A nurse-led tobacco treatment program (NL-TTP) was implemented on the provision of tobacco treatment offered for tobacco users admitted to a tobacco-free psychiatric hospital over 4 years. Results include non-significant decreases in tobacco use, significant changes in tobacco screening, significant increases in provided practical counseling, and significant increase in providing FDA approved NRT. Long term outcomes suggest NL-TTP to be an affective approach to improve tobacco screening and treatment for psychiatric facility inpatients.