KATHMANDU: On February 3, 2025, then-Health Minister Pradip Paudel sanctioned a crucial directive requiring 100 percent coverage of tobacco product packets with warning messages. Titled ‘Directive 2025 on Printing and Marking Warning Messages and Pictures on Tobacco Product Boxes, Packets, Wrappers, and Parcel Packaging,’ the policy explicitly stipulates implementation beginning on the 180th day from its promulgation. Nevertheless, the provision remains stalled, as implementation has failed even after nearly 10 months since the directive’s approval.

Previously, the arrangement required that 90 percent of tobacco products be covered with warning messages. However, Nepal’s largest cigarette manufacturer, Surya Nepal Company, filed a case in the Supreme Court against the new directive. Since the Supreme Court issued an interim order not to implement the directive, as demanded by the industry, the provision to place warning messages on 100 percent of the packaging has not been implemented.

Gopikrishna Regmi, undersecretary of the legal section at the Ministry of Health and Population, states that the court itself has become an obstacle to the implementation of the law created to control the use of tobacco products, which claim the lives of around 27,000 Nepalis every year.

According to Under Secretary Regmi, files that were burned during the Gen Z protest and arson at the Ministry of Health on September 9 have been retrieved from the department and are being advanced again. Following this, he says, the file for the directive mandating 100 percent coverage with warning pictures will also be opened soon.

In 2015, Nepal received the international ‘Bloomberg Philanthropies Awards for Global Tobacco Control’ prize, including USD 100,000, for being the first country to mandate 90 percent warning pictures on tobacco packets. However, the implementation of the provision to amend that and print warning pictures on 100 percent of the packaging is being obstructed by the judiciary.

Robust policy, fragile execution

According to the World Health Organization (WHO) and the Nepal Tobacco Factsheet 2018 report, 27,137 people die in Nepal every year from cancers, asthma, heart diseases, and other illnesses caused by the consumption of tobacco products. This number constitutes 14.9 percent of all types of deaths occurring annually in Nepal.

Gopikrishna Regmi, undersecretary of the legal section at the Ministry of Health and Population, states that the court itself has become an obstacle to the implementation of the law created to control the use of tobacco products, which claim the lives of around 27,000 Nepalis every year.

The majority of cancers are caused by tobacco use. Among those with head and neck cancer, 90 percent have been found to be tobacco users, and tobacco products are found to be the cause of more than 90 percent of lung cancer cases. Asthma, its complications, and death, seen widely in Nepal, are also caused by tobacco consumption. Smoking is also considered the main cause of heart disease.

Dr. Subash Pandit, a cancer specialist at the Civil Service Hospital, states that smokers have an eightfold higher risk of heart disease compared to non-smokers. According to him, smoking not only affects the user but also those living with them through passive smoking or secondhand smoking.

Dr. Pandit further said that since the Tobacco Product Control and Regulation Act 2011 includes good provisions, the death rate from cancer could be significantly reduced if the Act were fully implemented. However, the government has shown no interest in implementing the said law, which was introduced 14 years ago.

Dr. Radhika Thapaliya, Director of the National Health, Education, Information, and Communication Center, states that even as most countries in the world have moved to plain packaging, Nepal is in a situation where it creates excellent policies but cannot implement them.

Similarly, Madhav Timilsina, Secretary and Advocate of the Forum for Protection of Public Interest, said that the government needs to focus on the control of tobacco products, which are considered “legal killers” that end the lives of 50 percent of their own consumers, in a timely manner.

According to the WHO and the Tobacco Factsheet 2018, at least 28.9 percent of individuals in Nepal aged 15 to 69 years consume tobacco products. This includes 48.3 percent males and 11.6 percent females. The report also mentions that the number of female users is increasing in urban areas recently.

Dr. Subash Pandit, a cancer specialist at the Civil Service Hospital, states that smokers have an eightfold higher risk of heart disease compared to non-smokers

Breach of public smoking restrictions

Section 4 of the Act controlling tobacco products mentions that smoking or tobacco use is not allowed in public places. However, smoking and tobacco use are still found to be happening openly in public places.

Similarly, Section 11 of the same act, which deals with restrictions on sale, distribution, and display, states, ‘No one shall sell, distribute, cause to be sold or distributed, or freely provide tobacco products to persons under the age of 18 years and pregnant women.’ However, it is still found that anyone can easily buy cigarettes without any hindrance.

Likewise, Sub-section 3 of the same Section stipulates a prohibition on selling or facilitating the sale of tobacco products from any premises or shop situated within a 100-meter radius of specified public zones, including educational and health institutions, child welfare homes, infant care centers, old-age homes, and orphanages. Furthermore, subsection 4 mandates that the retail sale of single cigarettes, bidis, or cigars (by the stick) is prohibited. Regrettably, effective oversight and enforcement of these critical provisions are presently lacking.