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Victorian Public Health and Wellbeing Plan 2023–2027

Tobacco use remains the leading cause of disease burden and premature death in Victoria, despite significant progress in reducing smoking rates. Tobacco use is responsible for 9.3 percent of the burden of disease and 13.3 percent of deaths in Australia.1 There are concerns that this will increase with the rise of e-cigarette use.

E-cigarettes are devices that deliver an aerosol by heating a solution that users inhale. The solution may or may not contain nicotine. An aerosol is commonly referred to as ‘vapour’. Using an e-cigarette is generally known as ‘vaping’.

Tobacco harms our health through use, harms others through secondhand exposure, and negatively affects our environment. Smoking increases the risk of chronic diseases such as heart disease, diabetes, kidney disease, eye disease, stroke, dementia, certain types of cancer (for example, oral cancer), gum disease, and respiratory diseases such as asthma, emphysema, and bronchitis.2

Smoking has a significant economic impact, with an estimated total cost of $136.9 billion in 2015–16. These include tangible costs, such as lost lives and health care costs, and intangible costs, such as premature mortality and lost quality of life due to ill health.3

Response to the emergence of e-cigarette use

One of the biggest concerns is the possibility of another generation of young people becoming addicted to nicotine through e-cigarettes, undermining years of progress in reducing tobacco-related harm.

Urgent action is needed to reduce rates of e-cigarette use, particularly among young Victorians. Although e-cigarettes have not been around long enough to know the long-term effects, we do know that e-cigarette use (even short-term) has resulted in poisoning, acute lung injury, injuries and burns, toxicity and death, and neurological conditions, including seizures.4

Shared benefits among priorities

Reducing the harm caused by tobacco and e-cigarette use can lead to improvements in physical health and well-being, including sexual and reproductive health.

To improve fertility and reproductive health, it is recommended to stop smoking tobacco and using e-cigarettes. Smoking during pregnancy has been shown to carry health risks for mothers and babies, including low birth weight, premature birth and perinatal death.5 Quitting smoking during pregnancy helps mothers have a healthy pregnancy and helps babies get the best start in life.

Reducing the use of tobacco and e-cigarettes supports our environment and overall planetary health. These products harm the environment with plastic waste, fires, pollution and reduction of air quality.4 Tobacco production has a negative impact on our environment at every stage including growth, production, distribution and disposal.5

Improving health equity

The rapid increase in the availability and use of e-cigarettes is a public health threat that requires urgent action. We must continue to prioritize working in partnership with people and communities that have higher rates of tobacco use. These include people living in rural Victoria, Aboriginal Victorians, young Victorians, people with serious mental illness, Victorians who identify as LGBTIQ+ and people suffering from alcohol and drug addiction.2, 7

Smoking rates among Aboriginal people are declining faster than among non-Aboriginal people, although they are still disproportionately high.2 Smoking rates are higher among adults living in rural Victoria (14.1 per cent), compared to those in metropolitan Victoria (11.5 per cent).7

Targeted action is also needed to improve the health and well-being of mothers and babies. Although smoking at any point in pregnancy has decreased, there are groups that have higher rates, including Aboriginal mothers (43 per cent), mothers under 20 (34 per cent) and mothers aged 20 to 24 (21 per cent).8

Encouraging action to reduce harm from the use of tobacco and e-cigarettes

Coordinated efforts to reduce tobacco and e-cigarette use will reduce inequality for people who are in multiple forms of disadvantage. It will also reduce the negative economic, social and environmental impacts associated with the use of tobacco and e-cigarettes.

What we want to achieve

  • Strengthen the regulatory framework around the availability of tobacco and e-cigarette products in Victoria. Reduce the number of environments where a person can smoke.
  • Prevent the occurrence and reduce the harms associated with smoking and cigarettes, including second-hand and third-hand exposure, through continued support and strengthening of tobacco and e-cigarette regulations in Victoria.
  • Incorporate a national approach to tobacco and e-cigarette reform through the implementation of the National Tobacco Strategy 2022-2030.
  • Support the use of e-cigarette products through a medically supervised pathway, solely for the purpose of smoking cessation and nicotine addiction treatment.

Targeted strategies

Implementation takes place through state, regional and local partnerships to encourage collective action aligned with:


Outcome 1.3 Victorians act to protect and promote health.

Guidelines for taking action to reduce harm from tobacco and e-cigarettes

Evidence-based guidelines, policies, strategies and plans can be used by agencies involved in local and regional planning and service delivery (in particular local councils required to prepare municipal public health and well-being plans under Public Health and Welfare Act 2008.


  1. Australian Institute of Health and Welfare 2022, Australian Burden of Disease Study 2022. Canberra: AIHW. Cat. no: BOD 37.
  2. Australian Institute of Health and Welfare 2019, Alcohol, tobacco and other drugs in Australia. Canberra: Australian Government.
  3. Whetton S, Allsop S, Tait R, Scollo M, Banks E, Chapman J, et al 2019′Identifying the social costs of tobacco use in Australia in 2015/16‘, National Institute for Drug Research.
  4. Banks E, Yazidjoglou A, Brown S, Nguyen M, Martin M, Beckwith K, et al. 2022, ‘Electronic cigarettes and health outcomes: a systematic review of the global evidenceCanberra: Australian National University.
  5. Advisory Council on Obstetrical and Pediatric Mortality and Morbidity 2022, Victoria’s mothers babies and children 2020 report and presentations. Melbourne: State Government of Victoria.
  6. World Health Organization 2022, Tobacco: it is poisoning our planet. Geneva: WHO.
  7. Victorian Agency for Health Information 2022, Victorian Population Health Survey 2020. Melbourne: State Government of Victoria.
  8. Australian Institute of Health and Welfare 2022, Australian mothers and babies. Canberra: Australian Government.

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