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Attitudes of smokers towards tobacco control policies: findings from the Studying Tobacco users of Pakistan (STOP) survey
  1. Kamran Siddiqi1,2,
  2. Faraz Siddiqui1,
  3. Melanie Boeckmann3,
  4. Ziauddin Islam4,
  5. Amina Khan5,
  6. Fiona Dobbie6,
  7. Zohaib Khan7,
  8. Mona Kanaan1
  1. 1Department of Health Sciences, University of York, UK, York, North Yorkshire, UK
  2. 2Hull York Medical School, York, UK
  3. 3School of Public Health, University of Bielefeld-Germany, Bielefeld, Germany
  4. 4Tobacco Control Cell, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Islamabad, Pakistan
  5. 5The Initiative, Islamabad, Pakistan
  6. 6Usher Institute, University of Edinburgh, University of Stirling, Edinburgh, UK
  7. 7Office of Research Innovation and Commercialisation, Khyber Medical University, Peshawar, Pakistan
  1. Correspondence to Dr Faraz Siddiqui, Department of Health Sciences, University of York, York YO10 5DD, North Yorkshire, UK; faraz.siddiqui{at}


Background Public attitude is a political driver in successful implementation of tobacco control policies. We assessed support for a range of tobacco control policies among smokers in Pakistan.

Methods We conducted a household survey among adult smokers in 10 cities of Pakistan, using a two-stage random sampling strategy to select households and Kish grid method to select one smoker per household. Attitudes were measured using a five-point ordinal scale on four policy statements: a complete ban on tobacco sale within 10 years; raising the legal age to buy tobacco from 18 to 21; increasing tobacco taxes to fund healthcare and a ban on smoking in cars with minors.

Results 6014 participants were interviewed between September 2019 and March 2020. Most participants demonstrated strong support for all policy statements: a ban on smoking in cars with minors (86.5%); a complete ban on tobacco sale within 10 years (82.1%); raising the legal age to buy tobacco (77.9%) and increasing tobacco taxes (68.1%). Smokers’ support for tobacco control policies increased with age but decreased with higher educational attainment and heaviness of smoking.

Conclusions There is strong support among smokers in Pakistan to strengthen tobacco control. Given this, policy-makers should strongly consider strengthening existing national policies on tobacco control.

  • low/middle income country
  • public policy
  • public opinion
  • surveillance and monitoring
  • health services

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  • Contributors KS (principal investigator) along with AK, ZI, ZK and MB (coinvestigators) were involved in designing the original study and provided inputs throughout the project period. KS also wrote the introduction, methods and discussion section. FS analysed the data, drafted results and parts of methods sections and all tables and figures. FD was involved in the interpretation of the results and contributed to the write up. MK supervised the quantitative analysis and contributed to the manuscript. All the above listed authors reviewed and approved the final manuscript draft.

  • Funding The study was funded by European Union Horizon 2020, grant no 680 995.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and approved by the Health Sciences Research Governance Committee (HSRGC), University of York, UK and by the National Bioethics Committee of Pakistan Health Research Council, Islamabad, Pakistan.

  • Provenance and peer review Not commissioned; externally peer reviewed.