Smoking and other tobacco exposure have been recognized for several decades as the most significant preventable factors in premature morbidity and mortality. Most physicians believe they should address the issue of tobacco intake with their patients but are rarely provided with adequate training or support to do so effectively. Recent research identifies several ways in which physicians can have substantial impact on patient smoking rates, by use of very brief patient-centered counseling and by prescribing nicotine replacement therapies. This paper describes a model curriculum for medical students, residents, medical faculty and community physicians that can be integrated into current training and teaching practices. The goal is to create a "preventive" intervention perspective to smoking that is effective, practical, efficacious and cost-effective.