Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. As smoking cessation is an important part of cancer care, understanding pt attitudes towards smoking status assessment will help with integrating smoking cessation programs into survivorship care. Methods: Cancer pts were surveyed on their smoking history, assessment rates and attitudes/preferences towards smoking status assessment. Multivariate logistic regression models assessed for factors associated with screening preferences. Results: Among 501 pts, 115 smoked at diagnosis, 60% quit after; 53% had a tobacco related (lung/head and neck) cancer (TRC); 40% reported that their smoking status was assessed only on their first clinic visit, while 32% were assessed at a few visits and 12% all visits. Most felt smoking status should be assessed at the first visit (95%), while half (58%) felt it should be assessed each visit. Most felt comfortable with being assessed (96%), felt it was important for clinicians to be aware of smoking status (98%) and that smoking cessation discussions should occur at the first visit (87%). Most preferred being assessed by their oncologist (88%); less than half preferred being asked by another healthcare provider (44%), on paper (29%) or e-surveys (32%). Compared to ex/never smokers, current smokers were assessed more often at every/most visits (36% vs 20% P= 0.001) and were less comfortable with being assessed (88% vs 98% P< 0.001). Among current smokers, lung cancer pts were more agreeable (58%) to being assessed each visit compared to head/neck (aOR 2.48 95% CI [0.9-6.5] P= 0.06) and non TRCs (aOR 2.63 [1.0-6.8] P= 0.05). Among all, pts who are older (aOR 1.03 [1.0-1.1]), curative (aOR 1.92 [1.1-3.2]) and smoked less (aOR 0.98 per pkyr [0.97-0.99]) were more agreeable to assessment at each visit. Most pts also felt oncologists should screen for second hand smoke exposure (92%), felt its assessment was important (93%) and should help others who smoke to quit (68%). Conclusions: Most cancer pts felt that assessment of smoking status was important, were comfortable being assessed and preferred being assessed directly by their oncologist. Routine screening of those currently smoking is recommended to help with cessation.