Kentucky continues to report the highest adult smoking rates in the nation, and this persistent public health problem leads to substantial morbidity, mortality, and economic costs for the state. Given that physician intervention has been shown to increase cessation rates, the Kentucky Cancer Program developed a self-study continuing education program for physicians to promote the implementation of effective tobacco cessation treatment strategies. As a preliminary component, a pre-program survey was administered to participants to measure current knowledge, attitudes, and practices regarding the treatment of tobacco use and dependence. Results from this survey offered an opportunity to describe and analyze the areas in which physicians were utilizing tobacco cessation treatment approaches consistent with clinical practice guidelines as well as areas in which further training and resources were needed to improve clinical tobacco cessation treatment practices. Overall, physicians accepted their primary role in tobacco cessation treatment and acknowledged a moderate level of comfort with this role. They also reported implementing several of the recommended "5 A's" from the Treating Tobacco Use and Dependence: Clinical Practice Guideline. Further examination of the data, however, revealed that knowledge, attitudes, and practices were weaker regarding specific, formal, and systematic implementation of tobacco cessation treatment. Effective training and resources would provide physicians with the tools necessary to intervene with tobacco users more consistently and to reduce the health and economic burden of tobacco use and dependence in Kentucky.