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Physicians have frequent opportunities to intervene with their smoking patients as approximately 70% of smokers see a physician each year.1 Even brief counselling by a physician significantly improves the rate of smoking cessation according to meta-analyses performed by the Tobacco Use and Dependence Guideline Panel and summarised as “ask, advise, assist, and arrange follow-up” in the Agency for Health Care Policy and Research (AHCPR) guidelines.2 Despite these evidence based recommendations, physicians identify only about half of current smokers, advise less than half, and assist and arrange follow up with a small minority.3 There are several explanations for this disparity between physicians' knowledge and their actual behaviour including inadequate training, …