Introduction:
Smoking cessation (SC) counselling has rarely been recommended in cancer screening outpatient clinics and in Cancer Centers in Europe.

Objectives:
Main aims of this paper are to review the evidence of health benefits from SC among cancer patients and to identify strategies to approach SC among cancer patients, and, more in general, among people who undergo to cancer screening programmes or are exposed to clinical encounters at any healthcare service.

Methods:
To collect and summarize articles and reviews on health benefits of SC in cancer patients, and on strategies to approach smokers in healthcare services and in cancer screening settings.

Results:
A growing body of literature has identified substantial health benefits from SC in cancer patients including improved general health, improved all-cause and cancer-specific mortality, reduced toxicity, greater response to treatment and decreased risk of disease recurrence and second primaries.
In Europe, ascertainment and treatment of smokers in Oncologic Departments, in cancer screening outpatient clinics, and all healthcare services is not well embedded in service designs, patient pathways or disease treatment guidelines, and typically use an opt-in design. Systems in which smokers are systematically identified and offered treatment on an opt-out basis approximately doubles quit rates achieved by opt-in approaches. This is true for Cancer Centers, cancer screening outpatient clinics, and for every healthcare service. The main point is to develop a training system on SC counselling for health professionals.

Conclusions:
By offering SC counselling in cancer screening settings, smokers will increase quit attempts. Moreover, by systematically offering SC in Oncologic Departments, cancer patients will achieve the best possible health benefits from their cancer treatments. Framing SC as a quality of care issue will be a critical point in order to promote SC in Oncologic Departments.