Introduction. Smoking plays a causal role in several long-term conditions and worsens their outcomes. Focusing on six such conditions, we present a narrative review of seminal studies on the prevalence and impact of continued tobacco use on these conditions; the effectiveness of cessation interventions; the extent to which patients receive these interventions, and barriers to providing and taking up these interventions. Methods. A conceptual framework was used to identify questions for a series of focused literature reviews. Findings were synthesized and the literature was examined to identify themes common across these conditions. Results. Smoking prevalence is either similar or higher in patients with established long-term conditions compared to the general population. Continued smoking accelerates disease progression, worsens outcomes, and risks poor treatment compliance or further complications. There is strong evidence for the effectiveness of cessation interventions in achieving smoking abstinence. Despite this, only a small proportion of patients receive such interventions. Important barriers to uptake include concerns about weight management and drug safety, higher nicotine dependency and codependency, comorbidity, and misperceptions about the benefits of cessation. Conclusion. The benefits of offering smoking cessation in patients with long-term conditions are far too great for it to remain of a low priority. 1. Introduction Tobacco use is responsible for 5.5 million deaths and 4% of the global burden of disease in terms of disability adjusted life-years [1]. Tobacco’s causal association with several long-term conditions (e.g., coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD)) has long been established [2, 3]. In others (e.g., diabetes, schizophrenia), although tobacco does not play a causal role, its use is thought to worsen outcomes [4]. Using six prevalent long-term conditions as examples, CHD, diabetes, COPD, asthma, schizophrenia, and HIV/AIDS, we examine whether tobacco cessation in patients with established long-term conditions deserves a stronger focus than it currently receives. In this paper, we highlight some of the pivotal studies relevant to (i) the prevalence and impact of continued tobacco use on the outcomes of these conditions; (ii) the effectiveness and cost-effectiveness of cessation interventions; (iii) the extent to which patients receive cessation interventions, and (iv) key barriers to providing and taking up of these interventions. By highlighting some of the seminal work carried out in this
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