Housing evidence / case study · working draft
ASSIST: treatment in a hostel clinic
Specialist treatment came to a hostel clinic, revealing practical barriers to attending counselling.
01 / THE APPROACH
What was tried
ASSIST brought intensive treatment to a health clinic inside a Sydney homelessness hostel. Twenty men received varenicline, combination nicotine replacement and motivational interviewing over twelve weeks.
The plan included weekly counselling and fortnightly safety check-ins. Participants set a target quit date one week after starting. By locating care in a service they already attended, the project sought to make treatment easier to access while monitoring whether the combination was acceptable and manageable.
02 / THE FINDINGS
What was learned
Thirteen of twenty men were followed up at twelve weeks. Three reported continuous abstinence; two had breath-test-confirmed thirty-day abstinence. The ten followed-up participants who had not quit reported reducing average daily cigarettes from 19.4 to 4.7.
Medication use was relatively good, but participants attended about three of twelve planned counselling sessions. This contrast is useful: bringing care close does not make every appointment manageable. The small, uncontrolled study cannot establish a treatment effect.
03 / TRANSFER TO WALES
What Wales could learn
A hostel clinic made specialist medication and counselling available in a place participants already used. Delivery still required clinical staff, safety monitoring and repeated appointments.
Low counselling attendance showed that proximity alone did not make the planned schedule manageable. The case is useful for considering flexible contact, alongside its very small sample.
Sources & review
ASSIST pilot feasibility study. Addictive Behaviors 2022;124:107074. DOI 10.1016/j.addbeh.2021.107074.
