Introduction:
Tobacco is one of the leading public health burdens, killing six million people globally each year. The health system and health care providers can play a major role in tobacco cessation interventions to their patients. But Ethiopian health systems responsiveness level and care providers knowledge, attitude and practice level were not well understood.

Objective:
To assess health care delivery system’s responsiveness to smoking cessation services and its associated factors in Ethiopia.

Methods:
A cross sectional study was employed both quantitative and qualitative methods. The quantitative study was used to determine knowledge, attitude, and practice of health workers with a sample of 323. SPSS software was used for analysis. Qualitative data that was collected from key informants and transcribed translated and thematized.

Results:
Majority of the health care providers had poor knowledge and negative attitude and below average level of practice towards providing cessation intervention. In the multivariate analysis; being female, receiving training, having good knowledge score, and having positive attitude were associated with the above average practice. Data from the key informants indicated that no well-organized and established system in Ethiopia.

Conclusions:
Ethiopian health care providers were with poor knowledge, negative attitude and below average level of practice and medications are not in the essential drug lists of the country. Therefore, ministry of health should introduce tobacco dependence treatments in the health care system and strengthen existing weak behavioral counseling intervention.

Funding:
Funding source was center for Tobacco Control in Africa and International Development Research Centre.