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Introduction: Tobacco use is the leading preventable risk factor for chronic disease, disability, and premature mortality. People with disabilities experience higher tobacco use and reduced access to services when compared with the general population. The negative impact on treatment outcomes across all practice settings provides a strong incentive for physical therapists (PTs) to engage in tobacco cessation counseling (TCC). Methods: Prevalence of TCC and barriers toward implementation was explored using an anonymous cross-sectional survey of Florida-licensed PTs. Data were analyzed using frequency counts and percentages. Logistic regression was used to quantify relationships between individual knowledge and opinions, and rates of counseling. Results: Of the 212 respondents, 31% regularly provide cessation advice, 7% assist in identifying specific cessation strategies, 13% recommend additional resources, and 3% arrange for follow-up. More than 90% were unfamiliar with evidence-based TCC guidelines; approximately 80% had no prior training in screening for tobacco use or TCC. Conclusions: Most respondents agreed that patients should be screened for tobacco use and counseled accordingly, but few were familiar with evidence-based TCC guidelines. Further training is required to promote knowledge and skill in TCC, along with systems changes to reduce barriers toward the implementation of TCC within the clinical environment. [ABSTRACT FROM AUTHOR]