Smoking is deadly and exacerbates comorbid health conditions, especially among those with co-occurring substance use disorders. Tennessee does not require substance abuse treatment facilities to concurrently provide tobacco-cessation treatment options or limit smoking on facility property as a standard for licensure. This study examines the relation between Tennessee facility region and availability of pharmacotherapeutic options for tobacco cessation, and the relation between the facilities' region and facility smoking policy. This study is descriptive, cross-sectional, and exploratory in its design. Study findings are from a secondary analysis of data acquired from the 2016 edition of the National Directory of Drug and Alcohol Abuse Treatment Facilities published by the Substance Abuse and Mental Health Services Administration. The number of substance abuse treatment facilities providing pharmacotherapy options in west Tennessee (7.8%) are statistically significantly lower as compared with substance abuse treatment facilities in both middle (24.6%) and east (39.2%) Tennessee. A statistically significantly higher percentage of facilities in west Tennessee (23.5%) with policies that permit smoking without restriction as compared with the number of facilities in east Tennessee (6.8%) also was found, whereas the facilities in west Tennessee (60.8%) have a policy that permits smoking in designated areas that is significantly lower than the number of facilities in east Tennessee (81.1%). Tobacco-cessation options are a preventive intervention that can be easily incorporated into a treatment facility's standard of practice and should be made available within the context of all substance abuse treatment facilities. Failure to provide concurrent tobacco-cessation options during substance abuse treatment contradicts the purpose of medical treatment. Medically oriented substance abuse facilities are exemplary settings for offering pharmacotherapeutic options to concurrently treat tobacco use. It is suggested that interdisciplinary clinicians in the field of substance abuse advocate for the implementation of concurrent tobacco cessation treatment in their organization.