Despite known negative health effects, many women continue smoke during pregnancy, and many do not access available cessations supports. In a population of low-income mothers with children enrolled in Early Head Start (EHS) we explored which demographic, smoking behavior, and treatment access characteristics were associated with being referred for smoking cessation services. Findings highlighted equity among referrals, consistent with EHS’s anti-racist foundation. We found mothers only reporting smoking history were missed compared to mothers who reported current smoking behaviors, which presents an important opportunity for prevention work, given relapse rates. Finally, we found when EHS knows about a pregnancy, either from early referral to EHS or from other children receiving services, the referral mechanism is most successful. Implications for EHS include an emphasis on recruiting earlier in gestation. (author abstract)