 The primary hypothesis is that SBIRTNRT will be superior to SC in reducing self-reported and biochemically verified 7-day tobacco abstinence at 3 months. Secondary hypotheses include: 1 Patients with a tobacco related diagnosis for the ED visit will have a higher cessation rate than patients without a tobacco related diagnosis, and 2 Patients who believe their ED visit is smoking-related will have a higher quit rate than others. The investigators will conduct a cost benefit analysis of the interventions. Follow-up assessments at 1, 3 and 12 months will combine self-report with in-person carbon monoxide testing at 3 months for smokers who assert abstinence via phone. Expansions of the proposed project as compared to earlier studies include: 1 initiation of NRT during the ED visit; 2 provision of multiple forms of NRT; 3 a proactive referral made to the Quitline; 4a credible control condition with minimal baseline assessment, to avoid the assessment reactivity seen in similar ED studies; and 5 an economic analysis of the tested interventions. 