Strengthening Tobacco Control Surveillance in Pakistan: Experience from the Global Adult Tobacco Survey (GATS)

Worldwide, tobacco use is responsible for approximately 6 million deaths per year, and is the single largest preventable cause of death and disease. In Pakistan, the WHO estimates that approximately 32% of adult men and 6% of adult women use tobacco products[i]. Cigarettes are also becoming increasingly affordable in Pakistan; currently, a pack of 20 cigarettes costs less than USD $2.00.

Pakistan is conducting the Global Adult Tobacco Survey for the first time, establishing an accurate baseline of tobacco use and key tobacco control strategies. In April 2014, training was held to enhance surveillance capacity

Pakistan Bureau of Statistics and CDC in the field, conducting an interview with a Pakistani woman

To generate reliable and accurate data on the burden of tobacco and measure the impact of actions taken in response to this public health problem, the Global Tobacco Surveillance System (GTSS) was launched in 1999 and assists countries in establishing tobacco control surveillance and monitoring programs. Implementing GTSS fulfills obligations around tobacco control surveillance and monitoring for countries that have signed the WHO FCTC- a public health treaty. Pakistan has signed the WHO FCTC and is utilizing GTSS to evaluate MPOWER measures- an evidence-based technical package of strategies that reduce tobacco use. A component of GTSS, the Global Adult Tobacco Survey (GATS) is a nationally representative household survey of adults aged 15 years and older that uses a standard protocol. GATS is active in 31 countries, covering 61% of the world’s population. CDC is partnering with the Pakistan Ministry of Health, Pakistan Bureau of Statistics, and WHO to provide support for the implementation of GATS and thereby obtain a baseline on tobacco use and tobacco control indicators.

Colleagues from the Pakistan Bureau of Statistics participate in a CDC facilitated training on pretest methods and procedures for the Global Adult Tobacco Survey implementation.

To enhance country capacity in tobacco control surveillance and monitoring, CDC is offering ongoing training and technical assistance. CDC facilitated a training workshop in Islamabad, Pakistan on interviewing techniques, electronic data collection and management procedures. Electronic handheld devices and software were provided for survey implementation. Pakistan will use electronic data collection for the very first time to collect data from 9,856 households. Such capacity-building investments will contribute to efficiency and sustainability. Pakistan completed data collection in 2014 and is scheduled to release their Executive Summary and Factsheet on May 28, 2015. The full Country Report will subsequently be released in the late summer or early fall. GATS is supported by the Bloomberg Initiative to Reduce Tobacco Use, a program of the Bloomberg Philanthropies.

[i] 1 WHO. WHO report on the global tobacco epidemic: 2013. Geneva: World Health Organization, 2013.