Tobacco smoke (TS) exposure of children causes significant and completely preventable morbidity and mortality. The primary source of the TS to which children are exposed is smoking by parents or family members in the home. Clinicians who care for children can and should counsel families to make the childs environment completely smoke free and ultimately, to quit using tobacco altogether. In as little as three minutes, counseling to make environments smoke free and tobacco users to quit can be delivered. Basic techniques of behavior change counseling and cessation resources for families are discussed, including stages of change, the “Five As,” brief motivational messaging, and pharmacotherapies. The evidence supporting counseling of parents and patients to promote smoke free homes and tobacco use cessation is presented. Policies that promote smoke free homes are discussed briefly.