Elkhart, Indiana, has a regional population of approximately 150,000 people. The area has a long tradition of manufacturing in the recreational vehicle industry and in freight, shipping more primary metals than any other municipality in the United States [1]. This strong manufacturing base was hard hit during the economic downturn of 2008, leaving a large unemployed population in its wake. Elkhart County's population of smokers is among the state's highest at 23.4% (Indiana's rate is 17%) [2]. Data from the Elkhart General Hospital Cancer Registry over the past 10 years show that 50% of lung cancers diagnosed in the area were diagnosed at stage IV, higher than the national average of 50% of lung cancers diagnosed at stage III or stage IV [3]. In 2011, the Elkhart County Community Health Assessment identified smoking as a significant health concern affecting local residents. When compared with other screening programs, a lung cancer screening program compares favorably (with estimates of cost <$19,000 per life saved) with the costs of breast cancer screening mammography ($31,000–$51,000 per life saved) and colorectal screening with colonoscopy ($19,000–$29,000 per life saved) [4]. These assessments prompted the staff, physicians, and administrators at Elkhart General Hospital to develop a comprehensive lung cancer screening and smoking cessation program.