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Implementing smokeless tobacco control policy in Pakistan: a qualitative study among Naswar supply chain actors

This paper explores the challenges and opportunities in regulating smokeless tobacco (SLT), particularly Naswar, in Pakistan. Using qualitative research methods, the study examines the perspectives of Naswar sellers and vendors in Khyber Pakhtunkhwa province regarding the implementation of the WHO Framework Convention on Tobacco Control (FCTC). The research identifies three key themes: the involvement of children in the Naswar trade as consumers and future sellers, the economic significance of the Naswar business, and concerns over its health risks due to unregulated production processes. The study highlights conflicting views among supply chain actors regarding taxation, content disclosure, and health warnings, with many sellers opposing stricter regulations due to potential economic losses. However, a ban on selling to minors was widely supported, suggesting a viable first step toward policy enforcement. The findings underscore the need for a comprehensive SLT control policy, integrating stakeholder perspectives while aligning with international tobacco control measures.

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