Background:
The knowledge about the harmfulness of smoking is relatively well established. However, knowledge about the benefits of smoking cessation after cancer diagnosis remains at a low level among both oncologists and patients. Despite the importance of stopping smoking for all cancer patients and the fact that cancer diagnosis is a teachable moment when the motivation to quit smoking is at high level, the diagnosis of cancer is underused for smoking cessation. This is not only due to the fact that smoking is both physiologically and psychologically addictive, making it extremely difficult to quit even if the willingness to do it is relatively high after cancer diagnosis.

Objectives:
To search the literature to ascertain the barriers in successful smoking cessation on both sides – cancer hospital staff and patients themselves. To identify factors that promote effective smoking cessation interventions.

Methods:
A literature review.

Results:
The main barriers on the doctors’ side are: beliefs that addressing smoking issues will be difficult and/or undesirable by the patient, lack of time and lack of skills/training, and apprehension to increase patient’s stress. On the patients’ side, the barriers are: heavy nicotine dependence, lack of full awareness of the connection of smoking to cancers other than lung or head and neck, beliefs that barriers to quitting outweighed the benefits of quitting, depressive symptoms, and shame. Factors that promote success are: opt-out approach, interventions with positive message focused on the benefits of quitting rather than consequences of smoking to avoid increase in fear and guilt.

Conclusions:
It seems that just the simple message that smoking is doing harm is not enough now – all our intervention must be tailored to specific groups of smokers and cancer patients are such a group. It seems that intervention based on existing tools like smoking cessation clinics and Quitline is necessary since the oncologists do not have time and skills to provide smoking cessation interventions.