Most users of illicit drugs smoke cigarettes and those who enter treatment continue to smoke. These patients suffer predictable but devastatingly high tobacco-related mortality. Recent studies indicate that many clients are ready to quit smoking and that quitting does not threaten progress made in treatment. This article describes the prevalence of smoking among methadone clients, reviews promising interventions, and describes how programs can implement a systematic approach to smoking cessation that includes creating a cue system for identifying smokers, providing brief on-site intervention and arranging follow-up or more intensive treatment. References