Treatment is more likely to be offered and used if integrated into healthcare systems, including a system to identify smokers or tobacco users.

To date, few countries have implemented smoking cessation and treatment programs for smokers as part of their health care systems.
There is some evidence that institutional changes such as training, pharmaceutical availability, and stickers to identify smokers increased the amount of time physicians spent intervening with smokers and increased the likelihood of successful cessation (US Department of Health and Human Services, 2000). Fiore (1991) proposed making assessment of tobacco use a "new vital sign" and showed that this increased the proportion of patients reporting being asked and counseled about smoking cessation (e.g. Fiore et al., 1995). While the use of such a vital signs stamp on patient charts has been shown to increase identification of smokers (Piper et al 2003), it may not be sufficient in itself to increase the frequency of physician intervention with their patients who smoke. More recent developments include the success of automated (electronic) clinical reminder systems such as the Tobacco Use Cessation (TUC) Automated Clinical Practice Guideline (ACPG), a variation of the US Department of Health and Human Services Clinical Practice Guideline on Treating Tobacco Use and Dependence (eg Szpunar et al, 2006).
In England, following the publication of a government policy paper in 1998, smoking cessation services were made available to all smokers motivated to make a quit attempt on the National Health Service in 2000/2001. Between April 2006 and March 2007, nearly 600,000 people set a quit date through these services. At the four-week follow up, just over half (53%) of these reported successfully stopping smoking (ONS 2007).
In developing nations, integration of tobacco cessation services into existing programs such as those for tuberculosis, HIV/AIDS, maternity care, etc. seems more likely to reach persons who smoke than specialist clinics devoted to smoking cessation (Jha et al 2000).

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