Background: Tobacco use and obesity remain the primary and secondary preventable causes of mortality and morbidity in the United States. The objective of this study was to examine differences in prescription of smoking cessation medications among smokers with different body mass index (BMI) classifications. Methods: A retrospective cross-sectional study was conducted using the National Health and Nutrition Examination Survey data (1999 - 2008). The study included smokers 18 years and older who self-reported their smoking status. The outcome variable was an indicator for whether or not the smoker received an FDA-approved smoking cessation medication. Multivariate logistic regression analyses were conducted to assess the association between the outcome variable and the main independent variable (BMI classification) controlling for other covariates. Results: The study found that 2.72% of normal weight smokers were prescribed cessation medications, while 1.57% and 2.54% of overweight and obese smokers were prescribed cessation medications, respectively. Overweight smokers were less likely to be prescribed cessation medications as compared to normal weight smokers, however this finding was observed only after controlling for self-perceived weight. In addition, smokers who perceived themselves as overweight had a higher likelihood of being prescribed cessation medications. Older smokers, women, non-Hispanic whites, and smokers with a college degree or above, higher income and public insurance were more likely to receive smoking cessation medications. Conclusions: Self-perceived overweightness is positively associated with the prescription of cessation medications. This finding probably indicates that lower prescription of cessation medications among overweight smokers is driven by provider (instead of patient) preferences, thereby raising concerns about healthcare inequities among overweight/obese smokers.