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Introduction Stopping smoking at the time of lung cancer diagnosis is associated with improved overall survival, with one study demonstrating 22-month longer median survival in people with stage IA-IIIA who quit compared to those who continued to smoke. 1 However, smoking cessation (SC) interventions are known to be inconsistently delivered in routine care. Here we present outcomes before and after the introduction of a dedicated SC service alongside an urgent suspected lung cancer clinic (USC).Methods A new standard operating procedure for outpatient provision of SC interventions was developed, including brief guides to prescribing Varenicline and Cytisine as well as reminders regarding web referral to the local authority provided stop smoking service (LSSS). In addition, two LSSS smoking cessation practitioners (SCPs) attended two of the four lung cancer clinics per week (one USC clinic, one follow-up clinic). Clinic letters were audited for documentation of SC referrals and pharmacotherapy/cessation aids; SC outcomes were derived from LSSS records.Results A total of 117 people currently smoking at the time of their USC attendance were studied, of which 52 were first seen between November 2024 and January 2025 (prior to initiation of the service) and 65 were first seen between February and April 2025 (following initiation). Overall mean age was 66 yrs, 40% were female, 44% were from the lowest IMD decile, 84% were of white ethnicity, and 59% had an eventual diagnosis of lung cancer. SC interventions and outcomes from the two time periods are shown in table 1. Following initiation of the service, the proportion of patients referred to LSSS increased from 21% to 57% (p=0.0001), the proportion prescribed any pharmacotherapy/cessation aids in clinic increased from 6% to 40% (p<0.0001), and the number with any SCP-recorded self-reported quit increased from 10% to 20% (p=0.192). The proportion of patients referred to LSSS and issued with pharmacotherapy in clinic varied widely between clinicians.Abstract M5 Table 1Smoking cessation referrals, provision of cessation aids, and outcomes during the study periodDiscussion Increases in SC referrals, provision of pharmacotherapy, and self-reported quits were seen within the first three months of the service. Ongoing audit cycles aim to improve consistency of provision of these interventions.Reference Sheikh, et al. Ann Intern Med. 2021. DOI:10.7326/M21–0252