Disclosures: A. Khetan is a co-founder of SEHAT (Society to Enhance Health and Access to Treatments), Dalkhola, West Bengal, India. SEHAT provided funding for this study. Other authors have no relevant financial disclosures. Therapeutic Area: ASCVD/CVD Risk Factors; Preventive Cardiology Best Practices Background: The need for, and effectiveness of physician counseling for tobacco has been well emphasized. However, the medical curriculum in many countries offers very little training needed to offer effective behavioral counseling. We hypothesized that providing medical students with experiential training in tobacco cessation counseling will improve their knowledge, while providing a valuable resource to help patients quit. Methods: pandemic, the primary outcome was changed from a biochemically verified quit rate to self-reported 7-day point prevalence of smoking cessation at 6 months. Changes in medical student knowledge were assessed using a pre- and post-questionnaire delivered prior to and 12 months after training. Results: Among 688 patients randomized across three medical schools, 343 were assigned to the intervention group and 345 to the control group. After 6 months of follow up, the primary outcome occurred in 188 patients (54.8%) in the intervention group, and 145 patients (42.0%) in the control group (absolute difference 12.8%; relative risk, 1.67; 95% confidence interval, 1.24-2.26; p