Background and Objectives: Since 2000, tobacco control efforts have greatly increased state and local protections from childhood tobacco smoke exposure. The objective of this study is to examine changes in attitudes and practices regarding smoking bans in multiple public and private settings from 2000 to 2015, as well as to examine the changes in pediatrician and family practitioner screening and counseling for tobacco smoke exposure. Methods: Cross-sectional data from the annual Social Climate Survey of Tobacco Control were analyzed. Results: The majority of adults, 69.3%, reported household smoking restrictions in 2000, and these restrictions increased to 79.5% through 2015 (P < .05). Car smoking prohibitions increased from 68.3% to 81.8% (P < .05). A growing majority of adults supports smokefree policies in public settings, and tobacco counseling by child health care providers also increased. However, members of 1 in 5 households still permit smoking inside the home and family vehicle, and half of the US population is not protected by state or local laws prohibiting smoking inside of hospitality venues. Conclusions: Despite dramatic progress since 2000, these trend data reveal potential areas where child health care clinicians might focus effort at the family and community level to accelerate the protection of children from tobacco smoke exposure.