Iodine deficiency leads to a range of conditions with the most serious and overt consequences being cretinism and widespread goitre. Iodine surveys of Tasmanian school children in 1998 and 2000 revealed a recurrence of iodine deficiency. In October 2001, a voluntary iodine fortification program was implemented in Tasmania with the baking industry substituting iodised salt for regular salt in bread. According to this study this has resulted in a significant improvement in iodine status in Tasmania. Despite methodological differences between the pre- and post-intervention surveys, switching to iodised salt in bread appears to have resulted in a significant improvement in iodine status in Tasmania. Given iodine deficiency has been identified in other parts of Australia and in New Zealand, mandatory iodine fortification of the food supply in both countries is worthy of consideration. As voluntary fortification relies on industry goodwill, mandating fortification could be expected to enhance population reach and give a greater guarantee of sustainability in Tasmania.