Integrating smoking care in community welfare agencies to reach disadvantaged people: Findings from the Smoking Matters Project.

ISSUE ADDRESSED: smoking rates among very disadvantaged populations groups are much higher than for the general Australian population. Smoking makes a significant contribution to the reduced health and material well-being experienced by these groups. Community service organisations have been suggested as a promising setting to provide smoking cessation support for disadvantaged people, but few initiatives have explored the feasibility of this strategy.
METHODS: the project involved work with five non-government community service organisations as demonstration sites for the integration of smoking care. Sites were offered staff training, smoking-care resources and policy support to address tobacco in the service environment and in their work with clients. Pre-and post-training surveys were undertaken with training participants and a follow-up survey was conducted after three months. Survey questions assessed staff members' confidence, knowledge and skills to address smoking, as well as changes in staff practice.
RESULTS: the response rate for the surveys before and after the training sessions was almost 100%, with 63 of the 64 participants providing post-training surveys. The response rate of the three-month follow-up survey was approximately 50% with 34 respondents. Findings indicate that staff did develop confidence, skills and knowledge to address tobacco issues. Some organisations made changes to policy, such as introducing designated smoking areas and providing financial support for clients and staff to quit smoking. Practice change was evident among some staff, particularly in addressing smoking as part of routine case management and use of the 5A's brief intervention framework.
CONCLUSIONS: the project findings lend support to the view that community service organisations could play a role in providing smoking care to disadvantaged people.