Tackling Tobacco: addressing smoking in disadvantaged communities

About the Tackling Tobacco Program

The vision of the Tackling Tobacco program is to reduce health and social inequalities through addressing smoking in disadvantaged communities by partnering with and supporting not-for-profit community sector organisations (referred to as Community Services). We achieve this by developing and implementing Tackling Tobacco projects in partnership with Community Services.

The aim of a Tackling Tobacco project in Community Services is to:

  • increase your organisation’s capacity to address smoking
  • provide your clients with support to stop smoking
  • de-normalise smoking in the community sector among disadvantaged people
  • reduce opportunities to smoke within your organisation and the community sector broadly.

Your organisation is well-placed to respond to and do more about smoking because:

  • you have existing connections with the most disadvantaged population groups in NSW
  • you are familiar and skilled in promoting positive behavioural change among your clients
  • you have a commitment to the values of social justice, fairness and equity
  • you have a commitment to improving the wellbeing and opportunities of clients
  • addressing smoking provides real benefits to clients – better health, more money and greater control over life.

This last point is worth emphasising. Clients who quit smoking will enjoy substantial benefits, both immediate and longer term.

Since 2006, the Tackling Tobacco has successfully supported over 140 Community Services that work with a range of people including:

At-risk young people

Aboriginal People

Low-income families with dependent children, especially single-parent families

People experiencing homelessness

People with a severe mental illness

Culturally and linguistically diverse populations (CALD)

People with alcohol and drug dependencies

Lesbian, gay, bisexual, transgender and intersex (LGBTI) people

For any organisation introducing new concepts, ideas and practices, such as addressing smoking, can be challenging. Nevertheless, reducing tobacco-related harm and improving the wellbeing and opportunities for your clients is a worthwhile challenge that can only be achieved through sustained action and continued awareness.

Facts about smoking and social disadvantage

Smoking rates in Australia have declined in recent years to about 16.4%[1] of the population, but men and women in the lowest socioeconomic group continue to have significantly higher rates of smoking than the rest of the community.

Smoking has an impact on quality of life and imposes an enormous burden on individuals, families and communities through the combined impacts on health, material hardship and financial wellbeing.

The common link between disadvantaged groups is that they face circumstances that make it more likely that they will take up smoking and experience barriers to quitting smoking.

Social conditions associated with higher smoking rates include:

  • Low-income
  • Poor or unstable housing
  • Family members and friends who smoke
  • Lone parenthood
  • Unemployment

People with mental illness – 33% to 58%

People with drug and alcohol problems 44% to 73%

Homeless people 77%

Lone mothers 46%

Aboriginal people 47%

Vulnerable young people 63%

For many people experiencing multiple disadvantages and challenges, smoking is often used as a way of coping or to have a brief “holiday from hopelessness”.[1] Smoking can play a significant role in a person’s life when it is perceived as a friend, helps to relieve boredom and helps to punctuate the day.[2]

When these factors are coupled with the powerfully addictive nature of nicotine, smoking is reinforced making it more challenging to give up. Even when a person wants to give up smoking there may be other barriers to giving up – exposure to environments where smoking is ‘normal’,[3] a lack of social support,[4],[5] unable to access or afford quit smoking support or other recreations,[6] or perhaps they simply lack confidence in their ability to quit and sometimes they are less likely to be offered help to quit by health professionals.

Find out more about Why we need the Tackling Tobacco program.

The Tackling Tobacco program: an organisation-wide approach

Overview of the program

The Tackling Tobacco program is based on an organisational change framework made up of six core elements or areas of focus for change. Together the six core elements work together as an organisation-wide approach to addressing smoking where there is a shared responsibility of smoking care, where there is a positive culture to address smoking and where smoking care is routine and part of the usual care provided by Community Services.

Leadership committed to implementing changes in the organisation.

Comprehensive smoking policies to reduce smoking related harm at multiple levels within the organisation.

Building supportive systems in the organisation, linking policies to action.

Staff training and follow up, providing tools to promote smoking care with clients and throughout the organisation.

Consistent quit support and resources for clients and staff who consider quitting

Systematic monitoring and data collection of client smoking status, to assess the impacts of the other elements.

The Tackling Tobacco program helps to identify specific areas in your organisation that can be improved over time to make genuine and effective efforts to address smoking. The program is about setting goals to implement change, not a pass or fail assessment.

A fundamental principle of implementing a Tackling Tobacco project is that it is adaptable to the needs of your organisation – every organisation, service and individual is different and the crucial point is for your organisation to start somewhere.

Working with Cancer Council NSW

To help you implement a Tackling Tobacco project Cancer Council can also offer your organisation direct step-by-step support.

A Cancer Council representative will work closely with your organisation to plan and implement each of the six elements, attending meetings and providing guidance and advice and additional resources as needed.

In addition, Cancer Council can also offer free staff training and financial assistance ($3000 project grant) to address tobacco issues and to support the organisation’s staff and clients to quit.

Contact Cancer Council directly to find out how they can support your organisation with a Tackling Tobacco project.

Where do we start?

This toolkit has been designed as a set of guidelines and tools to help your organisation to implement a Tackling Tobacco project. The Tackling Tobacco program is not necessarily a linear or sequential process; however, the toolkit discusses how to implement a project in the following order:

1. Committed Leadership

2. Comprehensive smoking policies

3. Supportive Systems

4. Training and follow-up

5. Consistent quit support

6. Systematic monitoring and data collection

The expected outcomes of undertaking a project in your organisation include:

  • direct care staff provide clients with consistent quit support
  • direct care staff are trained to provide support
  • a new or revised organisational policy on smoking
  • data collection of smoking-related information.


[1] Chapman S (2007). Falling prevalence of smoking: how low can we go? Tob Control ;16:145-7.

[2] Carter S, Borland R, Chapman S (2001). Finding the strength to kill your best friend: Smokers talk about smoking and quitting. Sydney: Australian Smoking Cessation Consortium and GlaxoSmithKline Consumer Healthcare.

[3] Coleman C (2004). ABC of smoking cessation: special groups of smokers. British Medical Journal; 328:575-7.

[4] Stewart MJ, Brosky G, Gillis A, et al (2006). Disadvantaged women and smoking. Canadian Journal of Public Health; 87:257-60.

[5] Lacey LP, Manfredi C, Balch G, et al (1993). Social support in smoking cessation among black women in Chicago public housing. Public Health Rep; 108:387-94.

[6] French P (2005). Tobacco Control and Social Equity Project: Report on Stage 1 consultations. Woolloomooloo: The Cancer Council NSW.

[1] Australian Bureau of Statistics (2013). ‘Tobacco Smoking’ in Profiles of Health, Australia, 2011-13 webpage. Available at http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4338.0~2011-13~Main%20Features~Tobacco%20smoking~10008 accessed online 25 March 2015.