Abstract Aim: To assess the practice of lifestyle counselling among practice nurses (PNs) by measuring the frequency, perceived effectiveness and barriers to lifestyle counselling. Methods: A survey questionnaire was sent to all 77 PNs in an Irish health service administrative area (response rate = 69%). A focus group was subsequently conducted with ten PNs from this sample. Results: 43.8% (n = 21) and 45.8% (n = 22) ‘always’ promote physical activity and healthy eating with patients, respectively. Conversely, 29.2% (n = 14) of respondents stated they ‘rarely’ or ‘never’ counsel patients on risky drinking. Furthermore, a large number of PNs perceived themselves to be ‘minimally effective’ or ‘ineffective’ at helping patients to address smoking and risky drinking (47.6%, n = 20 and 63.6%, n = 28, respectively). Practice nurses perceived themselves to be the most appropriate people to provide lifestyle counselling. Education and the provision of accurate information is a key strategy used with patients. Insufficient time, however, was cited as the main barrier to lifestyle counselling by 73.8% (n = 31) of PNs.