This study sought to examine the practices and perceptions of clinical mental health counselors in addressing smoking cessation with clients. A survey instrument was mailed to 700 clinical members of the American Mental Health Counselors Association. Of those who responded (n=330; 53.1% response rate), the majority (58.9%) had not considered asking all clients about their smoking status at every visit. Counselors reported low use of the guidelines for smoking cessation intervention and for recommending pharmacotherapy. Levels of both efficacy and outcome expectations were significantly higher among counselors who reported regular use of smoking cessation interventions. Although 86.7% of counselors reported high confidence in assisting their clients in quitting smoking, there is a dearth of professional training for this.