Each year, World No-Tobacco Day, observed on May 31, serves as a vital reminder of the health and environmental consequences associated with tobacco use. Around the world, efforts are made to raise awareness, promote healthy lifestyles, and encourage people to make informed choices. In Pakistan, where millions are exposed to both tobacco and deteriorating environmental conditions, the relevance of this day cannot be overstated. Tobacco use remains one of the leading causes of preventable illness and premature death worldwide. In Pakistan, a significant portion of the population-both in urban and rural areas-continues to use tobacco in one form or another. This includes smoking cigarettes, using smokeless tobacco (such as gutka and naswar), and inhaling shisha or hookah. The health risks are numerous and well-established. Tobacco is directly linked to a wide range of non-communicable diseases, including lung cancer, chronic obstructive pulmonary disease (COPD), heart disease, stroke, and oral cancers. For pregnant women, tobacco use can increase the risk of complications and harm to the unborn child. Children and non-smokers exposed to second-hand smoke also suffer the consequences. Less frequently acknowledged, however, is the impact of tobacco on mental health. Research increasingly shows that tobacco use is associated with heightened anxiety, depression, and other mood disorders, creating a cycle in which users feel temporarily relieved but ultimately more vulnerable to emotional stress. Despite its widespread social acceptability, tobacco is not a solution for stress; rather, it often silently worsens it. Pakistan faces multiple environmental challenges, from urban air pollution to climate-induced heatwaves, droughts, and flooding. These conditions are making the population, particularly the urban poor, more vulnerable to respiratory illnesses and heat-related health crises. A soft, inclusive approach that encourages dialogue rather than confrontation can help people understand the broader implications of tobacco use. In this fragile context, tobacco use acts as a multiplier of health risks. For example, smoking in areas with already poor air quality-such as parts of Karachi, Lahore, or Faisalabad-can accelerate lung damage, even in young and otherwise healthy individuals. For those living in katchi abadis or informal settlements where ventilation is poor and medical care is limited, the combination of polluted air and tobacco smoke is particularly dangerous. Tobacco farming and manufacturing also have indirect environmental costs. The cultivation of tobacco often involves extensive use of pesticides and deforestation, contributing to soil degradation and water contamination. While it remains an important source of livelihood for some communities, the broader climate implications of large-scale tobacco production should be part of the national conversation. While traditional cigarettes remain prevalent, there is a growing shift toward modern and more discreet forms of tobacco and nicotine consumption, especially among youth. This includes vape pens, e-cigarettes, heated tobacco devices, flavored nicotine pouches, and shisha in trendy lounges. These products are often marketed as safer alternatives to smoking, yet many carry their own understudied and emerging health risks. Moreover, their appealing packaging, flavors, and digital advertisements make them particularly attractive to adolescents, potentially opening the door to lifelong nicotine addiction. With this shift, there is a pressing need to update our public health messaging to include these newer forms and to educate families, educators, and healthcare professionals about the risks they may pose. It’s important to note that tobacco use is legal in Pakistan, and its sale is regulated under existing laws. The aim of awareness campaigns, therefore, is not to criminalize or condemn but to promote informed choices and public well-being. Legal does not always mean harmless, and this is particularly true when looking at tobacco from a long-term health and environmental perspective. A soft, inclusive approach that encourages dialogue rather than confrontation can help people understand the broader implications of tobacco use. This includes acknowledging the role of socio-economic factors, stress, and lack of information that often drive people-especially youth and marginalized communities-toward tobacco. Tobacco-related harm can be addressed through multi-layered, respectful, and practical interventions: n Awareness campaigns tailored to schools, communities, and workplaces, focusing on both health and environmental consequences. n Integration of mental health counseling in tobacco cessation programs, recognizing the emotional and psychological triggers of tobacco dependence. n Training for community health workers and mobilizers, especially in underserved areas, to offer guidance and referral services. n Policy support that promotes alternative livelihoods for tobacco farmers, helping them shift to climate-friendly and sustainable crops. n Regulated advertising and packaging, especially for new tobacco products, to limit their appeal among younger audiences. Digital tools can also be powerful: mobile apps, SMS reminders, and social media campaigns can extend the reach of these initiatives and make quitting tobacco more accessible and relatable. World No-Tobacco Day is not a campaign against any group or business-it is a public health moment. It invites all of us-individuals, communities, educators, businesses, and policymakers-to come together for the well-being of current and future generations. In a climate where environmental hazards are increasing and healthcare systems are under pressure, small steps-such as reducing tobacco use, spreading awareness, and supporting those who wish to quit-can make a lasting difference. As we observe this important day, let us reaffirm our commitment to health, compassion, and sustainability-for ourselves, our children, and our shared environment. The author is a rights activist and freelance journalist