Smoking is the single most preventable cause of death and illness worldwide. Although smoking causes about one-third of cancers and accounts for 30% of cancer deaths, there are no specific, required competencies for smoking cessation in the medical oncology curriculum. Nurse practitioners (NPs) serve critical roles in health care as drivers for quality improvement through the implementation of evidence-based practice. Therefore, an NP-led smoking cessation program was initiated using the American Society of Clinical Oncology’s Tobacco Cessation Guide for Oncology Providers. Following education, pharmacotherapy, and nicotine supplement interventions, nine patients quit smoking, resulting in a $511,200 cost avoidance.