Australia has made remarkable progress in reducing cigarette smoking over the past three decades. Daily smoking rates have fallen from 24% of the population in 1991 to just 8.3% in 2022–2023, according to the Australian Institute of Health and Welfare. That is a significant achievement by any measure. Yet behind that national headline figure lies a more complicated story, one that reveals why government-led campaigns alone have never been enough to reach the Australians who need help most.

The National Tobacco Strategy 2023–2030 sets an ambitious target of reducing daily smoking prevalence to 5% or less by 2030. Research published in leading public health journals suggests that under current conditions, Australia is unlikely to reach that goal on time, particularly among disadvantaged, remote, and First Nations communities where smoking rates remain disproportionately high. This is where community health organisations are stepping in and making a measurable difference.

The Gap That Government Campaigns Leave Behind

National anti-smoking campaigns have historically relied on mass media: television advertisements, graphic health warnings on packaging, and public awareness messaging. These approaches work well at a population level and have undoubtedly contributed to the long-term decline in smoking rates. But they tend to be less effective among populations that feel disconnected from mainstream media messaging or who face entrenched social and economic barriers.

Research consistently shows that smoking rates in Australia are considerably higher among people experiencing socioeconomic disadvantage, those living in remote and regional areas, and First Nations communities. Among Indigenous Australians, smoking has been found to cause half of all deaths in older populations. These are the groups that broad government campaigns struggle to reach in a meaningful way.

Community-Led Programs That Are Making a Difference

Community health organisations operate differently from top-down government campaigns. They are embedded within the communities they serve, understand the local cultural context, and are able to build trust in ways that a national television advertisement simply cannot. Their approach tends to be personal, face-to-face, and sustained over time.

Some of the most effective community-led smoking cessation approaches across Australia include:

• Peer support programs where former smokers within the same community help others quit, reducing the isolation that often makes quitting harder

• Culturally appropriate smoking cessation programs tailored to First Nations communities, delivered in language by trusted local health workers

• Integration of quit smoking support into existing community health services such as maternal health, mental health, and chronic disease management

• Community pharmacies and GP clinics in low socioeconomic areas offering brief smoking intervention programs as part of routine care

The Role of Harm Reduction in Community Settings

Not every smoker is ready to quit immediately, and community health organisations understand this reality. A harm reduction approach acknowledges that some people will continue to smoke while working toward reducing their overall consumption. This is especially relevant when working with long-term smokers who have tried to quit multiple times and feel that the standard cessation pathways have not worked for them.

In these settings, conversations about reducing daily cigarette intake, switching to lower tar options such as Manchester Light Cigarettes, or using nicotine replacement therapy alongside continued smoking can form part of a gradual reduction strategy. Community health workers are trained to meet smokers where they are, rather than demanding immediate and complete cessation as the only acceptable outcome.

Addressing Mental Health and Smoking Together

One area where community health organisations have shown particular strength is in addressing the deep connection between smoking and mental health. Australians living with anxiety, depression, or other mental health conditions smoke at significantly higher rates than the general population. Yet mainstream quit smoking campaigns rarely address this intersection directly.

Community mental health organisations across Australia have begun integrating smoking cessation into their existing support programs. Rather than treating smoking as a separate issue, they address it alongside the mental health conditions that often drive or sustain the habit. This integrated approach has shown promise in helping people whom standard public health campaigns have historically left behind.

The Challenge of Illicit Tobacco in Community Settings

Community health organisations are also grappling with a growing challenge that government campaigns are ill-equipped to address: the rise of illicit tobacco. According to the Illicit Tobacco and E-cigarette Commissioner Report 2024–25, illicit tobacco accounted for an estimated 50 to 60% of total tobacco consumption in Australia in 2024–2025, with a market value of up to $6.9 billion.

For community health workers, illicit tobacco presents a serious complication. Smokers in disadvantaged communities are more likely to access cheap, unregulated tobacco products that carry unknown health risks and undermine the pricing mechanisms that government policy relies on to discourage smoking. Addressing this requires trusted community voices, not just enforcement.

What Needs to Change at a Policy Level

For community health organisations to have the greatest possible impact, they need sustained funding and genuine integration into Australia's national tobacco control strategy. The National Tobacco Strategy 2023–2030 acknowledges the role of non-government organisations, but community groups consistently report that funding is short-term, competitive, and administratively burdensome.

Community health workers also need access to the full suite of cessation tools, including prescription medications and nicotine replacement therapy, to offer the people they work with the best possible chance of quitting successfully. Reducing access barriers for disadvantaged communities should be a central priority of any future tobacco policy framework.

Meeting Smokers Where They Are

The most effective community health programs share one common trait: they meet smokers where they are rather than where public health policy would like them to be. Whether that means supporting a gradual reduction in daily consumption, providing information about lower tar options like Manchester Light Cigarettes as part of a harm reduction conversation, or simply building the trust needed before a smoker is ready to consider quitting, the community approach is fundamentally person-centred.

Australia will not reach its 2030 smoking targets through government campaigns alone. The evidence is clear that community-based organisations, working with cultural competence and genuine relationships, are filling a critical gap that no national advertising campaign can replicate.

Final Thoughts

The decline in Australian smoking rates over the past three decades is a genuine public health success story. But the work is far from finished. As the country strives toward a daily smoking rate of 5% or less by 2030, community health organisations will need to play an increasingly central role in reaching the Australians that mainstream campaigns consistently leave behind.

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