Study Procedures
Clinician enrollment proceeded in two steps: (1) announcement of study initiation at staff meetings, with opportunity to ask questions about design and impact on workflow, and (2) a personalized email delivered to all eligible clinicians reiterating study methods and providing instructions for opting out. All eligible clinicians (N = 246) were enrolled, with none opting out when offered. Patient enrollment began with a positive tobacco use assessment at the first patient visit within the study period, termed the 