Afghanistan is a landlocked multiethnic country located in the heart of south-central Asia. The country has a ubiquitous tobacco culture, resulting in thousands of deaths each year. The most common tobacco products invading Afghanistan are Naswar (used through mouth or nose), Cigarettes, Water Pipe (Chillam) and Cigars. People of Afghanistan are unaware of the Tobacco Industry and the intense effects that tobacco use has on human health. The inadequacy of this knowledge has led to a vacuum of people’s action against tobacco industry and its effects leading, in turn almost, to a tobacco epidemic in the country.

In comparison to the averages in other low HDI countries, 9.97% more men and 7.6% more women die each year due to tobacco use. Further, out of the 37% of deaths attributable to the Non-Communicable Diseases (NCD), 16% was due to tobacco. Although smoking prevalence information at a national level is scares, World Health Organization estimates a prevalence among men aged 15 years and older of 35.2%.

The main Domestic Tobacco supplier in the country is ‘Aram Group’. The other domestic suppliers and manufacturers are Amal Trading, Asia Meddle East Co, Nasib Aria Co. Ltd, Sarco Abad and Tamana Ltd. The international companies contributing to the Tobacco Industry in Afghanistan are Korea Tobacco, Ginseng Corporation and Alokozay Group of Dubai. The import industry of Cigarettes in Afghanistan takes up a large portion where they import from 10 countries in total, and there was an increase from USD$3.8 Million of cigarette imports in 2013 to USD$87.2 Million in 2015.

Afghanistan signed the World Health Organization ‘Framework Convention of Tobacco Control’ (FCTC) in 2004, and was later ratified in 2010 as a legal equivalent in Afghanistan, giving some hope to tobacco control within the country. FCTC was considered when the Afghanistan government developed certain laws for tobacco control in 2015, hence a multi sectorial commission was assigned to oversee the implementation of the law. The Ministry of Public Health was assigned as the focal agency to communicate the development reports with the World Health Organization. Because of these positive steps, the Article 5.3 of ‘Framework Convention of Tobacco Control’ was implemented and thus all parties who were involved in the law making process gave the assurance that their policies are protected from commercial and other vested interests of the tobacco companies. Adding more positivity, Afghanistan also adopted the legislation to implement Graphical Health Warnings covering 50% of the surface of the tobacco packaging.

However, whilst these improvements have been done in the country there are still many short falls in Tobacco Tax Reforms and capacity building program (short term and long term trainings and research activities) for example. There are also several laws and/or regulations which are in place yet not implemented in the country effectively. For example, despite legislations which banned advertisements that promote cigarette use in domestic media, seven in ten students saw pro-cigarette advertisements on billboards and three in ten saw pro cigarette advertisements in newspapers or magazines. Furthermore, legislative measures are yet to be taken on several of the other areas set out in the FCTC, Such as mandating anti-tobacco mass media campaigns for example.

In conclusion, while tobacco use contributes significantly to the disease burden in Afghanistan for both men and women and certain positive steps have been taken to curb the situation, further legislative, fiscal and human resource measures need to be urgently taken to effectively address this issue.

(This blog post is based on the presentation on ” Afghanistan country profile” done by Dr. Mohommad Nazir at the Initiation workshop of the South Asian Regional Consortium Centre for Combating Tobacco(SARC-CCT) held in July 2019)