Australia’s war on nicotine is entrenching smoking and organised crime, while countries adopting the opposire approach are witnessing success.
Australia is often portrayed—by its own institutions most of all—as a global tobacco control success story. Officials point to falling daily smoking rates, decades of strict regulation, and an ever-expanding web of prohibitions as proof that the country is on the right path. But beneath the headlines lies a far more negative reality.
Smoking cessation in Australia has stalled. In some demographics, it is going backwards. At the same time, an increasingly sophisticated criminal market for tobacco and nicotine products is thriving, fuelled by excessive taxes, bans on safer alternatives, and policies that ignore how people actually behave. By almost any meaningful public health metric, this is not success, it is a tragic policy failure.
Uptick in adult smoking rates
It is true that smoking rates are lower today than they were decades ago. But the pace of decline has slowed markedly, and tobacco-related disease still kills around 24,000 Australians every year. Among young adults, smoking prevalence has ticked upward in recent years, a trend that should alarm policymakers rather than reassure them.
Public health experts increasingly warn that Australia’s rigid approach, built almost entirely around prohibition, taxation, and stigma, has reached its limits. Declining rates are now being used to justify even harsher controls, rather than prompting reflection on why progress has slowed and why illicit markets are booming. The assumption that tighter restrictions automatically produce better outcomes is no longer supported by evidence on the ground, yet is still being used.
The alarming rise of tobacco-related crime
Nowhere is this clearer than in New South Wales and Western Australia, where illegal tobacco and nicotine markets have become deeply entrenched. Organised criminal networks now dominate the supply of untaxed cigarettes and unregulated vaping products, often selling openly through storefronts that operate with near impunity.
The NSW branch of the Australian Medical Association recently presented a submission to the Legislative Council acknowledging the scale of the illicit tobacco problem. Yet the proposed response remains familiar: more restrictions, tighter retail controls, and continued resistance to harm reduction.
Federal AMA president Dr. Danielle McMullen has argued against lowering tobacco excise, warning it would increase smoking. But harm reduction advocates counter that the current system (where cigarettes are taxed into illegality while safer alternatives are banned or heavily restricted) has already created the worst of both worlds: high smoking persistence and criminal supply chains. Prohibition has not eliminated demand for nicotine. It has simply handed that demand to organised crime.
Tackling the issue of youth uptake in the wrong way
Australian authorities also express growing concern about nicotine’s cultural visibility among young people. Behavioural researcher Michelle Jongenelis of the University of Melbourne has warned that vaping and smoking imagery on social media and streaming platforms are making nicotine use appear more common and socially acceptable than it should be.
Surveys show adolescents significantly overestimate peer vaping rates, despite fewer than one in six actually using vapes. Algorithms, influencer content, and repetitive imagery amplify a behaviour that remains a minority activity. And while these concerns may be legitimate, the policy response has been misdirected. Rather than separating youth prevention from adult smoking cessation, Australia has lumped them together, cracking down on all nicotine products regardless of risk. The result is fewer legal, regulated pathways out of smoking for adults, and more unregulated products circulating among youth.
The UK’s contrasting appoach – and it works!
Meanwhile, as Australia doubles down on prohibition, the United Kingdom offers a powerful counterexample of what works when policy aligns with evidence. Across England, the government-supported “Swap to Stop” programs actively encourage adult smokers to transition to vaping. These initiatives combine free vape starter kits with behavioural support, delivered through NHS-backed stop-smoking services. And the results are striking.
Richmond-upon-Thames now has one of the lowest smoking rates in England at 5.3 percent, edging toward the national smoke-free target. In the past year alone, 58 percent of participants in its cessation program successfully quit smoking.
Public Health Dorset reported similar success, with more than 3,500 smokers switching away from cigarettes after receiving vape kits. Participants consistently report improved respiratory health, reduced cravings, and rapid benefits that reinforce quitting. These outcomes are not accidental. UK policy explicitly acknowledges that vaping is substantially less harmful than smoking because it eliminates combustion—the true cause of smoking-related disease.
Critically, the UK’s approach has not normalised nicotine use among youth. Age restrictions, marketing controls, and enforcement remain strict. The difference is that adult smokers are treated as adults and given access to tools that work.
By contrast, Australia’s refusal to distinguish between smoking and safer nicotine use has created a policy vacuum. Adults who fail with patches and gum are offered little beyond abstinence or illegal products. Meanwhile, criminal networks fill the gap left by banned legal alternatives.
The cost of denial
Australia’s tobacco strategy is often described as world-leading. In reality, it is increasingly out of step with evidence and real-world outcomes. Smoking cessation has plateaued. Illicit markets are thriving. Organised crime is profiting. And adult smokers are left with fewer legal options than ever before. While countries that have embraced harm reduction, such as the UK, Sweden, and New Zealand, are seeing faster declines in smoking, lower disease burden, and far less reliance on prohibition.
The lesson is not subtle. Tobacco control succeeds when it prioritises outcomes over ideology. Prohibition without harm reduction does not end nicotine use. It entrenches smoking, fuels crime, and stalls public health progress. If Australia wants to reduce smoking-related deaths, it must stop mistaking rigidity for success and start learning from what actually works.