Introduction:
Australian and international guidelines recommend evidence-based smoking cessation support as part of routine antenatal care delivery. Research suggests evidence-based smoking cessation care is not routinely provided in Australian maternity services. This study assessed the effectiveness of implementation strategies in increasing the routine provision of recommended antenatal smoking cessation care in public maternity services.

Methods:
A stepped-wedge controlled trial was conducted in all public maternity services from three sectors in the Hunter New England Local Health District in NSW. A best practice care pathway for addressing smoking in pregnancy (Ask, Advise, Help) was implemented in maternity services across the three participating sectors. Organisational and clinician-focused strategies supported implementation of the smoking cessation care pathway in routine antenatal care. Specifically: guidelines and procedures, reminders/prompts, leadership support, service champions, training, resources/equipment and monitoring and feedback. Outcomes were measured via telephone interviews with randomly selected pregnant people/women after their first, 28 week or 36-week gestation appointment.

Results:
Of the 13,160 eligible participants, 6831 (52%) consented to participate in the telephone surveys. The intervention demonstrated significant improvements in care provision across three key care elements – Ask, Advise and Help. Assessment of smoking status using carbon monoxide breath testing was found to be significantly higher post intervention for the first antenatal appointment (OR: 24.46; 95%CI: 16.70; 35.82). Additionally, participants who smoked or had recently quit were significantly more likely to receive recommended cessation advice at the 28-week appointment (OR: 2.07; 95%CI: 1.15; 3.72 ), and to be offered evidence-based support, such as Quitline referral and/or nicotine replacement therapy, at their first appointment (OR: 3.27; 95%CI: 1.35; 7.89).

Conclusion:
These findings suggest that embedding theory-driven implementation strategies into maternity care systems can enhance the consistency and quality of smoking cessation support provided as part of routine antenatal care.

INTRODUCTION:
Make Smoking History’s ‘How To Tell You’ campaign aims to highlight the impact of smoking-related illness beyond the person who smokes. The campaign draws on formative research with people who smoke, which revealed that concern about causing loved ones distress—particularly through a chronic disease diagnosis—was a powerful motivator for quitting. Translating this evidence into creative action, the campaign depicts a man recently diagnosed with cancer telling his partner, children, mother, and friend about his diagnosis and treatment.

METHODS:
Qualitative research exploring emotional triggers and quitting motivations among people who smoke informed the concept and ad testing refined the creative to ensure authenticity, relatability, and appropriate emotional intensity. Evaluation of the first campaign burst, which ran in Western Australia in Feb-July 2025, assessed attitudinal, emotional, and behavioural responses among 327 Western Australian adults who smoke or recently quit.

RESULTS:
The campaign achieved strong message cut-through and impact, as well as strong emotional responses overall. Preliminary analysis revealed notable differences by parental status, prompting further exploration of how family context may enhance campaign resonance. Parents were more likely than non-parents to agree the ad was persuasive, personally relatable, emotionally impactful, and motivated them to quit or stay quit. Parents were also more likely to have discussed the ad, sought quitting information, or spoken with a health professional. However, parental status was not associated with the extent to which respondents said they thought about quitting, felt able to quit, or intended to quit as a result of the ad.

CONCLUSION:
From this case study, health promotion and preventive health professionals will gain insight into strategies for developing, refining, delivering, and evaluating an impactful anti-smoking mass media campaign that achieves emotional cut-through and prompts reflection and quit-related actions.

Introduction: Australia’s relatively low smoking prevalence (11.1%) makes once unthinkable goals, like phasing out retail sales of tobacco products, potentially achievable. Advancing such an innovative policy requires research to identify public responses to various rationales for phasing out retail sales and to understand counterarguments. This study explored perceptions about tobacco retail regulation in Australia, including responses to possible arguments for a phase-out.

Methods: Eight online discussion groups were conducted in December 2024 with n=46 Australian adults, segmented by age (26-44, 45-69) and smoking status (yes, no). Discussions explored participants’ perspectives on tobacco retail practices in Australia and perceptions about phasing out tobacco sales. Participants then assessed nine arguments in support of a phase-out.

Results: Participants generally accepted the need for some restrictions on tobacco sales, especially those related to age. Attitudes to phasing out retail sales varied, with support greatest among those who smoked and believed it would help them quit. Those less supportive, especially non-smokers, expressed concerns about individual freedoms, the illicit tobacco market, and supporting long-term smokers. In addition to helping people who smoke to quit, perceived benefits of a phase-out were to children and future generations by reducing smoking uptake and smoking-related harms, and easing pressure on the health system. The most persuasive arguments highlighted smoking harms, focused on protecting children, or emphasised environmental impacts of tobacco products. Arguments focused on industry conduct (e.g., highlighting profits and product manipulations) were less compelling.

Conclusions: While there is emerging support for phasing out tobacco retail sales, public health agencies will need to address concerns about restrictions on personal freedoms, the illicit tobacco market, and the needs of long-term smokers. Testimonials from people who smoke, that explain how a phase-out could empower them to quit may foster empathy, reduce resistance, and build support for this innovative policy, especially among non-smokers.

Introduction:
The commercial interests of Big Tobacco continue to undermine public health. With deep financial resources, the industry is constantly innovating, manufacturing and marketing new nicotine products designed to attract and addict new users - particularly young people. Despite strong restrictions in Australia, nicotine pouches have emerged as a new threat in the nicotine product landscape. Their growing presence raises urgent concerns about youth appeal, legislative and enforcement gaps, and broader implications for preventing nicotine addiction.

Methods:
This mixed-methods study draws on data from Generation Vape - Australia’s largest research collaboration on youth vaping. A national sample of 4,895 young adults (aged 18–24) was surveyed between October 2024 and April 2025 (Waves 7-8), with additional qualitative insights from 113 young adults participating in Wave 8 focus groups. By May 2026, findings from Waves 9 and 10 will also be included to track emerging trends.

Results:
The proportion of young adults who have tried nicotine pouches increased from 13.0% in 2024 to 14.8% in 2025. While overall patterns of use remained stable, daily use rose from 2.9% to 5.0%. Notably, 1 in 5 (21.5%) young adults who had attempted to quit vaping said they would consider using nicotine pouches as a cessation aid. Qualitative data revealed that while pouches were perceived as discreet and effective for managing cravings, many users described negative effects such as nausea and vomiting.

Conclusion:
Nicotine pouches represent a growing threat to the health of young people in Australia. Generation Vape findings have triggered public health action, including new factsheets for young people, parents, and educators as part of NSW Health’s Vaping Toolkit expansion. Continued surveillance on young people’s patterns of use and access, stronger legislation and sustained enforcement are essential to counter the evolving tactics of Big Tobacco and protect young Australians from harm.

Introduction: Previous research exploring the impact of vape product features on product appeal and use intentions has been limited by a reliance on self-report measures. We aimed to provide unique and objective insights into the impact of product features by exploring young people’s electrophysiological brain activity when presented with a vape product and determining whether exposure triggers rapid and automatic product approach tendencies.
Method: Young people (17 to 23-year-olds; n = 38) were presented with images of vape products for several seconds while their brain activity was recorded. For each product they were asked to report whether they (i) found the product appealing, (ii) were curious about using the product, and (iii) wanted to use the product (response options: yes/no for each item).
Results: Results from both support vector machine classification and support vector regression analyses indicated that young people’s vape approach tendencies can be predicted from brain activity as early as 100-300ms after exposure. These findings were observed in those who vape and those who had never vaped.
Conclusion: Results provide strong evidence that exposure to vape products has an immediate effect on young people’s neural processing, with findings indicating that attitudes and behavioural intentions that occur in response to exposure to vape products precede deliberate processing. These findings provide support for the elimination of product-based marketing and the introduction of plain packaging and devices.

Problem
Aboriginal and Torres Strait Islander peoples have historically experienced high rates of tobacco use and related health inequities. In 2010, approximately 50% of the population smoked, contributing to preventable chronic disease and premature mortality. Addressing these disparities requires culturally responsive prevention approaches that is built on trust and connection. The Tackling Indigenous Smoking (TIS) program was launched to meet this need in 2010, combining evidence-based strategies with Aboriginal and Torres Strait Islander leadership to drive sustained change.

What you did
The TIS program has delivered culturally responsive, community-driven prevention initiatives across Australia for 15 years. It blends evidence-based strategies with creative approaches to build trust, connection, and empowerment. To document this journey, the National Best Practice Unit Tackling Indigenous Smoking (NBPU TIS) developed a digital repository that capturing the evolution of the program through funding periods, highlighting program aims, activities, outcomes, and lessons learned.

Results
Over this period, smoking rates declined from 50% to 27%, demonstrating the impact of sustained, community-led prevention. The repository illustrates how community-led strategies have adapted to changing environments while centring culture, creativity and connection. It traces its growth from its 2010 beginnings to the internationally recognised population health promotion program it is today. Amplifying the powerful Aboriginal and Torres Strait Islander voices, and innovative strategies, that have driven the measurable change that defines the program.

Lessons
By centring culture and connection, the TIS program provides a blueprint for effective, sustainable prevention. Demonstrating that lasting change occurs when:
• communities' lead
• local voices and lived experience are valued
• trust and connections are built
The digital repository serves as a living record of sustainable prevention, sharing program impact, and preserving lessons to inspire future prevention initiatives.

Aboriginal Governance Structures
The TIS program is proudly led by Aboriginal and Torres Strait Islander peoples, and this principle of self-determination is embedded in the co-creation of the TIS digital repository. This project is managed by the NBPU TIS in collaboration with key voices from the TIS program workforce, stakeholders, and local cultural knowledge holders. This collaborative approach ensures the repository reflects the lived experiences, cultural strengths and leadership of the communities it represents.

The NBPU TIS is a consortium led by Ninti One Limited, an Indigenous-led organisation, working in partnership with the University of Canberra’s Health Research Institute and Edith Cowan University’s Australian Indigenous HealthInfoNet. NBPU TIS provides culturally responsive, evidence-based practice support to TIS teams across Australia.

More than a historical archive, the repository is a celebration of Aboriginal and Torres Strait Islander voices, leadership, innovation, and self-determination. By documenting the evolution of the TIS program, the repository contributes to a broader movement of sovereignty, truth-telling, and health equity.

The repository captures the stories, ideas and creativity of the TIS workforce over the years, highlighting their successful efforts to reduce smoking and vaping in Aboriginal and Torres Strait Islander communities. By sharing these insights, the repository honours past achievements and supports future community-led prevention efforts. It stands as a living record of Aboriginal and Torres Strait Islander excellence in health promotion, reinforcing the importance of cultural governance in achieving sustainable, meaningful change. This approach ensures that the knowledge, voices and leadership of Aboriginal and Torres Strait Islander peoples remain central to the ongoing story of tobacco control and health equity.

Introduction: To prevent vaping uptake and encourage cessation, particularly in young people, Australia has made significant gains recently in vaping control. Yet, how individuals align their identity with vaping can influence their e-cigarette perceptions, use and quitting intentions. This study therefore aimed to examine vaping identity in Australian young adults (18-24 years) who vape. Focus was on this cohort as they are the highest proportion of vape users compared to other age groups.

Methods: This study reports the qualitative findings from Wave 8 (conducted in April 2025) of the Generation Vape research project. Young adults, 18-24 years old, who currently vape participated in online focus group discussions about their vape use, perceptions and identity. A reflexive thematic approach was used to analyse the data.

Results: A total of 93 individual participants took part in 21 focus groups. Three main themes were generated from the analysis: i) influencing factors of vaping identity; ii) nuances of vaping behaviour and intent in shaping vaping identity; iii) reactions to being labelled a “vaper”. Findings highlighted that vaping is seen to be a less desirable behaviour, however context was seen as an important validation of use. The term "vaper" was shown to have negative connotations to young adults, being described by some as "offensive" and "embarrassing", wanting to dissociate from this label. Aspects of stigma were also evident as participants spoke about the shame and sense of perceived judgement from others for vaping.

Conclusion: Social acceptability of vaping appears to be shifting in young adults, influencing their vaping identity. Public health messaging to prevent vaping uptake or encourage cessation should be mindful of language (e.g., "vaper") as it may limit reach and influence. Similarly, consideration of vaping identity would be warranted in developing anti-vaping campaigns targeting young adults who vape to help ensure content resonates.

Intro: Tobacco use is the second highest behavioural risk factor for attributable deaths worldwide. To reduce this health burden, coordinated cessation care at all levels of the health system is required, including within primary care as a key point of contact with the health system. This scoping review aimed to consolidate the evidence on integrating smoking and vaping cessation support within the primary care setting to identify the most effective interventions and implementation strategies.

Methods: The search identified articles published in Australia, Canada, the European Union, the United Kingdom, and the United States between September 2020 – 2024 that evaluated smoking and/or vaping cessation interventions and implementation strategies in primary care settings. Key search terms included ‘smoking cessation’, ‘vaping cessation’, ‘primary care’, and ‘effectiveness’. Two reviewers independently extracted all relevant study details including outcome measures and methods used to verify abstinence. A narrative synthesis approach was used to identify and summarise the effectiveness of assessed smoking and vaping cessation interventions.

Results: From 2,166 initial records, 30 empirical studies met inclusion criteria. The majority of included studies examined smoking cessation strategies, with only two relating to vaping cessation. Comprehensive interventions combining behavioural support with medications like varenicline and/or nicotine replacement therapy (NRT) were found to produce favourable outcomes. Effective implementation strategies to prevent tobacco-related harm included cost-free pharmacotherapy, financial incentives, incorporation cessation care into low-dose computed tomography (LDCT) screening and spirometry feedback, and use of electronic health records (EHRs). Mixed results were found for provider education.

Conclusion: This review highlighted several interventions and implementation approaches for embedding smoking cessation into the primary care setting, and underscored the limited vaping cessation research available. The findings may enhance cessation support within primary care settings by informing best practice.

Problem: Third hand smoke (THS) consists of residual tobacco smoke pollutants that remain on surfaces and in dust after tobacco has been smoked. Safe housing is identified as a key social determinant of health, yet THS exposure is an often-overlooked issue. While evidence on the health risks is still emerging, there is consensus that THS is likely to cause harm. Social housing residents have limited choice to decline housing where previous tenants smoked inside and can be disproportionally affected. A lack of data on the prevalence and impacts of THS exposure among Australian social housing residents hinders policy action.

What we did: We explore the case of a social housing resident in NSW, who was negatively affected by THS pollutants from previous tenants who smoked in the property. We supported the resident to negotiate with their housing provider to remediate the residence to reduce their exposure to THS. Using this illustrative case study, we will briefly consider policy and practice implications.

Results: Our presentation highlights inconsistencies in social housing provider policy regarding indoor smoking, smoke-free housing provision and approaches to remediating properties affected by THS.

Lessons: It is difficult and costly to eliminate THS pollutants from a residence once established. Adopting smoke-free social housing policy would reduce resident exposure to second and third-hand smoke pollutants, contributing to greater health equity. There is also a need for evidence-based guidelines for housing providers on how to remediate properties affected by THS.

Background: Culturally and Linguistically Diverse (CALD) communities make up a significant portion of Victoria’s population. Despite public health efforts to reduce smoking, inequities in smoking-related beliefs and behaviours persist. CALD communities may face unique barriers to accessing tobacco control messaging, including language, cultural norms, and recency of migration. Understanding these perceptions is vital for developing targeted messages that challenge misperceptions and support healthier behaviours.

Methods: Prevalence estimates were generated using small domain estimation methods, integrating data from the 2022 Victorian Smoking and Health Survey (n=12,000) with demographic data from the 2021 Australian Census of Population and Housing. Estimates for agreement that “the dangers of smoking have been exaggerated” were calculated for groups defined by language spoken at home, country of birth (COB), and year of arrival.

Results: Individuals born overseas were more likely (16%–52%) to agree that the dangers of smoking are exaggerated compared to Australian-born (9%). Agreement was highest among Vietnamese-born (51.8%), Chinese-born (45.7%), and Indian-born (39.6%) adults. High agreement was also observed among Punjabi (64.0%), Mandarin (46.1%), and Vietnamese (42.6%) speakers. Across all groups, men were consistently more likely than women to hold this belief. Recent migrants (arrived 2016–2021) showed the highest agreement (38.1%), compared with those who arrived before 1971 (15.4%).

Conclusion: These findings suggest that beliefs about smoking harms are a significant issue for CALD communities and may be influenced by cultural background, language, COB and year of arrival. Older migrant groups showed greater awareness of smoking harms, likely influenced by longer exposure to local tobacco control efforts.

Implications: Implications for practice include the need for culturally and linguistically tailored awareness campaigns to bridge knowledge gaps and reinforce awareness of smoking dangers. This is critical to ensure all Victorians, regardless of background, are supported to live free from its harm.

Problem
Preventive health research generates valuable knowledge. However, without embedded systems for translation, findings often remain siloed in academic outputs rather than shaping policy or practice. Embedding knowledge translation (KT) into funding design supports the movement of evidence into real-world settings and enables long-term impact. Evidence shows that KT planning strengthens the likelihood of sustained policy and practice change (Grimshaw et al., 2012).

What we did
Healthway introduced a KT requirement across all research funding streams to strengthen pathways from research to policy and practice in WA. Applicants must include a KT plan outlining how knowledge will be shared, applied and measured throughout the project alongside project partners. Healthway’s KT guide supports this process by providing structured strategies, stakeholder engagement tools and indicators for impact.

What we are learning
Evaluation of Healthway’s research program shows that embedding KT early increases the likelihood of long-term influence. However, KT is shaped by local context, partnerships and the adaptability of evidence to real-world settings (Wolfenden et al., 2022). Even comprehensive KT strategies require sustained effort and time to yield results. There is strong consensus that the impact of preventive health research on policy and practice typically takes much longer than the period for which it is funded. To strengthen scalability and sustainability, Healthway is exploring implementing longitudinal data collection at two- and five-years post-project. This aligns with the national (National Health and Medical Research Council, 2023) and international calls to track delayed impact.

Key takeaway
Embedding KT within funding design helps close the gap between research, policy and practice, supporting scalable and sustainable prevention initiatives.

References
Grimshaw, J. M., Eccles, M. P., Lavis, J. N., Hill, S. J., & Squires, J. E. (2012). Knowledge translation of research findings. Implementation Science, 7(1), 50. https://doi.org/10.1186/1748-5908-7-50
National Health and Medical Research Council. (2023). Research Impact and Translation Assessment (RITRA) evaluation report. Australian Government. https://www.nhmrc.gov.au/sites/default/files/documents/reports/RITRA-evaluation-report.pdf
Wolfenden, L., Mooney, K., Gonzalez, S., Hall, A., Hodder, R., Nathan, N., Yoong, S., Ditton, E., Sutherland, R., Lecathelinais, C., & McCrabb, S. (2022). Increased use of knowledge translation strategies is associated with greater research impact on public health policy and practice: an analysis of trials of nutrition, physical activity, sexual health, tobacco, alcohol and substance use interventions. Health Research Policy and Systems, 20(1), 15. https://doi.org/10.1186/s12961-022-00817-2

Background
Smoking prevalence in the Northern Territory (NT) remains significantly higher than the national average. This study explores the perspectives of individuals involved in setting and implementing policy in the NT to identify influencing factors and opportunities to strengthen regulation public health approaches to reduce smoking.

Methods
Semi-structured, face-to-face interviews were conducted with nine participants with experience in range of policy roles in both the government and non-government sectors. Thematic analysis was used to explore attitudes towards the current and historic tobacco control policy context, to, perceived barriers to innovation and strategies for improving public health outcomes.

Results
Participants described a range of approaches to advancing tobacco control, including tighter regulation of tobacco availability, harm minimisation strategies, and balancing individual autonomy with collective public health goals. While some noted political and economic constraints, others emphasised the importance of strong leadership, bold decision-making, and addressing the social and structural drivers of tobacco use.

Conclusion
Urgent, coordinated efforts are needed to strengthen regulatory frameworks, support sustained leadership in tobacco control and guide practical community-informed policy action to address inequities in smoking prevalence and associated harms in the region.