Forty-three percent of young children live in homes with at least 1 smoker.1 The exposure of children to environmental tobacco smoke is associated with increased rates of lower respiratory illness, middle ear effusion, asthma, and sudden infant death syndrome.2 Despite these morbidities, pediatricians do not routinely counsel parents in smoking cessation.3 Pediatricians have cited lack of time, lack of skills, and hesitancy to counsel or treat a parent as reasons for not counseling.4 The American Academy of Pediatrics (Elk Grove Village, Ill) has created a workshop to train pediatricians in smoking cessation counseling (SCC).5 The goal of such training is to change physician behavior; its effectiveness, however, has not been tested. The aim of this study was to assess the effectiveness of physician training in SCC.