Background: Smoking is especially prevalent among Native Hawaiians. The 2002 Behavioral Risk Factor Surveillance System revealed that 33.8% of Hawaiians were current smokers. Native Hawaiians have the highest age-adjusted lung cancer incidence and mortality rates and the highest prevalence of asthma among all ethnicities. Purpose: This study describes the outcomes of a culturally appropriate, integrated smoking cessation program. Methods: Each participant (n=209) was exposed to multiple treatment options--Hawaiian therapies, Western pharmacotherapy, acupuncture, and fitness training--and was permitted to opt for the program of personal preference. Pre-post program evaluation, with three-, six-, and twelve-month follow-up, was performed. Results: Of the 177 participants who attended two or more sessions, 59% (n=105) quit or reduced smoking by one half, and 23% (n=41) quit. The three-, six-, and twelve-month quit rates were 23% (n=40), 15% (n=27), and 15% (n=27), respectively. Discussion: There is limited data available on quit rates for culturally specific, multi-component smoking cessation programs. A variety of methods and treatments, including pharmacological, lifestyle, alternative, and behavioral therapies, have enhanced smoking cessation program outcomes. Translation to Health Education Practice: Through the development of a multi-component program that integrated Western methodologies with traditional healing practices, a void was filled. Similar culturally informed methods may enhance future efforts in designing ethnic-specific smoking cessation programs.