The 2019 Global Burden of Disease Study shows that global deaths attributed to tobacco smoking increased from 1.5 million in 1990 to 2.5 million in 2019. Cigarette smoking is a well-known risk factor for urinary cancers, with well-established positive association between smoking and the cancer of bladder and kidney and presumable connection with increased risk of morbidity and mortality from prostate cancer. This paper aims to summarize major conclusions made by American and European scientists, researchers and representatives of the European Association of Urologists and the Cancer Patients Europe network on the special session during the ENSP Conference on Tobacco Control in Florence (October 10-12, 2023). The session has the following objectives: 1/ to sum up the recent evidence on the association between tobacco smoking and e-cigarette and the risk of urological cancers (bladder, kidney and prostate); 2/ to evaluate knowledge, beliefs and behaviors of urologists to the cancer risk and on the role of tobacco prevention and cessation in prevention and treatment of urological cancers; 3/ to assess recommended preventive and cessation procedures, programs and services that could be used by urologist, urological oncologists and cancer patients to decrease morbidity and mortality from urological cancers. The session concludes on strong relationship between cigarette smoking and bladder and kidney cancer and suggested association between tobacco smoking and prostate cancer. It also indicates on the serious health problem of smoking continuation in urological cancer patients after diagnosis. Results of the new epidemiological studies show that well-known carcinogens of bladder cancer, such as polycyclic aromatic hydrocarbons and volatile organic compounds, are also present in the urine of e-cigarette users. These findings suggest the urgent need for additional data collection and further clinical and epidemiological studies on the association between e-cigarette use and urological cancers. American research reports on beliefs and behaviors of urologists indicate, on the one side, that urologists recognize the importance of tobacco use assessment and treatment and relationship between tobacco smoking and urologic disease, but, on other side, very rarely include routine screening for tobacco use and evidence-based treatment of tobacco dependence. It takes a place despite scientific evidence that tobacco prevention and cessation decreases the cancer risk, incidence and mortality, also for urological cancers. It happens despite tobacco cessation counselling, including brief intervention based on 5As, is well-established and cost-effective method for improvement of the cancer prevention, treatment and overall cancer survival after diagnosis. It results, as urologists say, from a lack of time for incorporating these procedures in routine medical practice, loopholes in their training on tobacco dependence diagnosis and treatment, and limited comfort with recommended procedures. It is also not very clear how smoking cessation programs can be systematically embedded into cancer treatment. There is a need to comprehensively train urologists in treatment of tobacco dependence, motivate them to systematically lead a brief intervention in their medical work, set up standardized smoking cessation programs and services for smoking cancer patients, incorporate tobacco prevention and cessation procedures into clinical guidelines for urologists and urological oncologists, create a multi-stakeholder network of tobacco control specialists and advocates, urologists and cancer patients.