Tobacco cessation interventions by healthcare providers have been shown to significantly increase cessation rates. Three surveys were conducted in 2013, 2015 and 2017 to explore the state of tobacco cessation practices and services in the Central West Tobacco Control Area Network region. Key survey findings suggest that public health and healthcare organizations increased their capacity to provide smoking cessation and integrated evidence-based cessation approaches, such as the 5As (Ask, Advise, Assess, Assist, Arrange) into daily practice. Notable increases between 2013 and 2017 include: the integration of the standardized Advise questions into the documentation system (49.3% in 2013 vs. 63.5% in 2017) and the implementation of Assist and Arrange activities such as providing free nicotine replacement therapy (75.9% in 2013 vs. 91.4% in 2017) and referrals to local cessation services (36.4% in 2013 vs. 56.5% in 2017). However, findings also point to the need to focus future efforts on addressing barriers and areas with little or no progress (e.g., the integration of the Ask and Assess questions into the documentation system – Ask: 85.5% in 2013 vs. 85.9% in 2017; Assess: 59.2% in 2013 vs. 58.9% in 2017). Such efforts have the potential to facilitate additional system-level and organizational changes and adoption of evidence-based tobacco cessation interventions.