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BACKGROUND Proactive, population health cessation programs can guide efforts to reach smokers outside of the clinic to encourage quit attempts and treatment use. This study aimed to measure trial feasibility and preliminary effects of a proactive intervention offering text messages and/or mailed nicotine replacement therapy (NRT) to smokers in primary care clinics. METHODS From 2017-2019 we performed a pilot randomized trial comparing brief telephone advice (control BA), text messages (TM), 2-weeks of mailed NRT, or both interventions (