Smoking is an independent risk factor for stroke. The purpose of this prospective study was to determine whether significant changes in smoking behavior occurred in a cohort of stroke patients who were educated about risk reduction during their initial recovery period. Participants or their proxies were then contacted at 3 months for a follow-up interview, during which their current location, smoking status, and functional outcome were recorded. Of 405 participants interviewed, 112 were current smokers at the time of stroke. Participants younger than 65 years and Blacks were more likely to be smokers. At 3 months, 48 (43%) of the baseline smokers had quit smoking compared with an estimated rate of 28% previously reported in the literature. The number of participants who smoked > 20 cigarettes per day was 31 at baseline versus 7 at 3 months. This change of behavior was independent of baseline characteristics and the level of poststroke disability. Risk-reduction education provides stroke survivors with the information needed to change their lifestyles. Further research is needed to determine whether this behavior continues beyond 3 months and to determine why some stroke survivors continue to smoke.