The investigators propose a Type I hybrid effectiveness/implementation study to evaluate two population-based approaches for increasing use of Quitlines and text messaging at two VA sites. Specifically, the investigators will test the default bias, examining whether an opt-out approach to referral is more effective than an opt-in approach. The investigators will randomly assign teams to either an opt-out or opt-in approach to referring smokers to treatment. In the opt-out approach, the default is that everyone is referred to treatment unless they actively choose not to be. In the opt-in approach, people are offered treatment but must actively choose to enroll in it.
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Proportion of smokers who accept referral to treatment (Quitline or text messaging)
Timeframe: 2-year intervention period
Proportion of smokers who engage in treatment with the Quitline or text messaging service
Timeframe: 2-year intervention period
Abstinence at the end of the 2-year intervention period
Timeframe: 7-day abstinence