Packed GP waiting rooms might need to find space for hundreds of thousands more patients each year under an analysis of new vape rules.
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But as the number of e-cigarette users hits 1.3 million, one state minister says stemming the tide of an emerging health crisis is essential.
Under a national crackdown introduced in January, access to e-cigarettes for therapeutic purposes requires a prescription from a medical or nurse practitioner.
As well as the 70,000 people who vape and are already on prescriptions, about 450,000 people are expected to seek a script to continue vaping, according to a federal government analysis.
That could mean up to 900,000 more appointments in 2024/25.
Other measures could also push the cost of new vaping devices to $150, the analysis estimates.
But NSW Health Minister Ryan Park said standing by was not an option amid a surge of young people taking up e-cigarettes.
Recent data suggests one in seven adolescents aged 14 to 17 currently vape, rising to one in five in early adulthood.
"I have no doubt that there will be challenges but doing nothing is not an option for us," Mr Park said on Tuesday.
"When it comes to vaping, we have an opportunity to stem the tide on what is an emerging public health crisis, particularly for our young people.
"We don't know the long-term risks of vaping, but we know their immediate health impacts."
Federal regulations also ban the importation of disposable single-use vapes.
Further changes due in March are expected to outlaw the personal importation of vapes and the importation of non-therapeutic vapes.
Importers will need to be licensed and, along with manufacturers, will be required to notify the national drugs regulator of their products' compliance.
Flavours and permissible nicotine concentrations will also be reduced.
An Australian review of global research on vaping in 2022 found conclusive evidence that e-cigarettes cause poisoning, acute lung injury and burns.
Strong evidence was also found that vaping increased smoking uptake in non-smokers.
Australian Associated Press
