This E-Team developed a comprehensive tobacco cessation program that can be used by doctors and nurses in everyday primary health care situations. At the moment doctors typically spend little time trying to convince patients that smoke to quit due to constraints on time and the lack of an efficient, effective cessation program tailored to the clinical setting. The team’s program is an adaptation of one they developed and successfully implemented at Case Western, called the “Off (Officially free from) Nicotine” program. The Off program includes four weekly group sessions for smokers that focus on 1) self-assessment; 2) a personal strategic plan for quitting; 3) the cessation session; and 4) relapse prevention. This project allowed for adaptation of the support group format into shorter, individual counseling sessions run by doctors and nurses during regular office visits. Specifically, the team’s program includes: a workbook for smokers, with contents based around the smoker’s cessation strategy; the employment of a five-step cognitive restructuring procedure, based on a successful four-step procedure used to change behavior in Obsessive Compulsive Disease patients; relaxation techniques involving self-hand and self-ear massage to diminish symptoms of withdrawal; the use of Exhaled Carbon Monoxide (Ex CO) monitors to measure the level of one of the toxic agents in tobacco smoke present in the smoker’s body, and to track their progress; and lastly, the development of technology to allow for palmtop/tablet audio administration of the smoker’s clinical information, which results in an automatically generated report available to the physician before he enters the room.