Purpose: To assess whether counseling households to protect children from the effects of passive smoking (PS) is a priority for pediatric residents. Methods: We surveyed 102 pediatric residents and 27 of their primary care attendings from three pediatric residency programs in Alabama and North Carolina. We listed the following ten topics and asked them to rank the five they consider most important to discuss with families of their patients: guns, PS, car seat/seat belt use, discipline, bike helmet use, poisoning, immunizations, drowning, fires/burns, and nutrition. Respondent characteristics included training level, past training received on smoking cessation counseling, and previous smoking experience. Responses were analyzed using Wilcoxon rank sum test, Chi-square, and logistic regression. Results; Respondent characteristics Residents(%) Attendings(%) Ever smoked 26 33 Now smoke 3 0 Lived with smoker 54 44 Had PS counseling training 21 37 Est. clinic prevalence of PS 50±19 41±15 Residents ranked PS counseling as significantly more important than their attendings (Wilcoxon, p<.01), with 82% of residents and 63% of attendings ranking PS counseling within their top five topics of importance. Compared to attendings, residents were more likely to value PS counseling (OR 3.1, p=.025). First year and third year residents did not differ significantly in their ranking of PS. Ranking was not affected by smoking exposure (self/home) nor by previous training in smoking counseling. Ranking did differ by site, with UAB and NC residents ranking PS as more important than South Alabama (p<.01). Conclusions: Pediatric residents and their primary care attendings considered PS a counseling priority. Surprisingly, residents valued PS counseling even more than their attendings, independent of resident year.