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It is distressing how often studies of girl's smoking rates in countries previously protected by cultural and religious factors are finding results well on the way to catching up males of comparable age. Just a decade or two ago it was still assumed by most people in Pakistan that it was not even worth trying to measure schoolgirls' smoking as it was negligible. However, as often illustrated in this Journal, international tobacco companies, led by British American Tobacco (BAT), have let loose the might of their practically limitless promotional budgets in Pakistan, seeking to hook their next generation of regular smokers—the youth market—knowing that they could look forward to recruiting increasing numbers of girls. Girls increasingly have joined the general youth market being exploited by multinational and local companies, at least in the cities, where they have been exposed to promotions in the streets, discos and on televised pop music shows.

So it is no surprise, though of great concern, that in a recent study of Karachi senior school girls with a mean age of 15 years, some 16% had tried smoking and 6.4% smoked at least once a month (Int J Tuberc Lung Dis 2007;11:1366–71). This is around half the rate of Pakistani boys and higher than girls' rates reported in 13 of 18 Indian cities, as well as higher than in Indonesia, Myanmar, Nepal, Sri Lanka and other south Asian countries covered by the global youth tobacco survey. BAT's corporate social responsibility propaganda does not mention whether it is planning to underwrite the medical care and funeral costs of all the extra female patients of smoking-induced disease in Pakistan in the future.