Pakistan’s own experience with tobacco control, where partial measures have often been undermined by weak enforcement and industry interference.

There is, however, a countervailing force that deserves recognition and support: the Ministry of National Health Services Regulation and Coordination. In the face of mounting pressure, the ministry has taken a principled and evidence-based stance, advocating for a complete ban on vaping products due to their health risks and potential misuse. This position is not only consistent with global public health guidance but also aligned with the concerns of medical professionals, researchers and civil society organisations across Pakistan.

These concerns are not abstract. The rise of vaping among young people is well-documented, with increasing evidence linking these products to nicotine addiction, respiratory harm and exposure to toxic substances. Provincial governments have already recognised the urgency of the issue. The Punjab has imposed a ban on e-cigarettes and nicotine pouches, citing the growing threat to youth health. Public health advocates have consistently called for nationwide prohibition. These actions reflect a clear understanding: new nicotine products are not a solution to tobacco harm, but an extension of it.

The proposed bill risks institutionalising the problems it purports to solve. By creating a legal framework for import and sale, it would grant legitimacy to an industry that has thus far operated in defiance of regulatory norms. It would shift the burden from prevention to management, from prohibition to accommodation. In doing so, it will send a dangerous signal: that the state is willing to negotiate with public health when confronted with commercial pressure.

Civil society in Pakistan has been unequivocal in its position. Health experts, advocacy groups and policy researchers have consistently argued that regulation is insufficient in the face of such aggressive market expansion and a complete ban is the only workable option. They have called for decisive action, closing import channels, banning sales and eliminating the regulatory loopholes that allow these products to proliferate. This is not a fringe view; it is a consensus grounded in public health evidence and lived experience.

Pakistan cannot afford public health compromises. The economic cost of tobacco-related diseases is staggering (surpassing Rs 1.1 trillion per year). The introduction of new nicotine products threatens to swell this burden. More importantly, the social cost, measured in addiction, illness and lost potential among young people, is incalculable.

The government must close the loopholes that allow these products to enter and circulate in the country. Customs enforcement must be strengthened, not questioned. Legislative efforts must focus on prohibition, not normalization. Political leadership must align itself with public health imperatives, not industry lobbying.

The Ministry of Health’s resistance to the bill represents a commitment to evidence-based policymaking and a refusal to yield to pressures that would undermine the health of future generations. That stance deserves not only support but also amplification. Pakistan must not repeat the past mistakes of allowing harmful industries to shape its policy. The stakes are too high for anything less than decisive action.

The writer is head of Centre for Health Policy and Innovation at the Sustainable Development Policy Institute, Islamabad, and a tobacco control advocate.