the aim of this study was to assess the viability and potential efficacy of an environmental tobacco smoke (ets) exposure reduction intervention for at-risk children. the study consisted of a 12-week behavioral intervention and a 6-month follow-up, conducted on a convenience sample (n=43) of low-income, self-identified, adult smokers who were caregivers of 3-5 year old children. the intervention included a manualized program, plus nicotine replacement therapy, and monetary reinforcement of abstinence. outcome measures included breath carbon monoxide (co), self-reported smoking practices, level of nicotine dependence, and depression symptoms. significant reductions were observed in co concentration, frequency of smoking around children, and nicotine dependence and depression scores. sixty-one percent of the participants attended 8 or more weekly sessions, and one third remained smoke-free at follow-up. those who did not quit reported not changing their smoking behavior patterns in vehicles or indoors. the cessation intervention compared well with other interventions for treatment-seeking smokers, suggesting that implementing evidence-based cessation and education programs for caregivers at school sites may be effective in reducing daily exposure to ets of pre-school children.