Adult tobacco use in the US has been declining; however, rates remain elevated among socioeconomically disadvantaged persons. Community-based primary care clinics are crucial for reducing tobacco-related disparities. Electronic referrals (eReferrals) to state tobacco Quitlines are effective for cessation, but eReferrals remain low. A critical knowledge gap exists for the implementation of Quitline referral systems to maximize reach for patients using tobacco. The objective of this project is to implement a Quitline eReferral system using two strategies and compare rates of eReferral offers/acceptances, Quitline enrollment and orders for tobacco cessation medications.