Introduction: Advice provided by healthcare professionals can contribute to the success of efforts to quit smoking. Pharmacists, being the most accessible healthcare professionals among the community, provides a unique opportunity to deliver a more proactive smoking cessation services.

Aims: The present study aimed at 1) assessing the knowledge and attitude of pharmacists and pharmacy students regarding smoking/smoking cessation and 2) to document the extent of community pharmacists’ involvement in the provision of smoking cessation services in Ethiopia.

Methods: This study utilized a cross-sectional and direct observation methods. A series of questionnaires were administered to final year pharmacy students and practicing pharmacists. Two scenarios simulating tobacco use in pregnancy and cardiovascular patient were selected and played by two well trained simulated patients (SPs). Findings were analyzed and presented using mean total scores, analysis of variances (ANOVA) and independent sample t-test.

Results: A total of 410 participants [(213 out of 238 pharmacy students; response rate 89.5% and 197 out of 361 pharmacists; response rate (54.6%)] completed the survey. Both pharmacy students and practicing pharmacists had positive attitudes toward smoking cessation and both groups had similar mean knowledge scores. A total of 80 simulated visits were conducted. Recipients of training on smoking cessation had significantly higher mean knowledge and attitude scores as compared to those who did not received such training. The majority of the pharmacists demonstrated poor history taking practice and seldom assessed the patients’ nicotine dependence level. Nicotine replacement therapies (NRTs) were supplied in only 10 of the visits, and suggested but not dispensed in 35 of the visits. On the other hand, pharmacists in 59 visits counsel patients to visit addiction specialists and physicians.

Discussion: Educating pharmacists about smoking cessation supports as part of a continuous professional development and providing a hands-on customized educational intervention, such as a practice guidelines in a form of Ask-Advise-Refer approach, about smoking cessation would be useful.