Table 1.

Description of clinic and patient conditions

Randomization (level)	Condition	Description
Phase 1 (clinic)
	Ask–Advise–Connect Opt-In (AAC-In)	AAC-In consists of an EHR based point of care reminder that allows medical staff to choose when to perform Advise and Connect (i.e., the default does not require an action).
	Ask–Advise–Connect Opt-Out (AAC-Out)	AAC-Out consists of an EHR based point of care alert that requires clinic staff to Advise and Connect tobacco users to the UTQL or to “opt out” (i.e., the default requires an action; Advise and Connect or Opt Out).
Phase 2 (patient)
	Text message (TM)	Patients will receive text messages with a two-touch response that directly connects patients to the UTQL. Texts will be sent once per week for the first month and once per month for the remaining 5 months (10 texts total in 6 months).
	Continued AAC (CO)	Continued EHR intervention (i.e., AAC-In or AAC-Out). Clinic staff will perform AAC if patient returns to clinic.
Phase 3 (patient)
	Continued text message (TM-Cont)	Patients will continue to receive text messages with a two-touch response that directly connects patients to the UTQL. Texts will be sent once per month for 6 months.
	Text message + MAPS (TM + MAPS)	Patients will continue to receive text messages with a two-touch response that directly connects patients to the UTQL, plus two brief telephone calls from patient navigators/health educators trained in MAPS counseling.

EHR electronic health record, UTQL Utah Tobacco Quit Line, MAPS Motivation And Problem Solving