Smoking: Tobacco and E-cigarettes

Smoking tobacco remains the leading cause of preventable disease and death in Australia.3 

E-cigarettes and vaping are emerging as an alternative to traditional tobacco smoking.2 E-cigarettes deliver an aerosol by heating a liquid that users breathe in. The liquid may contain nicotine and a range of toxic chemicals including substances added for flavouring. The liquid used in e-cigarettes can contain nicotine even if they are labelled nicotine free.9 

Shisha smoking has become common in the past 20 years, shisha tobacco is usually fermented in molasses and fruit flavoured. Shisha tobacco contains significant amount of nicotine, carbon monoxide, tar and other toxins.10 

Smoking, vaping and shisha are harmful to users because of their addictive nature and harmful health effects.5,9,10


This 40 second animation was created by adolescent patients at The Children’s Hospital at Westmead, using clay, pipe cleaners and other materials  to spread the word that, Smoking Kills Fun.

Health effects of smoking:

  • Smoking inflames and irritates the lungs, the toxins in the smoke destroy lung cells imparing lung function. This can reduce stamina and exercise capacity.10 
  • Smoking is a proven risk factor for heart diseases, stroke and cancers including lung, neck and bladder cancers.7, 10
  • Passive smoking has a significant impact on the health of children and can lead to increased risk of asthma and breathing problems.8
  • Children of smokers have been found to be up to four times more likely to become smokers themselves.8
  • E-liquid has been linked with e-cigarette or vaping product use-associated lung injury (EVALI).2 
  • Symptoms of EVALI include: respiratory (shortness of breath, cough or chest pain), gastrointestinal (nausea, vomiting or diarrhoea) and non-specific (fatigue, fever or weight loss).11

Quick facts:

  • Smoking causes more than 5,400 deaths and 46,000 hospitalisations each year in NSW.7
  • In 2017, 1,714 deaths were attributable to second-hand smoke in Austrailia.1
  • 7.5% of 12-17 year olds report being current weekly or daily smokers and 18% of youth aged 16-24 smoke daily.6
  • 7% of young people (12 to 15 year old) and 27% of young people (16 and 17 years old) have vaped in the previous month.2
  • EVALI has resulted in at least 68 deaths and 2,807 hospitalisations across the United States of America.11, 12 
  • Quitting at any stage brings benefits to smokers.4
  • Most people take several quit attempts before they are successful and each time a person attempts to quit smoking, their chances of successfully quitting for good increases.4

Strategies to help you quit smoking:

  • Counselling: NSW Quitline can put you in touch with local quit smoking services in your area. If you decide to seek help from a counsellor or quit smoking group, it’s important to check whether the counsellor is certified in helping people quit smoking.
  • Develop a quit plan to track down the number of smoke-free days and connect with a community for inspiration and support. 
  • Call the Quitline for free on 137 848 or request a free call back service. 
  • Talk to your local GP or health professional for additonal support. 
  • Visit or for more information. 

Products to help you quit smoking:

Nicotine Replacement Therapy (NRT) can assist people to quit smoking. There are a number of types of NRT available in pharmacies and supermarkets ranging from patches, gums and oral sprays. Talk to your doctor or pharmacist to help develop a quit plan.

Did you know: Combining 2 forms of NRT can be more effective in helping quit smoking habits.

For example: NRT patches for slow release and oral spray for when there is an urge to smoke.

Smoking a packet of 20 cigarettes a day at an average cost of $35 a packet, will cost you about $245 per week or almost $13,000 per year.

Quit smoking today to improve your health and lower risks of heart diseases. 




  1. Global Burden of Disease Collaborative Network.(2018) . Global burden of disease study 2017 results. Seattle, United States Institute for Health Metrics and Evaluation (IHME), 2018. Available from:
  2. HealthStats NSW. (2020). Electronic cigarette use: 
  3. Ministry of Health. (2013). Current Smoking in Adults. Retrieved March 2, 2015, from Health Statistics of NSW:
  4. NSW Health (2005) "Let's take a moment" quit smoking brief intervention- a guide for all health professionals. Sydney: NSW Health.
  5. NSW Health. (2021). Electronic cigarettes.
  6. NSW Ministry of Health. (2011). Smoking Attributable Deaths. Retrieved March 2, 2015, from Health Statistics New South Wales:
  7. NSW Ministry of Health. (2013). Smoking Attributable Hospitalisations. Retrieved March 2, 2015, from Health Statistics New South Wales:
  8. NSW Ministry of Health. (2014). The Health of Children and Young People in NSW: Report of the Chief Health Officer 2014. Retrieved March 2, 2015, from Centre for Epidemiology and Evidence: 
  9. Department of Health. (2021). About e-cigarettes. Retrieved July 26, 2021, from Australian Government Department of Health:
  10. NSW Government. (2019). Shisha (waterpipe) smoking factsheet for health care professionals. Retrieved July 26, 2021, from Shisha No thanks:
  11. Lewin, E. (2020). What is EVALI. The Royal Asutralian College of General Practitioners. Retrieved July 26, 2021, from NewsGP:
  12. Centre of Disease Control. (2020). Outbreak of lung injury associated with the use of e-cigarettes, or vaping products. Retrieved July 26, 2021, from CDC, Smoking and tobacco use: