“…Smoking was high in this sample (17% vs. 13.7% nationally), 31 suggesting the need for concentrated outreach and engagement for tobacco cessation and lung cancer screening in the cancer center catchment area. The success of such programs will be influenced by purposeful and specific community, local clinic, and cancer center relationships 32 and acknowledgment and understanding of relevant historical and contemporary factors related to tobacco production, marketing, sales, and use in Virginia. As such, continued use of community‐based approaches to program development, implementation, and evaluation are recommended.…”