Center for Health Systems Improvement for a Tobacco-Free New York

This CAI project helps health systems in New York State ensure that every clinical encounter includes routine assessment and evidence-based treatment of tobacco use.

New York State has made significant progress in reducing smoking rates, addressing tobacco use dependence, and promoting tobacco cessation. However, more than two million adults and 35,000 high school students in New York State still smoke, and tobacco addiction remains the leading preventable cause of death. An estimated 70 percent of current smokers want to quit and more than 50 percent attempt each year, but only 20 percent of attempts use evidence-based treatment methods. To improve the diagnosis of tobacco use disorder, treatment experts are moving toward a behavioral health–based “recovery” framework that focuses on addressing tobacco use as an addiction.

The initiative

As the Center for Health Systems Improvement, CAI serves as a resource hub to help organizations implement changes in health care systems. Through a range of capacity-building activities, including trainings, webinars, resource packets, and media campaigns, CAI supports organizations in their efforts to facilitate statewide and regional health systems changes in mental health and medical settings, specifically focusing on the promotion of evidence-based treatment services for tobacco use disorder. CAI provides trainings and technical assistance to the state’s Health Systems Improvement grantees. Additionally, CAI manages and facilitates statewide workgroups that address tobacco use treatment.

The impact

CAI has engaged more than 40 community stakeholders to provide leadership, plan, implement, and evaluate activities to address tobacco-related disparities. These stakeholders include the Erie County Department of Health, the Buffalo Public Schools and teachers’ union, community-based organizations, health and behavioral service providers, faith-based, cultural, and business leaders, housing authorities, families, and youth. CAI has developed and administered a needs assessment and disseminated tobacco treatment tools and resources. In the coming years, CAI will assemble a statewide stakeholder workgroup, as well as regional tobacco and health equity coalitions, to promote tobacco policy change.

View a map of regional contractors (1 MB PDF).

Project funder and key partners

Funder: The New York State Department of Health Bureau of Tobacco Control.

Partners: The New York City Department of Health and Mental Hygiene (NYC DOHMH), as well as key health systems and organizations in New York: North Country Healthy Heart Network, St. Peter’s Health Partners, American Lung Association, New York University, Northwell Health, St. Joseph’s Health, University of Rochester, HRI/Roswell Park-Health Systems for a Tobacco-Free Western NY, New York City Health and Hospitals, Center for Practice Innovation, Smoke-free NYC-Public Health Solutions, and Community Healthcare Association of New York State.

Leadership and contact

David Davis, Director of Tobacco Control Health Initiatives, Makeda James, Project Director Health Systems Improvement.


These resources provide overall guidance on best practices for the integration of tobacco dependence treatment into every patient visit and the current state of systems-level work to promote the universal provision of evidence-based cessation services within health care organizations.

December 2023: "Getting Beyond No: Engaging Pre-contemplative Tobacco Users with Behavioral Health Conditions"

Download webinar slides (7 MB PDF)

Center for Health Systems Improvement Community of Practice for Practice (CoP) Facilitation Training Modules: 14 interactive training modules that are based on the Agency for Healthcare Research and Quality Primary Care Practice Facilitation Curriculum. The modules, each 30-45 minutes long, teach the people and technical skills, facilitators need to excel and provide opportunities to practice skills. They include videos of experienced practice facilitators who share insights and helpful hints.