Advocacy, Editorial, Travel, Uncategorized, Video


The Rising Prevalence of Tobacco Use in Developing Countries



“Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers” (15).

According to the World Health Organization (WHO), tobacco use is responsible for six million deaths each year (15). This includes an estimated 600,000 people who die from second-hand smoke. Health outcomes include death and/or disability from chronic diseases, such as cancer, stroke and chronic respiratory diseases. Additionally, smoking increases the risk of death from infectious diseases.

Overwhelming evidence suggests that tobacco marketing greatly influences tobacco use and initiation (3-5). As such, bans on tobacco marketing can greatly reduce individual tobacco use.


↓ Developed Countries   ↑ Developing Countries

Tobacco use in many high income countries is decreasing rapidly. This is due to government marketing bans and increased public education about the harms of smoking. In contrast, the prevalence of smoking is increasing in many middle- and low-income countries. According to the WHO global report on trends in tobacco smoking 2000-2025, males are more likely to smoke than females, and the prevalence is rising most dramatically in the African Region and the Eastern Mediterranean Region (13).


Photo by: Merinews

Table 1. Age-standardized prevalence of current tobacco smoking among persons aged 15 years and older (14,16).

  Year 2000 Year 2015
Men Women Both sexes Men Women Both sexes
Canada 29.3 27.5 27.5 17.7 12.2 14.3
Sweden 32.8 32.9 32.9 20.4 20.8 20.6
China 56.2 3.3 30.4 47.6 1.8 26.3
India 33.8 5.7 20.2 20.4 1.9 11.0
Pakistan 35.2  7.5 21.8 41.9 3 22.9
Zimbabwe 29.8 2.7 16.1 31.2 2.1 16.65


Tobacco marketing is 81 times greater in Pakistan, India and Zimbabwe than in the United Arab Emirates, Canada and Sweden (7). 

In 2003, member states of the World Health Assembly adopted the Framework Convention on Tobacco Control (FCTC) (6). This agreement provided 180 nations with evidenced-based steps to minimize tobacco sales and ban tobacco marketing. This legally binding treaty even provided agricultural alternatives to those growing tobacco, so as to minimize the economic hardships faced by local producers. Nearly 13 years later, what is the present state of tobacco marketing trends?

A recent study led by the World Health Organization examined the global tobacco marketing environment by comparing 462 communities located in 16 low-, middle- and high-income countries (1). Researchers found that exposure to tobacco marketing is 81 times greater in Pakistan, India and Zimbabwe than in the United Arab Emirates, Canada and Sweden (7). Additionally, the tobacco industry is targeting poor urban youth in developing countries (10-12). This is due to cheaper marketing costs and the greater potential to reach more people in densely populated regions. Furthermore, according to the WHO study (1), high levels of tobacco marketing (e.g. posters, print media and cinema) was even found in 14 middle- and low-income countries that had ratified the FCTC. Countries that ratified this agreement were required to implement a comprehensive ban on tobacco advertising, promotion and sponsorship. However, many developing countries are lacking in agency and governmental capacity to fully implement the recommendations of FCTC (2). This is worsened by the alarming influence of the tobacco industry in lobbying their interests (8,9).

Governments, NGOs, and other key stakeholders need to take a stand against the tobacco companies. Media and advocacy work must continue to focus on the populations currently being abused by corporate greed. Urban youth in developing countries are the greatest target of the tobacco industry, and therefore, should become a major focus for public education initiatives about the harmful effects of tobacco use. Nations across the globe have already taken a positive step forward by agreeing to the Framework Convention on Tobacco Control. People must now take the next step by supporting fellow nations in implementing this agreement to ban tobacco marketing. Financial resources, capacity building and continued media attention are needed now more than ever. A healthier and more equitable world is possible in the future, but there is a long way to go.

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3) The role of the media in promoting and reducing tobacco use. NCI Tobacco Control Monograph No.19. Bethesda: National Institutes of Health; 2008.

4) DiFranza JR, Wellman RJ, Sargent JD, Weitzman M, Hipple BJ, Winickoff JP; Tobacco Consortium, Center for Child Health Research of the American Academy of Pediatrics. Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality. Pediatrics. 2006 June ;117(6):e1237–48. doi: PMID: 16740823

5). Pierce JP, Choi WS, Gilpin EA, Farkas AJ, Berry CC. Tobacco industry promotion of cigarettes and adolescent smoking. JAMA. 1998 Feb 18;279(7):511–5. doi: PMID: 9480360

6) World Health Organization. Parties to the WHO Framework Convention on Tobacco Control.  Updated 26 July 2016. Retrieved from

7) Gilmore, Anna. Big tobacco targets the young in poor countries – with deadly consequences. The Guardian. 1 December 2015. Retrieved from

8) AMESCA regional plan 1999-2001. London: British American Tobacco: 1999. Available from: [cited 2014 Jul 15].

9) Lee S, Ling PM, Glantz SA. The vector of the tobacco epidemic: tobacco industry practices in low and middle-income countries. Cancer Causes Control. 2012 Mar;23(1) Suppl 1:117–29. doi: s10552-012-9914-0 PMID: 22370696

10) Perlman F, Bobak M, Gilmore A, McKee M. Trends in the prevalence of smoking in Russia during the transition to a market economy. Tob Control. 2007 Oct;16(5):299–305. doi: PMID: 17897987

11) Gilmore AB, Radu-Loghin C, Zatushevski I, McKee M. Pushing up smoking incidence: plans for a privatised tobacco industry in Moldova. Lancet. 2005 Apr 9-15;365(9467):1354–9. doi: 6736(05)61035-5 PMID: 15823388

12) Neuwirth B. Marketing channel strategies in rural emerging markets: unlocking business potential. [Internet]. Evanston: Kellogg School of Management; 2012. Available from: http://www.kellogg.northwestern. edu/~/media/files/research/crti/marketing%20channel%20strategy%20 in%20rural%20emerging%20markets%20ben%20neuwirth.ashx [cited 2013 Aug 15].

13) World Health Organization. Global Health Observatory (GHO) data: Prevalence of tobacco smoking. Accessed 1 December 2016. Retrieved from

14) World Health Organization. Prevalence of tobacco smoking. Accessed 1 December 2016. Retrieved from

15) World Health Organization. WHO global report on trends in tobacco smoking 2000 – 2025. Updated 2016. Accessed 1 December 2016. Retrieved from

16) World Health Organization. WHO global reports on trends in prevalence of tobacco smoking 2015. (2015). Retrieved from


Advocacy, Editorial, Nina Kharazmi || Photography, Video

Honor Killings in Pakistan

Over 1,000 women are brutally murdered in Pakistan each year.

October 6, 2016

Photo by: Borgen Magazine

Pakistan is a patriarchal society where women’s behaviors are traditionally limited by cultural restrictions in order to preserve their chastity. Any deviant behavior is therefore deemed immoral and brings dishonor upon the family. Consequently, women labeled as deviant are often murdered by male relatives or neighbors in order to restore familial honor and reputation within the community (1). These brutal acts of murder are known as honor killings. Each year, over 1,000 women in Pakistan are murdered in the name of honor.

While “immoral behavior” includes infidelity, it also encompasses a range of unexpected behaviors. For instance, women are often murdered for being raped, refusing an arranged marriage, dressing “inappropriately” or acting flirtatious. It can also be warranted by familial quarrels over property ownership, inheritance issues, or a woman’s desire to marry for love. Many times women are even murdered on the basis of suspicion alone (2).


Photo by: Gospel Herald

Human rights groups have been pressuring the Pakistani government to put an end to honor killings. However, authorities have been unsuccessful and have often even turned a blind eye. In many cases, murders are not even investigated, leaving perpetrators free from prosecution (3).


Photo by: BBC

This issue has gained international attention, especially with the rising number of high-profile honor killings this year. One such case was Qandeel Baloch, a Pakistani social media star, who was strangled to death by her brother in July. Pakistani filmmaker and activist, Sharmeen Obaid, also heightened international attention towards this issue in her Academy Award winning documentary, A Girl in the River: The Price of Forgiveness.

In response to the rising campaigns for women’s rights, the Pakistani government passed a bill ensuring that killers receive a mandatory life sentence (4). Previously, a killer could be pardoned for murder if he gained forgiveness from the victim’s family. This new legislation no longer allows freedom from impunity. Even still, it remains uncertain whether this law is enough to deter honor killings. However, activists everywhere are celebrating this new step in the right direction towards ending violence against women.


Honor killing suspects are blind folded before their court hearing. (Photo by: CNN)


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Check out Maternal Mortality or Tobacco.


  1. “Pakistan rejects pro-women bill”. BBC News. March 2, 2005.
  2. Hassan, Yasmeen. “The Fate of Pakistani Women”. New York TimesMarch 25, 1999.
  3. “Pakistan’s honour killings enjoy high-level support”. Taipei Times. The Liberty Times Group. Retrieved September 20, 2016.


Nina Kharazmi || Photography, Video


Freedom, Poverty and Human Rights

Poverty is the failure to acquire certain fundamental freedoms, including the freedoms from disease, hunger, and illiteracy. In order for people to have the freedom to live a healthy life, there cannot be obstacles preventing the legitimate pursuit of good health and well-being. Simultaneously, society must support individuals by creating an environment that allows for the achievement of good health. Once these basic freedoms are acquired, an individual attains a level of minimal human dignity. According to the human rights approach, people have inalienable rights to these freedoms. It is a human right to be free from hunger and disease. Once people attain a minimal level of human dignity they are then able to gain something greater – the freedom of choice and the power to create a better life.


Office of the United Nations High Commissioner for Human Rights. (2004). Human Rights and Poverty Reduction: A Conceptual Framework. Retrieved from


Nina Kharazmi || Photography, Video

Alice: Modern Tale of Wonder

A surrealist portrayal of a young adult’s struggle in search of truth beyond the realm of her preconceived reality

As human beings age, they become increasingly constrained by the social world. Innocence and curiosity from childhood escapes, as our understanding of reality becomes solidified over time. At a point of transition in life, many people find themselves questioning their purpose. This is especially true of young adults moving from the role of dependency to the independent world of professionalism. Who am I? What should I be doing? What will I become? These questions are often answered with a false sense of certainty and limited within supposed normalcy.

Throughout life, external influences have shaped our perceptions of the world. The media, parental pressures, and peer judgments have all contributed to these views. In the process of socialization and learning, we often lose touch with the ability to question our perceived truths. What is reality? What is the ‘real’ world?

This film presents these concerns through surrealist experiences of a young adult in an urban setting. The story begins by presenting a world void of color. This black and white realm is symbolic of the preconceived notions of the world based on our own knowledge and experiences. In this universe, everything has a place and manner of being. People move rapidly throughout their daily lives, which represents the idea that we are always running out of time. As a result, people are forever chasing the future while forgetting to be present in the moment.

The delusional black and white world is shattered once events take place that disrupt the norm. The young girl then follows her own curiosity in search of truth. By opening her mind, an alternate universe of color is exposed. She is then led to contemplate her own beliefs and identity, which is portrayed through the use of masks. Through self-discovery, she learns that she had been blind to the color of her own world all along.

The themes of time, curiosity, and identity are presented and inspired by the works of Lewis Carroll.


Nina Kharazmi || Photography, Video

Life is made of stories.

Violence, corruption, abuse.

Somewhere between past & present lies truth.

Discover truth and you will find power,

The power to change the world.

The power to fight for freedom, justice & hope.

By exposing the dark side of the human condition,

There may be light.

As truth is enlightenment.

And people have the power,

The power to change the world.