Aim: To examine smoking cessation communication between patients and registered nurses, with a few days of Motivational Interviewing (MI) based education, in consultations over time at nurse-led Chronic Obstructive Pulmonary Disease (COPD) clinics in primary health care (PHC). Method: The first and third of three consultations were videotaped, involving 13 smokers and six nurses. In these consultations smoking cessation communication was analyzed using the Motivational Interviewing Treatment Integrity (MITI) Scale and Client Language Assessment in Motivational Interviewing (CLAMI). Results: The nurses did, but only to a small extent, evoke patients’ reasons forchange, foster collaboration and support patients’ autonomy. In the registration of specific utterances; they provided a lot of information (42%), asked closed (21%) rather than open questions (3%) and made more simple (14%) than complex (2%) reflections. Most of the registration of the patients’ utterances in the communication were either toward or away from smoking cessation coded in the category Follow/Neutral (59%), followed by utterances in the categories of Reason for change 40%, Taking steps 1% and Commitment 0%. No significant differences could be observed in the results of MITI and CLAMI between the first and third consultations. Conclusion: Smoking cessation communication at nurse-led COPD clinics neither focused on the patients’ reasons for or against smoking nor motivated patients to express commitment to, or take steps towards, smoking cessation