Quitting smoking products now more expensive than illicit tobacco
Posted 10 Apr, 2026
Australia’s approach to smoking cessation is leaving behind the people who most need support, with researchers warning that the cost of quitting can now be higher than the cost of continuing to smoke, particularly for people on low incomes.
A paper just published in Public Health Research & Practice shows Australia falls well behind World Health Organization (WHO) recommendations and comparable countries in providing free or affordable access to evidence-based stop smoking treatments, despite tobacco remaining the leading preventable cause of death.
The paper, Failing those who most need support to quit smoking: Australia must do better, highlights that while overall current smoking rates in Australia have fallen to about 10 per cent, rates remain dramatically higher among some population groups.
Smoking prevalence in Australia is significantly higher among people living with mental illness, alcohol and other drug dependence, those who have experienced trauma and people facing social and economic disadvantage and is as high as 78 per cent among people experiencing homelessness.
University of Notre Dame Professor and co-author of the research, Lisa Wood, said while there is currently a lot of focus on the supply side of tobacco, the demand side could not be ignored.
“Most people who smoke want to quit, but quitting is hard and often takes many attempts,” she said.
“The people most likely to still be nicotine dependent are also the least able to afford effective treatment.”
“Using a nicotine patch alongside fast acting options like inhalers, sprays or mists reduces cravings and withdrawal symptoms much more effectively than a patch alone,” she said.
“But in Australia, only nicotine patches are subsidised through the PBS and access is limited to two 12-week courses per year.”
“I have spoken with people who have smoked 20 to 30 years and are highly nicotine dependent and desperately want to quit, but the monthly out of pocket costs can be up to $200-$300 for combination evidence-based treatment. Some faster-acting nicotine replacement products are no longer available on the PBS at all.”
“By contrast, countries like the United Kingdom and Ireland provide free combination stop smoking medications alongside behavioural support through national services.”
While some states and territories have introduced programs to provide free combination nicotine replacement therapy, access remains uneven and dependent on where people live. There is currently no ongoing, nationally consistent commitment to ensuring affordable cessation support for all Australians who want to quit.
Rachael Andersen, Quit Director, believes that equitable access to quitting support and medication is crucial if we’re to continue driving down Australia’s smoking and vaping prevalence.
“Smoking still kills 66 Australians every day, that’s 24,000 people every year. We have a responsibility to provide more people with effective methods of cessation in affordable, accessible ways.”
“It’s hard to justify that nicotine replacement therapies (NRT) have become more expensive than a packet of illegally sold cigarettes in this country.”
“We look forward to sharing news in coming weeks about some pilot work in different states trialing provision of free NRT products,” Ms Andersen added.
Professor Wood and co-author Dr Beth Greenhalgh, Research and Policy Manager from Cancer Council Victoria, also highlight disparities in how different types of addiction are treated in Australia.
“In a damning contrast, opioid replacement therapy is heavily subsidised with no time limits, yet tobacco kills around 20 times as many people as opioid overdoses,” Professor Wood said.
“There is also more free or low-cost treatment available for alcohol dependence.”
“This creates mixed messages for people who are heavily addicted to nicotine. We tell them smoking is the biggest preventable cause of death and disease, but if they need treatment to quit, they are often expected to pay out of pocket.”
Professor Wood warned that the rapid growth of illicit tobacco market had made quitting even less achievable for many smokers.
“It can now be cheaper to continue smoking, particularly if people are buying cheap illicit tobacco, than to self-fund adequate cessation support,” she said.
“That makes strong, accessible quitting support more important than ever if we want to reduce harm and health inequity.”
The paper calls on governments to better align smoking cessation support with the scale of harm caused by tobacco use, including making combination stop smoking medications available on the PBS, with minimal out of pocket costs, removing time limits on treatment, ensuring free access to evidence-based cessation medications for people who seek help through Quitline services and prioritising cessation support for population groups with the highest smoking prevalence.
“We are not calling for new or experimental interventions,” she said
“The evidence already exists.”
“What’s missing is investment and policy settings that genuinely support people who want to quit especially those who are already experiencing disadvantage.”
For free, confidential support to quit smoking or vaping visit www.quit.org.au or call 13 7848.