Become a QuitlineNC Referral Site

Research shows that 70% of smokers want to quit. In most cases, people who use tobacco need assistance to quit successfully. Just advising your patients to quit using tobacco during office visits increases their chances for success. Promoting smoking cessation to your patients increases their satisfaction with their visits, even among smokers not yet motivated to quit.

QuitlineNC is a frontline tool to help individuals quit tobacco and has helped thousands of North Carolinians start a tobacco-free life. It is effective, confidential and free.

Referral Options

There are two steps to begin referring patients to QuitlineNC:

1. Register your site using the QuitlineNC form
2. Start making referrals using any of the following options:

• Traditional Fax or Electronic Fax Referral 
  • How to use: Download the referral form and send completed forms via fax to 1-800-483-3114. Ensure patient consent is documented.
    • Fax referral form – English
    • Fax referral form – Spanish
  • Benefits: Works for clinics that prefer a simple and traditional way to submit referrals.
• Web Portal Referral
  • How to use: Submit referrals online at the QuitlineNC eReferral Portal. Fill out the form with patient details and submit securely. 
    • Get the Referral Guide. 
  • Benefits: Fast, easy, and paper-free, allowing real-time tracking. Patient outcome reports can be received by email or fax.
• EHR Integration (Gold Standard)
  • How to use: Refer patients directly through your EHR system (e.g., Epic) using a bi-directional (closed loop) referral. Outcome Reports populate into patient’s medical record. EHR capabilities are set up in collaboration with the QuitlineNC vendor and your IT team with a one-time interface build/cost. 
    • QuitlineNC Electronic Health Record (EHS) Integration (PDF)
  • Benefits: Integrates seamlessly into clinical workflows, reduces manual processes, supports care coordination and documentation efficiency.

What Happens After Referral? 

• Proactive Contact: QuitlineNC’s expert coaches reach out to patients within 24–72 hours. If not reached, 3-4 contact attempts are made.
• Personalized Quit Coaching: Provided through phone calls, text messages, and online chat.
• Nicotine Replacement Therapy (NRT): For eligible participants, QuitlineNC can mail between two to 12 weeks of free NRT (nicotine patches and gum or lozenges) to participants.
• Specialty Services: Participants with behavioral health conditions, pregnant individuals, American Indian, active military, and youth can receive enhanced support. 
  • Read the QuitlineNC Summary of Services (PDF)

Benefits of Being a QuitlineNC Referral Site

• Prioritizes Cessation: Facilitate the integration of cessation referrals into routine practice. 
• Outcome Reports: Track patient engagement. 
• Free Materials: Posters, brochures, wallet cards. 
• Ongoing Support: Access updates, new services, and training materials to assist patients.

Tips for Success

• Ensure patient consent is obtained before submitting referrals. 
• Train the health care team on the importance of best practice tobacco treatment. 
• Encourage staff to integrate QuitlineNC referrals into workflows. 
• Display QuitlineNC materials in waiting areas to remind patients about available support. 
• Strive for EHR referral integration to maximize care coordination and reporting. 
• For guidance on treating youth nicotine addiction. see American Academy of Pediatrics (AAP) considerations for clinicians or AAP's web based application.

Key Contact for Registration and Questions

For registration or questions about the referral process, contact Mariam.Ali@dhhs.nc.gov and for EHR information contact Kim.Bayha@dhhs.nc.gov. 

References

1. Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff (2008). A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update. A U.S. Public Health Service Report. American Journal of Preventive Medicine, 35(2), 158-176. https://doi.org/10.1016/j.amepre.2008.04.009 
2. Conroy MB, Majchrzak NE, Regan S, Silverman CB, Schneider LI, Rigotti NA. The association between patient-reported receipt of tobacco intervention at a primary care visit and smokers' satisfaction with their health care. Nicotine Tob Res. 2005 Apr;7 Suppl 1:S29-34. doi: 10.1080/14622200500078063. PMID: 16036267. https://pubmed.ncbi.nlm.nih.gov/16036267/