Julian Hill’s certainty is doing more work than his evidence

Australians deserve an honest account of vaping, smoking and policy failure. Hill’s remarks offer selective science and a demand to double down.

Julian Hill begins with diseased and dying Australians and ends by telling governments to “double down”. Between those two points, he owes the public evidence that his preferred policy produces better outcomes than the alternative. What he supplies is a sequence of alarming images, selective scientific claims and enforcement statistics that cannot carry the weight he places on them.

Invoking hospital wards is easy. Demonstrating which policy will keep people out of them is harder, and Hill’s remarks do far too little of that work. Concern for children and anger at organised crime may explain the intensity of his language, but neither excuses a misleading account of the evidence.

The most objectionable part is his treatment of vaping as a smoking-cessation tool. Hill describes the suggestion that vapes help people stop smoking as part of a “lie”, then retreats to an exception for a “very small number” of highly addicted smokers. That leaves his audience with the impression that an established research finding is essentially an industry sales pitch with a minor qualification.

Cochrane’s August 2026 updated systematic review found high-certainty evidence that nicotine e-cigarettes help more people stop smoking than nicotine-replacement therapy, including patches and gum, translating to approximately four additional successful quitters per hundred people. The finding concerns smoking cessation, not a guarantee of harmlessness, and longer-term safety research remains necessary. But it makes Hill’s dismissive framing difficult to defend. Cochrane review, August 2026

Those additional quitters are people who may otherwise continue smoking. Their success deserves more than being waved away as a marginal exception, particularly by someone opening his argument with the prospect of preventable deaths. Nor did this evidence suddenly appear in 2026: Cochrane’s January 2025 review had already reached the same high-certainty conclusion about nicotine e-cigarettes outperforming nicotine-replacement therapy. Cochrane review, January 2025

Hill is entitled to argue for strict regulation. He is entitled to challenge the opposition’s proposed sales model. He is not entitled to present the cessation evidence so dismissively and expect the language of public health to shield him from scrutiny.

His declaration that “vaping drives an increase in smoking, not the other way around” has the same problem: the confidence of the sentence exceeds the reach of the evidence. It bundles adolescent experimentation and adult smoking cessation into one sweeping claim, despite these being different behaviours in different populations. A teenager who has never smoked and an adult trying to escape a decades-long cigarette habit cannot sensibly be treated as interchangeable.

There is an Australian study consistent with Hill’s fivefold figure. Published in 2024, it examined recalled smoking and vaping histories among 5,114 adolescents aged 12–17. After adjustment, the estimated rate of smoking initiation among those who had ever vaped was 4.9 times that among those who had never vaped. The authors interpreted this as evidence of increased risk, and the finding deserves serious attention. Australian adolescent study, 2024

What it does not deserve is promotion into a universal rule about everyone who vapes. This was observational research using retrospective recall data. Statistical adjustment strengthens an analysis, but it does not guarantee that all relevant differences between participants have been removed or that causation has been established.

A 2025 systematic review in Addiction found consistent associations between youth vaping and subsequent smoking in individual-level studies, while judging certainty about a causal relationship to be very low. Population-level findings were mixed and, on balance, suggested an inverse relationship between vaping availability or use and youth smoking, also with very low certainty. That is a complicated evidence base, and Hill’s certainty conceals its complications. Begh and colleagues, 2025

Research by Dr Arielle Selya and Dr Sooyong Kim illustrates why those qualifications matter. Their study, published in the July 2020 issue of Nicotine & Tobacco Research, analysed 12,421 American eighth- and tenth-grade students using Monitoring the Future survey data. After adjustment for shared risk factors, current vaping was not significantly associated with current cigarette smoking: the adjusted odds ratio was 0.95, with a 95% confidence interval of 0.55–1.63. In that analysis, accounting for differences between young people materially changed the apparent relationship. Kim and Selya, 2020

That study was cross-sectional and could not establish causation or the order in which behaviours occurred. An association with lifetime cigarette smoking also remained after adjustment, so it does not prove that a gateway effect is impossible. Its relevance is more precise: it shows why an association cannot simply be presented as a settled causal explanation. Hill’s audience deserves to hear that qualification before being asked to accept his conclusion. Kim and Selya, 2020

Youth nicotine use warrants prevention, but it cannot be used to erase evidence about adult smoking cessation. Hill’s formulation effectively asks one question to settle both questions, which may simplify a television appearance but leaves the public less informed.

His discussion of relative harm is similarly deficient. For an established smoker, the relevant comparison is between continuing to smoke and switching completely to vaping. A major evidence review commissioned by England’s Office for Health Improvement and Disparities concluded that vaping posed a small fraction of smoking’s risks over the short and medium term, with significantly lower exposure to numerous harmful substances. It also emphasised that vaping is not risk-free and that longer-term evidence remains necessary. Government-commissioned evidence review, 2022

Someone who has never smoked has no health reason to start vaping. Someone who already smokes faces a different choice, and a responsible public message must explain both situations accurately. Hill’s remarks instead place legitimate warnings about youth addiction alongside language that undermines confidence in a recognised cessation option. Smokers should not have to work through a political attack to discover information relevant to their health.

Even his description of legal access needs qualification if the remarks were made after October 2024. Hill points to doctors, chemists and prescriptions, but from 1 October 2024, eligible adults could also obtain therapeutic vapes containing no more than 20 mg/mL nicotine from participating pharmacies without a prescription, following consultation and subject to conditions and state or territory restrictions. A prescription is one pathway, not a complete description of the arrangements. Therapeutic Goods Administration

More fundamentally, saying that access exists does not demonstrate that it works adequately. The relevant questions concern affordability, availability, uptake and successful cessation. “They can already do that” dismisses those questions without answering them, as though the existence of a rule were sufficient proof of its effectiveness.

The meth-lab comparison is where the argument becomes especially thin. Selling nicotine products to children is unacceptable, and criminal suppliers should face enforcement. But invoking a meth lab tells us nothing about the merits of pharmacy access, licensed retailing, product standards or the balance between restrictions and adult cessation. It is a substitute for explaining why the government’s chosen arrangements should work better.

Hill’s suggestion that opponents have got into bed with Big Tobacco and the vaping lobby follows the same pattern. Documented financial relationships and improper influence deserve exposure, but insinuation is not a policy evaluation. If the opposition’s proposal would benefit tobacco companies at the expense of Australians’ health, Hill should demonstrate the mechanism and support the prediction. An accusation delivered with conviction remains an accusation.

His defence of enforcement is no more satisfactory. Record seizures show that authorities have intercepted large quantities of illegal goods, but they cannot establish, on their own, that the illegal market is shrinking. More seizures may reflect better enforcement, more attempted supply, or both. Shop closures can disrupt trading, but their lasting value depends on whether sellers disappear, reopen or relocate.

A government claiming success should be able to move beyond announcing activity and show its effect. Hill instead offers seizures, closures, higher vape prices and calls to Quitline as though the health outcome follows automatically. It does not.

Higher prices may deter use, but the consequences depend on who changes behaviour and what they do next. A teenager deciding not to start and an adult smoker abandoning an attempted switch are different outcomes. Increased calls to Quitline are encouraging, but sustained cessation matters more than the number of calls received.

His reference to rising legal sales is particularly revealing. If he means legal tobacco sales, an increase could reflect purchases moving from illicit suppliers into the taxed market without any reduction in smoking. A cigarette does not become less harmful because the government collects excise on it. Recovering legal market share may serve an enforcement or revenue objective, but a health benefit requires additional evidence.

Hill invokes hospital wards to condemn his opponents, then offers measures that do not tell us whether fewer people will end up in them. That gap sits at the centre of his argument, and forceful language cannot close it.

A credible assessment would measure sustained smoking cessation, youth uptake, access to regulated products, illicit supply and unintended consequences. It would explain how enforcement contributes to those outcomes and identify where the arrangements are falling short. Most importantly, it would specify what evidence would justify changing course.

“Double down” provides no such accountability. If improvement proves the policy works, while continued problems merely prove that enforcement must intensify, the government has built an argument that can accommodate almost any result. Australians should expect a policy that can be tested against evidence, including evidence of failure.

None of this automatically vindicates the opposition’s proposal. Its provisions deserve scrutiny on adult access, youth protections, marketing, product quality and criminal supply. But Hill cannot establish the superiority of his position by describing the alternative in the most frightening terms available, any more than his critics can establish theirs through slogans.

His statement that addiction is a health issue rather than a moral issue is welcome, but that principle carries obligations. It requires accurate communication with people who smoke, serious consideration of effective cessation options and a willingness to acknowledge evidence that complicates the government’s preferred message.

On those measures, these remarks fail. They diminish credible cessation evidence, overstate what a youth association establishes and treat incomplete enforcement measures as reassurance that the approach is succeeding. The result is an argument that sounds more conclusive than it is.

Julian Hill has chosen to make preventable illness and death the measure of his opponents’ policy. He should expect his own claims to be examined with equal seriousness. Australians at risk of smoking-related disease deserve more than a demand for confidence in the government’s approach; they deserve evidence that earns it.