Australia Must Maintain Progress in Tobacco Control, Expert Warns
16 Oct 2026
Professor Nick Zwar has spent more than 20 years helping develop Australia’s smoking cessation guidelines for general practitioners (GPs), driven in part by seeing the serious effects of smoking early in his medical career.
As a medical student in the 1990s, he encountered many men in their 50s with end-stage chronic obstructive pulmonary disease (COPD) at Edinburgh’s Northern General Hospital in Scotland.
The experience showed him the devastating health consequences of tobacco use and influenced his later work on smoking cessation.
In the late 1990s, Professor Zwar also worked with Professor Robyn Richmond of UNSW through the Smokescreen program, which helped thousands of GPs support patients trying to quit smoking.
When the Australian Government funded the development of a national smoking cessation guideline, he became involved in addressing the lack of clear guidance for healthcare professionals.
The first edition was published in 2004 and received support from organisations across the health sector, including dental, pharmacy and nursing groups. It subsequently became Australia's national guideline for smoking cessation.
At that time, around 21% of Australians smoked daily. The National Drug Strategy Household Survey later reported a record-low daily smoking rate of 5.6%.
Professor Zwar links the fall in smoking rates to strong tobacco control policies, including higher tobacco taxes, smoke-free public spaces and bans on tobacco promotion through sport. He also highlights changing social attitudes, with smoking becoming less socially acceptable, particularly among young people.
Although smoking rates remain high in some communities, he believes the decline has occurred across different socioeconomic groups.
However, Professor Zwar has identified areas where smoking cessation support could improve. These include wider access to nicotine replacement products through the Pharmaceutical Benefits Scheme (PBS) and greater use of medicines such as varenicline and bupropion.
He also supports the role of vaping in smoking cessation for people who have not successfully quit using approved treatments. However, he believes its potential has not been fully realised within Australia's healthcare system.
Although smoking rates have fallen, Professor Zwar remains concerned about the rise in illegal tobacco sales and the growing availability of illicit vaping products. He also warns that other nicotine products, including nicotine pouches, could create additional challenges.
He said the possibility of smoking rates rising again should not be underestimated.
Professor Zwar continues to emphasise the importance of GPs in helping patients quit smoking. He believes supporting someone to stop smoking remains one of the most significant steps they can take to improve their future health.
Alongside his clinical work, he has held several leadership and advisory roles, including at Bond University and within the RACGP. He has also contributed to COPD-X guidelines and advised organisations such as Cancer Council Victoria and the National Health and Medical Research Council.
One highlight of his work was the World Health Organization's recognition of the smoking cessation guideline in 2020. The guidance was also adapted for hospital use in New South Wales and Queensland.
Professor Zwar identified inconsistent funding for guideline updates as a continuing challenge, although support from VicHealth and the Commonwealth Government has helped in recent years.
As Dr Hester Wilson takes over as Chair of the RACGP's Expert Advisory Group, Professor Zwar remains committed to tobacco control. He stresses that ongoing action is essential to prevent the progress made in reducing smoking from being lost.
Australia Must Maintain Progress in Tobacco Control, Expert Warns
Source: newsGP