Australia’s Tobacco Harm Reduction Crisis: When Policy Becomes the Problem
When it comes to reducing the harms from smoking, Australia finds itself cast as the global village idiot—clinging to policies that perpetuate harm, empower criminals, and squander opportunities to save lives.
Last month, I flew to Warsaw to accept the Michael Russell Award for advancing tobacco harm reduction. I prefaced my acceptance speech by apologising for being from Australia– such is the level of incredulity amongst international harm reduction experts at our federal government’s approach to the issue. While we once stood as pioneers in public health and particularly harm reduction, we are now the cautionary tale.
The award is named for Michael Russell, the visionary British psychiatrist who famously observed, “People smoke for the nicotine but die from the tar.” This adage remains as relevant as ever. Right now, 66 Australians die every single day from the effects of tar in their lungs—not from an addiction to nicotine, but from the toxic delivery mechanism of cigarettes. That is 24,000 Australian lives lost every year.
Australia’s tobacco policy is a paradox of legal sanction and de facto prohibition. Legal cigarettes are taxed at rates so punitive that they have become virtually inaccessible to many, while vaping devices, which offer a far safer alternative, are rendered unobtainable through deliberately restrictive access avenues. The result? One of the most lucrative and violent black markets Australia has ever seen.
Apart from organised crime—whose fortunes have never been brighter—and a handful of well-intentioned but misguided health groups, nearly everyone else recognises the Federal Minister for Health, Mark Butler, has made a huge mistake in his approach to controlling tobacco and vapes. His message is that we should continue down the path of prohibition in the vain hope that we will eventually get a different result. But the fire bombings continue and huge profits continue to flow into the pockets of organised crime.
Around the world, doctors, scientists, and governments have embraced harm reduction and have acknowledged that prohibition does not and cannot ever work. Instead, the focus has shifted toward making safer nicotine products accessible to adult smokers—products such as nicotine pouches, Swedish snus and most notably, vaping devices. And in countries where these products are promoted smoking rates have plummeted.
In the UK, the health department actively provides nicotine vaping products to adult smokers and their smoking rates are dropping as a result. Sweden, having championed tobacco harm reduction, now boasts a smoking rate under 5%—a level considered “smoke-free”—and has some of the lowest lung cancer rates in the world. Japan, too, has reduced its smoking rate by over 30% in just seven years by allowing a less harmful, smoke-free product to flourish. New Zealand’s progressive policies on vaping and nicotine have it poised to join Sweden as a smoke-free nation. The message is clear: when governments allow and encourage safer alternatives, lives are saved and deadly smoking rates decline. They are also not experiencing illicit tobacco wars.
In stark contrast, Australia’s approach has grown ever more draconian. Vaping, the most successful smoking cessation tool on record, is met with the harshest prohibitions. The policy not only fails to acknowledge international best practice or the science underpinning harm reduction, but also produces perverse, dangerous outcomes: Australians are increasingly turning to black market tobacco and vapes; overall smoking rates are stagnating, even increasing in some disadvantaged communities and preventable deaths continue to mount.
Despite threats of jail terms and million-dollar fines, over a million Australians now use a nicotine vaping device. Most of them are using an unregulated product that has been supplied by the black market. And while it is still safer than smoking tobacco, it is not regulated, and the ingredients and components are unknown. Instead of controlling the market in the interest of public health, the government has ceded it to organised crime.
The complete lack of common sense and logic in this ‘war’ that is being waged by governments is self-evident. The mere possession of a vape in many states attracts thousands of dollars in fines and even prison terms. In the ACT the possession of a nicotine vape means you can be jailed for two years and fined $32,000. This is in a jurisdiction that has legalised the personal use of cannabis and decriminalised the use of other illicit drugs like cocaine and heroin. In my home of Melbourne we provide a safer injecting facility for people who use heroin but they could be fined thousands for using a nicotine vape.
The Federal government in its wisdom has this month made it even more difficult to supply a vape legally to an adult, by requiring that vapes meet the standards of a medical devices. Most of the vapes entering Australia are from overseas where manufacturers have little interest in meeting the stringent ISO 13405 manufacturing standard. This means that the handful of legal vaping devices available have all but vanished.
I gave up smoking seven years ago with the help of vaping. But tobacco had already had its wicked way with me, and I contracted a smoking related cancer which led to surgery and a couple of years of treatment. I’m pleased to say I am one of the lucky ones and have now recovered.
It is time for the state and federal health ministers to look at what the rest of world is doing to encourage smokers to move to safer nicotine options and stop pretending that we are world leaders. We are throwing bucket loads of money at preventing adults who smoke from accessing a less harmful nicotine product and one that could actually be a tool in reducing the illicit tobacco market.
Published in The Age, 1 September 2025
https://www.theage.com.au/national/australia-has-become-the-global-village-idiot-on-quitting-smoking-20250722-p5mh0p.html