The Wisconsin Medicaid Program, which purchases health care for Wisconsin's low income residents, has entered into a number of partnerships designed to systematically address tobacco use by Medicaid recipients. With the help of Wisconsin HMOs, a chart audit established an overall tobacco use prevalence of 45.7%, about double that of the general population. A direct survey of Medicaid recipients confirmed a rate of 45.0%. The chart audit also revealed a dramatic under-utilization of currently available Medicaid smoking cessation benefits. Plans are now being made to increase this utilization on a statewide basis. In addition, a partnership with the Wisconsin Women's Health Foundation and the Bureau of Family and Community Health Program within the Division of Public Health has resulted in a pilot project to address tobacco use by low income, pregnant women. Finally, a partnership with a specialized HMO serving those with disabilities and the Mental Health Association in Milwaukee County plans to address tobacco use by those with chronic and persistent mental illness.