Most smokers want to quit smoking but try to stop without using tobacco cessation treatment. Because abundant evidence supports the efficacy of behavioral, pharmacologic, and combination treatment for tobacco dependence, it is important to increase the proportion of smokers who take advantage of therapy. Evidence confirms that current tobacco treatment models that rely on the patient or clinician to initiate treatment fail to reach all smokers interested in quitting. Proactive outreach strategies are increasingly being evaluated as a systematic approach to engage “hard-to-reach” smokers to increase the use of evidence-based tobacco treatments.