Support referrals to smoking cessation programs

State Quit Services can help your patients stop their tobacco use.

Provider referrals help drive enrollment in State Quit Services programs. If health professionals used the brief tobacco intervention method each time they saw someone using tobacco or other nicotine products, we would reduce tobacco use by 20%. (1)

What will your patients experience?

Your patients will be enrolled in an evidence-based program designed to help them successfully quit smoking, vaping and other tobacco products.  Regardless of where they are in their journey to quit, these programs can help.

It’s hard to quit using tobacco. State Quit Services offers multiple methods to help patients create a plan and get support to increase their chances of success. This approach is validated by the Surgeon General’s 2020 report. (1)

All you need to do is ASK, ADVISE, and REFER. We’ll take it from there.

Support Referrals to smoking cessation progrtams

Brief tobacco intervention

ASK about all nicotine product use.


ADVISE the patient to quit.


REFER the patient to resources.

Thank you for referring your patient and/or client to 1-800-QUIT-NOW services

Fax Referral

  • Fax form to 1-800-483-3114


  • Secure and straight forward
  • NRT authorization at time of


  • Requires fax capabilities
  • Outcome reports returned by
    fax or email
  • Time to fill out form
fax machine
online application through computer

Online Referral

  • Online Provider Referral Site


  • Real-time referrals
  • Easy and secure way to refer
  • NRT authorization at time of


  • URL is external from the electronic medical record
  • Outcome reports returned by fax or email
online application through computer