A great need exists for providers trained in tobacco use treatment at all levels of health care.  Currently, less than half of patients who smoke or use tobacco receive provider advice for becoming tobacco free and less than a quarter receive counseling, medication or referral to services to help them quit smoking.¹ One in five North Carolina adults continue to use tobacco (20.9%), causing one in five deaths in the state annually.² Even as overall rates of smoking have declined, rates have remained disparately high among underserved populations in North Carolina, including African Americans (24%), American Indians (36%), people with less than a high school education (32%), people with very low income (36%), and people with mental illness (36%).^2,3Training provided through a TTS Certification program has been shown to have significant impact on smoking abstinence. ⁴   Currently a number of medical institutions in other regions of the US offer TTS Certification Programs (e.g. Mayo Clinic, University of Massachusetts, Florida State University, Portland Maine), but there is no such program available in North Carolina or in any state adjacent to North Carolina. Availability of a TTS Certification Program in North Carolina would greatly increase the number of tobacco treatment specialists in our state and impact smoking abstinence rates in North Carolina.  The Duke-UNC TTS Certification Program is being constructed to meet all requirements for national accreditation under The Association for the Treatment of Tobacco Use and Dependence (ATTUD) and the Council for Tobacco Treatment Training Programs (CTTTP) see www.attudaccred.org/home. We are also partnering with NC Department of Health and Human Services (DHHS) to ensure that we meet the needs of medical institutions and smokers, especially underserved populations, teens, pregnant women and other vulnerable populations as per DHHS mission for these groups.