KARACHI: Pakistan is facing a growing public health emergency — one that is spreading quietly but aggressively. A recent report by the World Health Organization has revealed that Pakistani men now have the highest rate of oral cancer in South Asia, raising urgent questions about prevention, policy, and public awareness.
Even more alarming: experts warn the crisis is being fueled by a deeply entrenched habit — the widespread use of gutka, mainpuri, and mawa.
Karachi at the center of the storm
While the nationwide prevalence of oral cancer stands at around 4 percent, the situation in Karachi is far more severe.
Health experts estimate that nearly 30 percent of individuals in Karachi are affected, with one in every five people addicted to hazardous chewable tobacco products.
This sharp rise has transformed the city into a high-risk zone for oral cancer, particularly among low-income and younger populations.
Gutka: the hidden driver of a deadly trend
Medical professionals point to gutka and similar substances as a primary cause behind the surge.
These products contain a toxic mix of tobacco, betel nut, lime, and chemical additives — all known to significantly increase the risk of oral cancer.
Despite awareness of these dangers, accessibility and addiction continue to drive widespread use.
Law enforcement vs reality: a widening gap
Authorities have attempted to curb the illegal trade, but with limited success.
In one notable operation in 2021, Sindh Police arrested a suspect, Muhammad Tahir, in Shrafi Goth and seized a large cache of gutka manufacturing materials, including:
- Packing and mixing machines
- 100 kg of betel nut
- 6.6 kg of tobacco
- 20 kg of lime
- 64 kg of china powder
- 26 kg of chemicals
- Over 15 kg of prepared mawa
Yet, such actions have failed to create lasting deterrence.
The real problem: weak prosecution
Legal experts highlight a deeper systemic issue — extremely low conviction rates.
Only about 5 percent of arrested individuals are convicted, largely due to poor investigation and weak prosecution.
Data shows that in 2019 alone, over 10,000 gutka-related cases were registered, with more than 5,500 still pending in courts.
Even more concerning, by the end of 2025, at least 145 gutka dealers were arrested, yet not a single conviction was secured.
Renewed crackdown — but will it be enough?
A spokesperson for Sindh Police confirmed that a high-level meeting chaired by Inspector General Javed Alam Odho has resolved to intensify and streamline crackdowns against the sale and distribution of gutka and mawa.
However, experts caution that enforcement alone is not enough.
A crisis that demands urgent national action
Public health specialists warn that without stronger legislation, effective enforcement, faster judicial processes, sustained public awareness campaigns, the oral cancer burden in Pakistan will continue to rise — particularly in urban centers like Karachi.
Why this matters now
This is no longer just a dental or medical issue — it is a national health crisis with long-term consequences.
Oral cancer is largely preventable, yet thousands remain at risk due to avoidable habits and systemic gaps.
The message is clear: Without decisive action today, Pakistan risks facing an even more devastating cancer burden tomorrow.
Stay informed, stay ahead
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