When Cancer Council NSW set out to reduce smoking rates two decades ago, the team asked a question that would reshape everything: who is tobacco impacting the most and how can we help reduce smoking rates for these groups?
What started as a single research study in 2004 has grown, helping thousands along the way. The Tackling Tobacco program has spent 20 years proving that quitting smoking is possible - even for those facing the greatest disadvantage.
2004: The research that changed the conversation
It started with a study. In 2004, Cancer Council NSW commissioned research into the economic impact of reducing smoking in NSW - and what it found was striking.
Not only did lower smoking rates have economic benefits, but the most disadvantaged households stood to gain the most from quitting.
This finding reframed tobacco as not just a public health issue, but a social justice issue for Cancer Council.
The communities bearing the greatest burden of smoking-related illness were the same communities facing housing stress, mental health challenges, unemployment and other forms of disadvantage.
If Cancer Council NSW was serious about health equity, it needed to go where those people were.
2006: A new program and a question that sparked change
In 2006, Cancer Council NSW launched the Tackling Tobacco program with the aim to reduce inequities and health risks associated with tobacco use. By providing training and support directly to social and community service organisations, the issue was approached from a different angle.
Rather than targeting people who smoke directly, Tackling Tobacco would build the capacity of frontline workers to ask the question: "Have you thought about quitting?"
2010: Evidence, research and positive results
The program's first published research (published in the Health Promotion Journal of Australia in 2010) confirmed it was working.
After years of building capacity across community service organisations - from mental health and homelessness to youth and drug and alcohol services - the program's impact continued to grow.
2011: Real people, real stories
By 2011, the program had its first powerful proof point: the Ask the Question campaign.
Six people supported by community services - Ace, Gaye, Vic, Graeme, Gary, Janet and Len - shared their quitting journeys. They were living proof that change was possible.
2013-2018: Building the evidence base
Tackling Tobacco was never content to simply deliver the program - it wanted to prove it worked, especially in the settings with the greatest need.
From 2013, Cancer Council NSW co-founded the Tackling Nicotine Together trial in partnership with the University of Newcastle's School of Medicine and Public Health.
This landmark study involved 500 drug and alcohol sector staff and over 900 drug and alcohol clients across 32 drug and alcohol treatment centres in four states.
The results were compelling: clients smoked fewer cigarettes per day, staff became more confident offering quit support, and addressing smoking became an accepted part of treatment.
Then came Call it Quits in 2018, a research trial with 431 people who smoke who were experiencing socioeconomic disadvantaged. While abstinence rates were modest, participants made significantly more quit attempts and smoked fewer cigarettes.
2016-2019: Collaborating with Aboriginal Communities
In partnership with the Aboriginal Health & Medical Research Council, Cancer Council NSW developed the Tackling Tobacco in Aboriginal Communities Initiative.
2019: A breakthrough for mental health services
A randomised controlled trial across 26 community mental health organisations - reaching 194 staff and 257 consumers - delivered some of the program's strongest results yet.
Consumers who received the Tackling Tobacco intervention were more likely to be offered nicotine replacement therapy, use it, and reduce their nicotine dependence.
The findings laid the foundation for the Tackling Tobacco Summit and the development of the Tackling Tobacco in Mental Health Action Plan.
2021: Supporting more people to quit smoking across Australia
Fifteen years into the program marked a turning point.
Cancer Council ACT as a federation partner licensed the Tackling Tobacco program, followed by Cancer Council SA. Then, in 2024, Cancer Council WA joined the family.
What began as a Cancer Council NSW initiative was now reaching more people across Australia.
2023: A formal commitment to change
In a significant milestone for the program, Cancer Council NSW and the NSW Ministry of Health signed a five-year Statement of Collaboration to drive the implementation of the Tackling Tobacco in Mental Health Action Plan.
A dedicated Steering Committee - bringing together community mental health organisations, peak bodies, local health districts and government stakeholders - was reconvened to review and refresh the Action Plan, ensuring it remained practical and relevant for the sector over the years ahead.
2025: Award-winning and still growing
In February 2025, findings from the Tackling Tobacco in Mental Health randomised controlled trial were published in the journal Addiction, confirming the program increases staff's offers of nicotine replacement therapy and consumers' likelihood of using it.
In November 2025, Tackling Tobacco received the Outstanding Partnerships and Collaboration Award at the Equally Well Conference in Adelaide - recognition of two decades of genuine collaboration between Cancer Council, NSW Ministry of Health, researchers, community services and, most importantly, the people those services support.
Looking back, looking forward
Twenty years ago, a research study sparked an idea about how to tackle smoking rates in disadvantaged parts of our community.
Today, Tackling Tobacco continues that mission - supporting people to quit smoking, live healthier lives and reduce their cancer risk. Find out how the Tackling Tobacco program is making a difference - and how evidence-based support is helping people quit smoking for good. "The success of the Tackling Tobacco program shows that with the right resources and support, [CMOs] are in a great position to help people quit smoking. Their long-term, trusted relationships with clients allow them to address smoking alongside other needs and connect clients with clinical support when needed." – Dr Laura Twyman, Program Lead Tobacco Cessation, Cancer Council NSW.
