The purpose of this study was to determine the type and extent of tobacco control activities provided to dental patients by Iowa dental hygienists. Surveys were mailed to 1056 dental hygienists who had active Iowa dental hygiene licenses. Forty-one were returned by the post office and 138 did not meet all of the criteria for the survey. Of the remaining pool of 877-340 were completed and returned for a response rate of 38.8%. Only 4.6% of the hygienists routinely asked their patients about their tobacco use. Thirty-five percent routinely advised smokers to stop and 57% routinely advised smokeless tobacco users to stop. Thirteen percent routinely assisted smokers to stop and 20% routinely assisted smokeless tobacco users in stopping. None of the hygienists routinely engaged in follow-up to tobacco cessation activities. Cessation practice activities and amounts varied by several categorical variables. The majority of Iowa dental hygienists who responded to this survey did not routinely ask, advise, assist or arrange for or about their patients' tobacco use or cessation. Recommendations are given on how to improve tobacco prevention and cessation programs in dental offices.