Travel through interior Sindh (Mirpurkhas, Tharparkar, Umerkot, Sanghar) or walk through low-income neighborhoods of Karachi, and one finds Safina sachets everywhere: at tea stalls, bus stops, roadside kiosks, even outside schools. These tiny packets, sold for a few rupees, have quietly entrenched addiction among youth and working-age men, while oral cancer wards in public hospitals continue to swell.
This is not merely a public health problem. It is a structural assault on Pakistan’s social fabric.
Smokeless tobacco is globally recognised as a major cause of oral cancer, cardiovascular disease and chronic addiction. Families affected by these diseases do not just lose health; they lose livelihoods. Medical costs push already poor households into debt. Children are pulled out of school. Productive adults become dependent patients. The long-term economic loss far exceeds the short-term profits of smugglers and retailers.
What makes this crisis more disturbing is its cross-border nature.
India has, over the years, acknowledged the dangers of smokeless tobacco and imposed various restrictions and regulatory measures within its own territory. Yet the same hazardous products find their way into Pakistan with remarkable ease. Whether through smuggling, informal trade or regulatory blind spots, the result is the same: harm is exported, not prevented.
It is important to state this carefully. One need not allege a formal state policy or deliberate intent to recognise a dangerous pattern. In international relations, outcomes matter as much as intentions. When a toxic product is produced in one country, restricted for its own citizens, and yet consumed overwhelmingly in a neighbouring country, where enforcement is weaker, the imbalance becomes a political and moral issue.
In strategic terms, this fits what analysts increasingly describe as hybrid harm.
Hybrid conflict does not rely solely on weapons. It uses economics, misinformation, cyber tools, narcotics and social decay to weaken a society from within. When heroin flows across borders to finance violence, we rightly call it narco-terrorism. When addictive consumer toxins hollow out a generation, undermine productivity and overwhelm public services, the effect is different in speed but not in seriousness.
Safina and similar products operate precisely in this grey zone — legal in origin, illegal in destination, lethal in impact.
National security is not only about borders and missiles; it is about the capacity of a society to remain healthy, productive, and resilient.
Pakistan must therefore recalibrate its response.
First, illicit smokeless tobacco must be recognised as a serious organised crime and public health emergency, not a minor regulatory violation. Supply chains — ports, highways, wholesale markets — must be dismantled with the same seriousness applied to narcotics trafficking.
Second, enforcement must be paired with public health intervention. Mass oral cancer screening, addiction counseling and community awareness programmes are urgently needed in high-impact districts, particularly in Sindh’s desert and border regions.
Third, accountability cannot stop at street-level sellers. Manufacturers, distributors and facilitators must be named, documented and challenged through legal, trade and diplomatic channels.
Fourth, Pakistan should raise this issue at international health and trade forums, framing it as a case of exported public-health harm. Global norms increasingly recognise that corporations and states share responsibility when hazardous products devastate vulnerable populations across borders.
Safina may come in a small sachet, but its impact is strategic. It weakens families, burdens hospitals, erodes productivity and steals futures — quietly, persistently, and profitably for others.
Pakistan must finally call this poison by its real name: a silent weapon, operating in plain sight.