Meta-analyses have shown that quit rates for smokers who receive smoking counseling but are unmotivated to quit are 3–5% ; our study produced quit rates of 9–19%. Paradoxically, caregiver smoking cessation at the two month follow-up was associated with increased health care use and costs in the follow-up period. Our data do not allow an analysis of the timing of health care use during follow-up, and some of these health care costs may have occurred prior to actual cessation of smoking, and may even have motivated cessation.