Background: The Department of Pharmaceutical Care at the University of Iowa Hospitals and Clinics sponsors a pharmacist-managed smoking cessation group clinic. Ask-Advise-Refer is a method to refer patients to smoking cessation programs, but few data are available to support its use by pharmacists in an academic medical center outpatient pharmacy. Objective: To quantify the number of individuals asked about tobacco use, advised to quit smoking, referred, and enrolled in the pharmacist-managed smoking cessation group clinic through the hospital's 2 ambulatory care pharmacies. Methods: The Ask-Advise-Refer program was implemented and evaluated prospectively in both ambulatory care pharmacies. Patients over 18 years old who received their own prescriptions were asked about tobacco use. Pharmacists advised tobacco users to quit and surveyed their interest in quitting within the next 30 days. A pharmacist contacted interested patients by phone to provide them with more information to enroll them in the smoking cessation group clinic. A documentation form followed the prescription through the filling process. Forms used for data collection were gathered daily and information on tobacco use was entered into the dispensing system weekly. Forms also provided numerical counts for evaluating the program. Results: Of the 3,267 patients asked about smoking status, 889 of them used tobacco. Of those, 53.8% were interested in quitting in the next 30 days; 30% of these patients wanted the pharmacist to contact them. Of the patients who were contacted, 22 agreed to enroll in the clinic, and 10 attended the clinic. Conclusions: By implementing an Ask-Advise-Refer brief smoking cessation intervention at an academic medical center outpatient pharmacy, referrals and participation were increased in the pharmacist-managed smoking cessation group clinic.