 This study will test the effectiveness of an Emergency Department ED initiated tobacco intervention which includes counseling and medication. Our proposed intervention combines a Brief Negotiated Interview BNI with initiation of nicotine patch and gum in the ED, as well as a faxed referral to the states Smokers Quitline. A 6 week supply of nicotine patches and nicotine gum are provided to subjects in the intervention arm. Subjects randomized to the control arm will receive a brochure from the states Smokers Quitline only. 