Smoking-Cessation Services in Iowa Community Pharmacies Mary L. Aquilino, Ph.D., F.N.P., Karen B. Farris, Ph.D., Alan J. Zillich, Pharm.D., and John B. Lowe, Ph.D., FAHPA, FAAHB Study Objective. To examine community pharmacy practice with regard to providing smoking-cessation counseling. Design. Mailed survey. Setting. Iowa community pharmacies. Participants. A stratified random sample of pharmacists statewide. Measurements and Main Results. Descriptive statistics were computed for all study variables. Fisher exact test or  2 analysis was performed on selected variables to determine the relationship of each item with pharmacists routinely offering smokers suggestions for quitting. Responses from 129 (38.2%) of 338 pharmacists indicated that although most felt it is important to offer smoking-cessation counseling, about half actually offer this service. Most pharmacists indicated they are prepared to provide counseling, but fewer than 25% had received formal training or were aware of national clinical practice guidelines. Those who had received specific training (p=0.020) or recently attended an educational program (p=0.014) on smoking cessation were more likely to counsel smokers. Primary barriers to providing counseling were lack of time, inability to identify smokers, low patient demand, and lack of reimbursement. Conclusion. Our findings suggest that opportunities exist for improving pharmacist education and reducing practice barriers in order to bridge the gap between pharmacists’ knowledge and attitudes related to smoking- cessation counseling and their provision of patient counseling in community pharmacy practice. (Pharmacotherapy 2003;23(5):666–673) Cigarette smoking, the leading cause of preventable morbidity and mortality in the United States, poses significant health risks and economic burden to individuals and society. 1 Twenty-three percent of adults aged 18 years or older smoke cigarettes. 1 Over 400,000 adults die from tobacco-related diseases each year. 1 Smoking affects not only the tobacco user, but also those near the smoker, such as family, friends, coworkers, and unborn children. National expenditures attributable to cigarette smoking surpass $75 billion in medical costs plus $80 billion in indirect costs. 2 Seventy percent of smokers have made at least one quit attempt, yet only about 2% successfully quit each year, and relapse is common. 1 Minimal intervention with patients who smoke, as simple as advising them to quit, can result in quit rates From the Department of Community and Behavioral Health, College of Public Health (Drs. Aquilino and Lowe); the Division of Clinical and Administrative Pharmacy, College of Pharmacy (Drs. Farris and Zillich); and the Department of Family Medicine, Carver College of Medicine (Dr. Zillich), University of Iowa, Iowa City, Iowa. Supported by a grant (CFDA no. 93.283) from the Centers for Disease Control and Prevention through the Iowa Department of Public Health (award no. 5882TP13). Presented in part at the 130th annual meeting of the American Public Health Association, Philadelphia, Pennsylvania, November 13, 2002. Address reprint requests to Mary L. Aquilino, Ph.D., R.N., F.N.P., Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242.