The use of tobacco has been a known contributing factor in the development of disease and death since the 1960s. Unfortunately, evidence-based tobacco cessation protocol is still not effectively being taught in healthcare curriculum as evidenced by the lack of clinical competencies in many institutions. The purpose of this study was to gain an in-depth understanding of the process dental hygiene program directors use to adopt and implement tobacco dependence information into their curricula. Gaining a clearer idea of how and why dental hygiene faculty diffuse tobacco curriculum may inform future dissemination efforts leading to improved adoption and implementation of evidence-based information in healthcare education. A total of ten, one hour interview data sets of US dental hygiene program directors were chosen for this study. They were selected from a possible 14 interviews collected from a larger research project consisting of 32 one hour interview data sets. A case study research methodology was used to guide the collection of interviews. The Diffusion of Innovation, Five Stages in the Innovation Process in Organizations (Rogers, 2003) was used as the theoretical framework to inform the extraction of themes and patterns. The analysis of interview data revealed that all ten program directors reported a similar process of: learning about tobacco cessation, discussing the topic in a faculty meeting, deciding what class the topic should be taught, and that cessation should be a part of the clinical experience. What was not evident from these interviews was how and why the evidence-based tobacco cessation guideline was reduced from five essential elements to minimal implementation by most of the ten schools. Though the process of how dental hygiene programs learn of and implement tobacco cessation into their curriculum, further research is needed to explore how faculty make decisions on content and level of clinical competencies when new innovations are introduced into their program.