ABSTRACT Cigarette smoking is the leading cause of death accounting for more than 480000 deaths each year and 16million Americans suffer from one or more diseases caused by smoking. Cessation can significantly reduce therisk of disease even for those who have smoked for decades. Interventions using a combination of behavioralapproaches that focus on maintaining smokers' motivation to quit providing specific techniques for quitting andrelapse prevention and using Nicotine Replacement Therapy (NRT) are effective at helping tobacco users quit.However standard behavioral treatment may not appeal to or be effective for some smokers and novelapproaches are needed to assist these individuals. Guided Imagery (GI) is a form of mind-body therapy thatinvolves controlled multi-sensory visualization of specific mental images. GI is an effective therapeutic tool tochange behaviors including tobacco use. Multiple studies have shown that exposure to GI results in significantlyincreased abstinence rates compared to controls or those taking bupropion. A large proportion of the U.S.population uses integrative health approaches. A GI tobacco cessation intervention could appeal to smokers notinterested in using a behavioral approach. Although GI is an effective tool for smoking cessation the mode ofdelivery has generally been in person limiting dissemination to large populations. Systematic and meta-analyticreviews have shown that telephone quitlines are a highly scalable way to help individuals quit smoking. Quitlinesare available in all 50 U.S. states Puerto Rico and Guam. The proposed project is highly responsive to PAR-20-154 by delivering a GI intervention via telephone which is highly scalable and could greatly increase the reachand accessibility of an effective GI smoking cessation intervention. We recently completed a randomizedfeasibility trial of the Be Smoke Free program. Although not powered to determine efficacy the interventionshowed promise in helping participants to quit and showed high consumer satisfaction. We developedprocedures for recruiting participants and surpassed our recruitment goals. We had >90% retention at 8-weeksand >80% at 6-months. We also found high levels of adherence. The results of this randomized feasibility studyindicate that a fully powered study of a GI tobacco cessation intervention delivered via telephone is warranted.Therefore the objective of this R01 application is to conduct a randomized controlled trial to test theefficacy of the Be Smoke Free telephone-based GI intervention (IC) for smoking cessation compared toactive behavioral control (CC). The study will recruit 1200 diverse smokers from three states Arizona NewYork and West Virginia to increase generalizability. Participants will be randomly assigned to receive either theIC or CC delivered by telephone by University of Arizona study coaches and will be assessed at 3- and 6-monthspost-enrollment by study staff. The primary outcome is biochemically verified 7-day point prevalence abstinenceat 6 months. This innovative and rigorously designed project conducted by an experienced team has the potentialto improve public health through the delivery of an innovative integrative GI intervention via telephone.