This spotlight highlights the North Carolina Medicaid and public health 6|18 team accomplishments in improving the process for utilization of the state tobacco quit line; requiring Medicaid providers to implement a tobacco free campus policy, a change in policy that will particularly benefit people with behavioral health conditions; expanding access to Nicotine Replacement Therapy; implementing measures to increase tobacco cessation involving care management, screening and treatment, telehealth, provider training, and billing; and adopting a new protocol to the quit line for people with behavioral health diagnoses.