Introduction:The aim of this study was to assess Veterans' and primary care clinic staff's knowledge about, and experiences with, tobacco cessation services available through their Department of Veterans Affairs (VA) medical facility. Methods:Qualitative, semi-structured, in-depth interviews and surveys were conducted with 7 patients and 12 providers/clinic staff members at three VA primary care clinics serving large numbers of rural Veterans. Interviews were transcribed and coded for the- matic content. Results:Five primary themes emerged: (1) lack of knowledge about available cessation services, (2) smoking cessation services provided to patients, (3) perceived barriers to cessation and the provision of treatment, (4) patient receptiveness to treatment and primary care provider involvement, (5) recommended strategies for improving smoking cessation services. Discussion:Our findings suggest there is a considerable lack of knowledge regarding available tobacco cessation services in VA primary care clinics serving rural Veterans. While many patients expressed the opinion that VA was providing adequate care for nicotine dependence, they also identified important barriers to cessation and offered opinions regarding what more could be done to help them to quit smoking. Clinicians/staff also provided insight into barriers they encounter in the delivery of cessation services. Future work should focus on attempting to address these barriers.