the purpose of this study was to determine the extent to which tobacco clinical practice guidelines are followed by nurses within 22 primary health care settings in first nations communities in northwestern ontario and to examine; the beliefs, confidence, barriers, and facilitators to the provision of tobacco use interventions. extensive research has shown that health care organizations and individual health care providers can positively impact rates of tobacco use when following specified recommended practices (fiore, bailey, cohen, dorfman, gritz, heyman, et al., 2000).