Building Capacity to Increase Commercial Tobacco Cessation - Component 2 - Healthcare systems play a significant role in promoting tobacco cessation. According to the Centers for Disease Control and Prevention (CDC), 80% of people who use tobacco see a physician each year. However, in 2015, CDC reported that less than three in five smokers received advice to quit from a health professional. Because of this, the 2008 Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence, CDC’s 2014 Best Practices for Comprehensive Tobacco Control Programs, and the Million® Hearts’ Tobacco Cessation Change Package all recommend that state Tobacco Control Programs (TCP) promote health systems change for tobacco prevention and control. The National Association of Chronic Disease Directors (NACDD) seeks to promote and support the implementation of health systems change initiatives that integrate tobacco dependence treatment into routine care across clinical settings through training and technical assistance (TTA) for state Tobacco Control Programs (TCP) with funding from CDC-RFA-24-0056 Component 2, Building Capacity to Increase Commercial Tobacco Cessation. Activities described in this proposal focus on prioritizing interventions that reach population groups disproportionately impacted by tobacco use and cessation-related disparities. NACDD will leverage more than 35 years of experience in chronic disease prevention/management and health promotion initiatives, including expertise in community-integrated health, health systems change, and clinical care transformation, to deliver TTA to state TCPs and their health system partners. The strategies and activities of the project include: 1) Identifying and cataloging relevant health systems change competencies for the TCP workforce in a Key Competency Resource Inventory; 2) Assessing the knowledge, skills, and abilities of the TCP workforce related to the identified competencies by implementing a TCP Workforce Knowledge and Capacity Assessment that includes Listening Sessions and Key Informant Interviews; 3) Developing, promoting, and delivering an annual National TTA Action Plan that provides broad, relevant TTA to TCPs and their health system partners, and provides specialized, extensive TTA to up to 20 TCPs and their health system partners through four annual State TCP Health Equity Learning Collaboratives; 4) Developing and utilizing mechanisms to facilitate learning, and document and share information and knowledge, including best and promising practices, experiences, and lessons learned, through a National Dissemination Plan, Tobacco Cessation Health Systems Resource Hub, and a Tobacco Cessation Health Systems Playbook; and 5) Developing and implementing a project evaluation and performance plan that effectively evaluates the TTA provided to TCPs and their health system partners, assesses progress toward achievement of outcomes, and ensures continuous quality improvement. NACDD and its proposed partners for this work – the American Academy of Family Physicians, North American Quitline Consortium, and AllianceChicago – have in-depth knowledge of the science of tobacco addiction and cessation and effective tobacco cessation interventions and treatments, as well as specific knowledge and understanding related to promoting and supporting the implementation of health systems change initiatives that seek to integrate tobacco dependence treatment into routine clinical care across clinical settings. As such, NACDD is uniquely positioned to support and develop the TCP workforce to increase the application of approaches that promote and support cessation within health systems.