This outlines a project by the North American Quitline Consortium (NAQC) to enhance electronic referral (eReferral) capacity for state quitlines, moving from pilot projects to institutionalized practices. The 18-month project, involving four state teams, progressed through four phases: foundation, capacity building, demonstration, and dissemination. Initial outcomes included strengthened partnerships, established technical expertise, improved physician access to quitline referrals, and increased data availability. The project highlighted the need to address the complexities and costs associated with scaling up eReferral, especially regarding maintenance and expansion to new healthcare organizations, prompting the NAQC eReferral Workgroup to investigate best practices and resources for cost-effective scaling.