Smoking has emerged as a significant public health issue and evidence showed that in people who use or used drugs and alcohol smoking rates are at an all-time high. Smoking has been identified as a contributing factor in a myriad of chronic illness including Asthma, COPD and Cancer. For people to break a smoking habit, of many years, requires a dynamic comprehensive approach like those currently utilized in drug and alcohol treatment programs. The literature suggests that intensive smoking cessation interventions involving behavioral support through counseling and pharmacotherapy are needed to effectively treat this population. An evidence-based project was conducted to assess the quit rates among patients receiving Nicotine Replacement Therapy (NRT) and intensive counseling compared to patients receiving standard care: NRT and brief information on smoking cessation. A significant decrease in tobacco use and a willingness of staff to incorporate the intervention into clinical practice was observed. This change in practice has resulted in more sustain quit rates over time. The findings of this project revealed significantly better results in the intervention group’s quit rates over-time. This intervention can be used in all healthcare settings.