Significant advances in tobacco cessation and prevention initiatives have occurred over recent years, yet smoking amongst Indigenous populations remain double that of the relevant non-Indigenous population. As such tobacco use is considered a significant risk factor contributing to health disparities among these populations. Two Cochrane systematic reviews, one evaluating tobacco cessation and the other tobacco prevention initiatives for Indigenous populations summarize the available evidence for use by policy makers, researchers and consumers alike. Culturally tailored tobacco cessation initiatives show evidence of long-term abstinence, however, both cessation and preventioninitiatives specifically designed in collaboration with Indigenous cohorts are lacking. Despite the significant health burden attributed to tobacco use including the development of tobacco related illnesses and associated economic expenditures, there remains a paucity of data in this field. Methodologically rigorous collaborative research is needed to highlight the barriers and facilitators for tobacco cessation and prevention programs inorder to effectively reduce the prevalence of tobacco use and subsequent co-morbidities. NOTE: This chapter (text, tables and figures) contain excerpts from articles published previously. Please refer to Carson and colleagues (2012a, 2012b and 2012c) in the reference list at the end of this chapter.