This article explores reasons for social work's minimal involvement in the development of programs and policies related to smoking cessation and proposes how social workers can engage in a range of micro, mezzo, and macro activities. The extensive literature on the harmful effects of smoking is reviewed, and a rationale for social work involvement is presented, namely, that the profession focus on those populations that are already vulnerable and among whom smoking rates are rising, including poor people, less-educated people, young women, aboriginal people, and some visible minorities. Whereas other health professions have been declarative about their positions on smoking, social work has not registered its concern. However, considerable opportunities exist for counseling individuals offering group education and support services, developing policies for a smoke-free environment, and influencing government policymakers to promote health.