Cigarette smoking is the single greatest preventable cause of lung disease in the U.S. adult population. Tobacco smoking has numerous, well-documented, adverse health effects, both alone and in combination with hazardous workplace exposures. People who work may be active smokers and be exposed to workplace toxins or stressors, including environmental tobacco smoke. Tobacco smoke in the home can also affect the children of smoking adults, and these children are more likely to take up smoking. Prevention of the health effects related to tobacco among American workers and their families remains one of the highest public health priorities. Over the past two decades, the public health and medical communities have made substantial progress in combating cigarette smoking. However, despite overall progress, the burden of tobacco-related illness has clearly shifted toward blue-collar and service sector workers, whose cigarette smoking and exposure to environmental tobacco smoke, as well as to many other occupational health and safety hazards, is considerably more frequent than white collar workers. To address the impact of tobacco on the health of American workers, the National Institute for Occupational Safety and Health (NIOSH) convened a scientific workshop in June 2000 and invited leaders from labor, industry, academia, government, and non-governmental organizations to participate. The objectives of the workshop were to: 1. Describe the current state of knowledge of the complex interrelationships among work, work exposures, tobacco use, and health; 2. Review interventions that have been successful; 3. Identify key gaps in knowledge relevant to improving worker health protection; 4. Evaluate research, policy, and action priorities to reduce the adverse health effects of tobacco on American workers and their families; 5. Bring the occupational safety and health and tobacco control communities together; and 6. Motivate further action and improve coordination in the attack on tobacco-related hazards.