Bringing smoking cessation support to where people already are

About Bill Crews Foundation

The Rev. Bill Crews Foundation is a homelessness drop-in centre in Sydney, supporting people experiencing homelessness, insecure housing, social isolation, and complex health needs. A large proportion of the community they work with smoke daily. Many also experience co-occurring mental health challenges, alcohol and other drug use, and chronic stress related to housing instability. Smoking is highly visible within the community Bill Crews Foundation support and is often closely linked with trauma, stress and other health challenges clients face.

Understanding the challenge

Before implementing Tackling Tobacco, smoking cessation support was limited and inconsistent at Bill Crews Foundation. Many clients faced high levels of nicotine dependence and competing priorities such as food, housing and safety. Staff were often cautious about raising smoking with clients due to concerns about damaging rapport. Smoking was commonly discussed informally rather than as part of a structured health intervention.

Bill Crews Foundation were motivated to take part in the Tackling Tobacco program because they recognised a clear gap in equitable access to smoking cessation supports for their clients experiencing homelessness. Tackling Tobacco stood out to them because it offered structured support, resources, and training that could be embedded within a drop-in homelessness service setting.

An innovative, low barrier approach to quit support

To make smoking cessation support more accessible, Bill Crews Foundation established a weekly Tackling Tobacco pop-up in its community hall. The idea was simple: bring quit support directly to a central and safe place where clients were already spending time. Many clients who regularly accessed the community hall for meals, social connection and practical support were less likely to engage with medical or social work services. This was largely due to previous negative experiences with health systems or concerns about stigma.

The pop-up was intentionally designed to be informal and easy to access, making it a strong fit for Bill Crews Foundation’s drop-in model. It was held after breakfast when attendance in the community hall was highest, ensuring maximum visibility and engagement. Familiar staff members were available to have conversations about smoking, provide brief advice, answer questions and offer free nicotine replacement therapy (NRT) in a welcoming, non-judgemental environment. Cancer Council NSW resources were used to support discussions and provide clear, evidence-based information about quitting in a way that was easy for clients to understand. Clients who missed the weekly pop-up were encouraged to speak with staff outside the scheduled session, ensuring support remained available when people were ready to engage.

“The pop-up helped normalise discussions about smoking and quitting within the service, shifting it from an occasional or sensitive topic to a routine part of health and wellbeing conversations.”

Helen Kearney, Tackling Tobacco Champion

Staff also became more confident raising smoking cessation opportunistically in other settings across the drop-in centre. This reinforced consistent messaging across the drop-in centre and made quit support feel more accessible, and achievable for clients.

Free NRT as a pathway to broader support

Providing on-the-spot support through the Tackling Tobacco pop-up had a significant impact on client engagement and readiness to consider quitting smoking. For many of Bill Crews Foundation’s clients, cost and access had previously been major barriers to make a quit attempt. Providing immediate access to free NRT through the pop-up helped turn conversations about quitting into practical action. Clients were more willing to make quit attempts when the support was tailored to their circumstances.

The pop-up also created clear pathways into ongoing support, particularly through strengthened connections with the alcohol and other drug (AOD) clinicians. As part of the pop-up approach, Bill Crews Foundation incorporated routine data collection about other AOD use, which enabled staff to identify additional support needs and make direct referrals for clients where more comprehensive support was needed. This integration meant that clients were linked into both AOD and smoking cessation supports in a coordinated way rather than in isolation.

“Smoking cessation conversations often became an entry point into broader holistic care.“

Helen Kearney, Tackling Tobacco Champion

Since implementing the broader Tackling Tobacco program, smoking is more routinely addressed as part of everyday practice, and clients are increasingly seeking support, advice and NRT. Notably, some clients have reduced or successfully quit smoking as a result of the increased accessibility and consistency of support within the drop-in centre.

Embedding smoking cessation into holistic care

Through Tackling Tobacco, smoking cessation has become a more visible and routine part of service delivery, with staff better equipped to initiate conversations and connect clients with practical support when they are ready.

Looking ahead, Bill Crews Foundation hopes to build on this momentum by ensuring smoking cessation remains integrated into everyday practice, rather than being treated as a standalone intervention. For clients, this means continued access to free NRT, stronger connections to AOD and other health services, and more opportunities to reduce or quit smoking in ways that are flexible and tailored to their individual circumstances.

Bill Crews Foundation’s advice to other homelessness and community services is to start with accessibility. By bringing support into trusted spaces, reducing barriers such as cost and stigma, and equipping staff to have supportive conversations, even small interventions can create meaningful change.