The prevalence of cigarette smoking among young people is a cause for concern. College health care providers (HCPs) can provide evidence-based interventions but frequently do not, in part, because of concerns that tobacco interventions might alienate their young patients. Six hundred and eighty-four college student patients were interviewed as they exited a college health centre. The patients were asked about smoking status, about discussions with their provider regarding tobacco and to rate their satisfaction with the visit. Of the students who smoked, 48.6% reported the HCP discussed tobacco use and 38.6% reported that the HCP provided advice to quit. Mean ranked satisfaction was significantly higher among students who received tobacco discussions and/or advice to quit. This study should encourage college providers to intervene with smoking college students without fear that this will alienate patients.