To see someone with emphysema fighting for every breath, or to watch the painful decline of someone with lung cancer is to endure a harsh lesson that changes lives.

Smoking doesn't just kill; it kills with pain, horror and indignity. Many people will thus understand and sympathise immediately with Andrew Forrest's new anti-smoking campaign, intended to cut youth smoking and make the industry pay for some of the damage it causes.

Mr Forrest and his wife, Nicola, want the legal age for buying tobacco to be raised from 18 to 21 – a move they say would stop young people getting hooked, save lives and save government coffers up to $3.1 billion a year. But are they right? Is this the best way to reduce smoking, and the harm it causes, to the minimum possible?

There is a balance to be struck here between discouraging smoking and banning it altogether. It has been sobering to learn that tobacco is now a target for criminal activity. Recent high-profile arrests have exposed extensive international smuggling operations. Busts all over Australia – including the Albury-Wodonga region – have highlighted how widespread the sale of cheap, illegal tobacco has become in this country.

Tobacco excise is now so high, and cigarette production so circumscribed that smuggling is a lucrative alternative to the illegal drug trade. This should be a warning to policymakers. It signals clearly that current approaches need to be rethought.

Australia should do nothing that turns tobacco into just another illegal or quasi-illegal drug that profits only criminals. Instead we should use tobacco as a proving ground for policies that can be used to manage other drugs which are currently illegal, so that when common sense eventually prevails, they may be decriminalised and their use minimised.

Compulsory plain packaging is an excellent example of how a dangerous recreational drug might be managed. It may also be worth considering making tobacco available only by prescription but in contemplating moves like these, our society will have to accept that some people will still smoke.

If we base our initiatives solely on empty moralising about the harm tobacco does, and pay no regard to the unintended consequences of bans or near-bans, we will never find the right balance.

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