The goal of this study is to test, in combination with the nicotine patch, the incremental efficacy of a motivationally tailored behavioral intervention over a minimal intervention. The interventions will be delivered through primary care medical clinics. The defined population comprises low income, less educated smokers who will vary in their level of motivation to quit smoking. Patients will be randomly assigned within clinics to one of two interventions (a) Nicotine patch prescription plus brief physician advice (minimal care); and (b) Nicotine patch prescription plus brief physician advice, with the addition of a tailored motivational intervention, a behavioral skills counseling session for smoking cessation.

Inclusion Criteria:

• 18 years of age or older
• Currently smoking at least 10 cigarettes/day for past 3 months
• Speak English or Spanish
• Have a telephone or live close to a relative or neighbor with a telephone
• Agree to participate in the study and be available over the next 6 months.

Exclusion Criteria:

• Unable to use nicotine patch due to medical status
• Active skin condition or history of skin allergy
• Currently using smokeless tobacco, nicotine replacement or other smoking cessation treatment
• Pregnant or nursing