Key Points: Community readiness and social norm changes are important issues to consider when delivering cessations services to underserved/overburdened populations.

Learning Objectives: Importance of including social context of clients in the design, delivery, and evaluation of cessation services.

Benefits: Seasoned cessation service providers/researchers will present examples of multiple service delivery methods they have designed for working with diverse underserved communities.

Due to their expense, labor intensiveness, and low return on investment, direct cessation services have been relegated to low or no priority in many states/foundations comprehensive tobacco control plans. With programmatic emphasis put on policy change, prevention, youth access, and quit lines, direct cessation services and research have historically been under-funded. While, in past years, more affluent communities accessed cessation services through voluntary organizations and/or medical insurance, overburdened communities, with the highest rates of health disparities, went largely underserved. As many states and foundations shift to increase funding for direct cessation services and research, many providers are grappling with a multitude of service delivery/implementation issues.

Even when programs are designed and delivered using best practices and community involvement, the delivery of successful cessation services to underserved populations remains difficult and requires great flexibility and resourcefulness. Most lessons learned are hard won.