OBJECTIVE: To evaluate the effectiveness of an intensive community-based smoking cessation intervention on smoking behavior and blood pressure control among patients with hypertension. METHODS: A cluster randomized controlled trial was conducted from June to September 2024 in primary healthcare institutions in Yinchuan and Chongqing, China. Institutions were randomized to either a 1-month intensive intervention or routine care. Follow-up assessments were conducted at 7 days, 1 month, 3 months, and 6 months. Per-protocol(PP) analysis was performed, with available case analysis(ACA) as sensitivity analysis. Chi-square tests and robust Poisson regression models were applied using SAS version 9.4. RESULTS: A total of 803 participants were enrolled(398 intervention; 405 control), and 753 completed follow-up(93.77%). The mean age of participants was 61 years. Educational attainment was predominantly junior high school or below(62.30% vs.67.12% in the intervention and control groups, respectively). The mean age of smoking initiation was 20 years in both groups. The proportion of participants who had never attempted smoking cessation was 45.81% in the intervention group and 40.70% in the control group. Blood pressure control rates were 62.83% and 60.38%, respectively. In the PP analysis, continuous abstinence rates at 1, 3, and 6 months were significantly higher in the intervention group(28.01%, 19.37%, and 16.75%) than in the control group(12.40%, 9.97%, and 8.36%)(P<0.001). After adjustment for covariates, the likelihood of continuous abstinence in the intervention group was 2.43, 2.08, and 2.11 times that of the control group at the respective follow-up time points. Smoking reduction rates were also consistently higher in the intervention group across all follow-ups(P<0.05), with adjusted relative risks ranging from 1.50 to 2.07. Sensitivity analyses yielded consistent findings. Compared with baseline, blood pressure control improved in both groups during follow-up. At 7 days, 1 month, 3 months, and 6 months, blood pressure control rates in the intervention group were 77.75%, 81.41%, 86.65%, and 83.51%, respectively, compared with 65.50%, 72.77%, 73.58%, and 79.78% in the control group. Significant between-group differences were observed at all time points except at 6 months(P<0.01). CONCLUSION: The intensive smoking cessation intervention significantly increased smoking abstinence rates, reduced cigarette consumption, and improved blood pressure control among hypertensive patients in community settings.