This study examined smoking-related knowledge, attitudes and practices of hospital-based nurses. The specific aims were: to determine the prevalence of self-reported smoking and the characteristics of hospital nurses who smoke; to describe nurses' knowledge of the health risks of smoking and strategies which aid quitting; and to describe their attitudes to smoking and quitting and providing smoking cessation care. The sample was formed from all direct-care nurses from six large hospitals in the Hunter region of New South Wales, Australia rostered on the randomly selected data collection days over 4 months in 1991 (n = 388, 98%). Participating nurses completed an interview measuring demographic and smoking history characteristics, and knowledge of smoking-related diseases, quitting strategies and referral options (open-ended questions). A self-completed questionnaire measured attitudes about smoking, quitting and nurse provision of smoking cessation care. Twenty-two percent of nurses reported being current smokers and 21.5% reported being ex-smokers, with higher smoking rates reported by enrolled nurses compared with registered nurses. Knowledge about the health effects of smoking was high, but knowledge of more effective strategies to aid quitting and referral options was poor. Nurses had positive attitudes towards assisting patients to stop smoking (60%), but restricted this to patients who wanted to quit. Only 21% felt competent to discuss cessation with patients and identified skills training as necessary. The findings suggest that smoking rates among nurses may be lower than those reported in past decades and lower than rates among women of the same age in the general population. The findings also suggest that nurses, while perceiving a role in smoking care, require training in the provision of smoking cessation care to hospital patients, and that hospital policies and nurse education providers need to strongly support the provision of smoking cessation by providing nurses with time, access and incentive to undertake such activities.