With new Medicare guidelines now in place, more than 4 million smokers age 55+ are likely to be eligible for lung cancer screening. Yet little is known about how best to deliver smoking cessation treatment in the context of lung cancer screening. This multi-site randomized trial tests the effectiveness of a digital (Internet and text message) cessation intervention–alone and in combination with smoking cessation treatment by a Tobacco Treatment Specialist counselor–compared to an Ask-Advise-Refer usual care control condition. Participants will be 1,650 patients who present for lung cancer screening at Mayo Clinic. The study is designed to answer key questions of importance to decision makers, including the potential for adoption of a combined digital-clinical smoking cessation treatment approach in lung cancer screening clinics.