Strengthening Advocacy to End Tobacco Inequities
Advocating for public health is the process of converting evidence into action. It define it as the use of research, communication, and community participation to influence policy and improve health outcomes. Tobacco smoking control campaign is a typical example of advocacy. Activists in Australia have worked relentlessly to reduce the consequences of smoking through measures such as additional fees, smoke-free car legislation, and campaigns aimed at vulnerable groups. Despite opposition from the tobacco industry and the government, their efforts saved millions of lives and public dollars, demonstrating that determined health professionals can influence legislation for the community's benefit. This example highlights how advocacy can overcome resistance and generate long-term public health gains.
However, despite these achievements, disparities persist. Tobacco use remains the biggest cause of preventable mortality in Australia, accounting for almost 24,000 mortalities per year and around 66 deaths per day. Although global smoking rates have decreased, the smoking pattern is not uniformly distributed. In 2022-23, less than one in ten Australians reported daily smoking. However, Aboriginal and Torres Strait Islander peoples aged 15 and over had a prevalence of 29%, which was more than three times higher than the non-Indigenous population. Smoking is disproportionately prevalent among individuals with mental illnesses and those living in low-income settings, exacerbating health and financial disparities.
Addressing these gaps requires activism that goes beyond conventional methods. Evidence-based policies can boost cessation support programs, integrate harm reduction initiatives, and improve community engagement. Expanding access to culturally tailored programs and supported therapies provides parity in quitting options, particularly in First Nations communities with high smoking rates. Harm reduction strategies, such as regulated nicotine alternatives, are becoming more widely accepted as safer options for smokers who are unable to quit traditional cigarettes. These initiatives are consistent with international best practices under the WHO Framework Convention on Tobacco Control, which emphasizes both prevention and harm reduction. Effective advocacy requires community engagement to design interventions that reflect cultural needs and lived experiences.
This advocacy's target audience includes policymakers, health professionals, and community leaders. To integrate harm reduction into the National Tobacco Strategy 2023-2030, policymakers must be convinced that it is in the community's best interests, as previous advocates successfully persuaded governments to adopt plain packaging and smoke-free laws. Health professionals have an important role in providing cessation assistance and advocating for culturally relevant therapies. Community leaders, especially those from Aboriginal and Torres Strait Islander communities, play a crucial role in co-designing local solutions to address smoking disparities. By presenting cigarette smoking as a health and social justice problem, advocates can rally support for measures that save lives while eliminating inequities. With tobacco use still accounting for 12% of all preventable deaths in Australia, the need is evident. Advocacy must drive the next phase of tobacco control, balancing prevention and harm reduction, strengthen cessation support, and ensure that no community is left behind. Just as previous advocates transformed Australia's tobacco landscape, today's public health professionals must speak up, challenge opposition, and champion equality in tobacco policy.
References
Australian Institute of Health and Welfare. (2020). Australia’s health 2020: In brief. AIHW. https://www.aihw.gov.au/getmedia/2aa9f51b-dbd6-4d56-8dd4-06a10ba7cae8/aihw-aus-232.pdf.aspx?inline=true
Australian Institute of Health and Welfare. (2024). Australian Burden of Disease Study 2024. Canberra: AIHW.
Australian Institute of Health and Welfare. (2025). Alcohol, tobacco & other drugs in Australia: Aboriginal and Torres Strait Islander people. Canberra: AIHW. https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/priority-populations/aboriginal-and-torres-strait-islander-people
Department of Health and Aged Care. (2023). National Tobacco Strategy 2023–2030. Canberra: Australian Government. https://www.health.gov.au/resources/publications/national-tobacco-strategy-2023-2030
Stoneham, M., Vidler, A., & Edmunds, M. (2019). Advocacy in action: A toolkit for public health professionals (4th ed.). Public Health Advocacy Institute of WA. https://www.phaiwa.org.au/wp-content/uploads/2019/09/2019_Advocacy-in-Action-A-Toolkit-for-Public-Health-Professionals-1.pdf
World Health Organization. (2021). WHO report on the global tobacco epidemic 2021: Addressing new and emerging products. WHO. https://www.who.int/publications/i/item/9789240032095
Welcome to Tikaram Rawat's Online Space
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Tobacco smoking in Australia
Tobacco smoking remains the most common cause of preventable death and disability in Australia, killing an estimated over one million people between 1960 and 2020. In 2018, tobacco use was expected to kill over 20,500 people. It also accounts for 7.6% of the total illness burden in 2024 and it is connected to a variety of ailments, including lung cancer and chronic obstructive pulmonary disease. Despite dropping smoking rates, the problem disproportionately affects Aboriginal and Torres Strait Islander peoples, older adults, particularly those aged 50 and up, and people with mental illnesses have a higher smoking rate, less access to cessation support, and higher health and financial costs. Addressing these disparities is crucial for minimizing tobacco-related harm throughout the population.
Tobacco use remains a major focus of Australia's public health agenda. In 2025, the government implemented significant adjustments under new tobacco legislation to minimize smoking rates and associated harm. These regulations include restricting flavored additives like menthol and clove, prohibiting misleading phrases like "smooth" on packaging, and printing health warnings directly on cigarettes. These initiatives are consistent with the National Tobacco Strategy 2023-2030, which aims to reduce smoking prevalence while addressing its health, social, and economic consequences.
The Australian government has adopted strong health policies to combat tobacco smoking, most notably the National Tobacco Strategy 2023-2030. This method seeks to minimize smoking prevalence and its health, social, and economic consequences. Some important measures include plain packaging, graphic health warnings, high tobacco pricing, public education programs, and severe advertising limits.
The Department of Health, disability and aging (2025) provided strategies such as a prohibition on flavored additives (menthol, rum, clove), the removal of misleading descriptions such as "smooth," and mandatory health warnings printed directly on individual cigarettes minimize appeal and support quitting efforts.
High tobacco taxes, while successful at reducing use, disproportionately affect low-income smokers. The restriction on regulated vaping goods may limit harm-reduction alternatives for those who cannot stop regular cigarettes.
While talking about policy gap unlike other nations, Australia has not adopted controlled nicotine alternatives, restricting options for smokers who are attempting to quit and also The tobacco business continues to promote new products such as e-cigarettes, confounding regulation and public messaging. The National Tobacco Strategy (2023-2030) lacks detailed mechanisms for engaging affected communities and integrating harm reduction into mainstream policy.
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