We're delighted to spotlight Carol Cramer and the Kansas Tobacco Use Prevention Program in our latest edition of NAQC Highlights: Programs and People. This series is all about celebrating the passionate individuals and innovative programs that make our Quitline community so special. Carol’s leadership and dedication are a true reflection of the spirit that drives us forward—together.

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Carol Cramer’s public health journey spans more than 25 years, beginning in Minnesota’s Bureau of Health Promotion with a dedicated focus on tobacco control. Her leadership as the state’s Tobacco Prevention Manager for fifteen years helped shape initiatives that have significantly advanced health outcomes across the state.

What drives her work forward? The answer lies in a deep commitment to improving health and quality of life. Over time, tobacco prevention efforts have led to tobacco-free environments, expanded access to treatment, and smoking rates among adults and youth that are now at historic lows.

Yet the work remains as critical as ever. With tobacco and nicotine industries persistently marketing e-cigarettes and smokeless products to attract new users, the urgency to protect public health continues to fuel advocacy, innovation, and collaboration.

Carol offered her perspective in response to several questions exploring the current landscape of the Quitline program in Kansas.

In what ways has your Quitline program evolved over the past five to ten years—whether in terms of technology, outreach strategies, client engagement, or funding—and what prompted those shifts?

Over the past decade, the Kansas Tobacco Use Prevention Program has undergone significant transformation to keep pace with evolving technologies and shifting public health needs. Originally focused on phone counseling and printed materials, the program now offers comprehensive support through web-based platforms, text messaging, and app-based services. This shift was driven by growing demand for more accessible, digital tools.

Thanks to continued support from the CDC’s Office on Smoking and Health, tobacco settlement funds, and strong partnerships, Kansas provides six weeks of free nicotine replacement therapy (NRT) and tailored counseling to diverse populations. In 2020, digital cessation services were expanded, and the Kansas Tobacco Cessation Help (KaTCH) online training for providers was launched—over 2,100 health professionals have enrolled since.



In 2023, the program began offering over 200 scholarships for Tobacco Treatment Specialist Training. In return, recipients commit to integrating web-based Quitline referrals into their organizations and facilitating peer trainings to promote system-level change.

Social media has become a key, cost-effective outreach channel, enabling broader engagement. Integration with electronic health records has further streamlined Quitline referrals within health systems.

What emerging opportunities and potential challenges do you foresee for Quitline services over the next few years, particularly in relation to Medicaid coverage, digital engagement, or population health priorities?

Emerging nicotine products like pouches and smokeless tobacco continue to challenge cessation efforts, especially among youth. The recent end of CDC’s Tips From Former Smokers campaign—a vital tool for boosting awareness and Quitline enrollment—will be difficult to replace.

Federal funding cuts threaten core program offerings such as NRT access and evaluation activities. Yet, partnerships with Medicaid Managed Care Organizations (MCOs) present a promising path forward. Kansas Medicaid contracts now include robust tobacco cessation benefits: up to four rounds of any FDA-approved NRT annually with no lifetime caps, plus individual and group counseling. These services, however, remain underutilized. Collaborative efforts are underway to increase member engagement.

Integration with chronic disease programs continues to be a strategic priority. A recent partnership with the Cancer Control Program resulted in adding lung cancer screening questions to the Quitline intake process—evidence suggests such screenings may encourage quitting.

If you could offer one piece of advice to professionals newly entering the Quitline field, what insight or lesson would you share from your experience managing a program? Recognize that you do not have to do this work alone. Tobacco control thrives on collaboration, both within states and nationally. Build connections, communicate openly, and lean into partnerships—they’re essential for sustaining impact.