Aim: To evaluate changes in staff smoking rates following the implementation of , an innovative, change-management process that introduced a smoke-free workplace policy in the North Coast Area Health Service of NSW. Methods: Survey questionnaires were sent to all staff before and after the introduction of the policy. Return rates were 17.3% (690/3988) in 1999 and 25.4% (2012/7921) in 2007. Chi-square tests and multivariate logistic regression analysis were used to determine differences. Results: Staff smoking rates decreased significantly from 22.3% to 11.8% (<0.0001). Smoking rates in 1999 were not significantly different to the state population’s (22.3% and 24.1%, =0.3), but were significantly different in 2007 (11.8% and 20.1%, <0.0001). Over a quarter (27.6%) of staff who smoked when implementation began quit smoking; more than twice the rate before implementation (12%, <0.0001). Conclusion: These changes in staff smoking rates indicate the effectiveness of a comprehensive change-management approach to implementing smoke-free workplace policy.