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The overarching purpose of this study was to explore the implementation of an innovation in the North American quitline network using qualitative data and a systems approach. The innovation chosen to explore in more depth was evaluating effectiveness of the tobacco cessation quitlines. The three research questions guiding the study were 1) What are the factors influencing implementation of the innovation, 2) How do system structure and dynamics impact implementation of the innovation, and 3) What strategies can be used to achieve successful implementation of the innovation. To answer the research questions, 19 semi-structured interviews were conducted with decision-makers in the quitline network. The interview data were analyzed using a thematic analysis technique and a systems change framework from the literature. The findings suggest that there were a broad range of factors influencing implementation of the innovation at multiple levels of the system. The findings also provide insights into how differences in quitline structure and system dynamics influenced implementation of the innovation. Lastly, these findings were used to identify potential strategies and provide recommendations to improve future implementation efforts in the quitline network.