Health care professionals and health care students need effective skills to address the public health issue of tobacco use disorder. An accredited tobacco treatment specialist (TTS) program that includes case-based motivational interviewing (MI) instruction and role-playing with case-based tobacco scenarios, provides an opportunity to obtain or improve tobacco cessation skills. It is important for health care students to develop competency in MI as part of the evidence-based strategies used to assist individuals with tobacco cessation. The purpose of this short report was to evaluate the effectiveness of case-based teaching of MI concepts and assess health care students’ ability to apply these techniques during tobacco cessation scenarios. Ten percent of the TTS program’s certification examination consisted of case-based questions in MI skills developed by a team of experts. A total of 156 West Virginia University Health Sciences Center students (including dental and dental hygiene students) were examined. The mean overall correct response for MI case-based questions score was 89.0% (SD, 0.29). With an 80% competency score, this assessment of tobacco cessation case-based learning questions displayed proficient application of MI and case-based learning was considered a valuable method to teach a complex skill.