Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the participant was still admitted. A follow-up telephone call was made three months after the intervention in order to assess self-reported smoking cessation. Findings: A total of 30 participants were enrolled. At the three-month follow-up, 22 patients were currently smoking and eight had quit smoking. Chi-square analysis indicated that there was no difference in the incidence of successful smoking cessation based on level of functional health literacy. The results of a stepwise logistic regression analysis suggest that predicting whether a study participant will quit smoking or not appears to be a function of the participant's environment, since the only variable that contributed significantly to the equation was environmental factors. Practical implications: The results of this study suggest that the participants had a relatively high level of functional health literacy. Participants with all levels of functional health literacy were able to quit smoking, as the incidence of smoking cessation was no different across levels of functional health literacy. A participant's ability to quit smoking did not appear to be a function of their functional health literacy, but instead appeared to be a function of their environment. Originality/value: Health educators and smoking cessation counselors need to consider all factors that have an impact on people's ability to quit smoking, but environmental factors may deserve additional consideration. (Contains 6 tables.)