Background: Smoking cessation even after a cancer diagnosis can improve survival, but access to smoking cessation support is limited. The purpose of this abstract is to describe results from a systems change approach by the Canadian Partnership Against Cancer (CPAC) to promote adoption of evidence-based cessation within provincial and territorial cancer systems across Canada. Methods: Beginning in 2015, an initiative was developed to convene a meeting of all Canadian provinces and territories to apply for 15 months of CPAC funding that could be used to support planning, implementation, and evaluation of smoking cessation services in the ambulatory cancer care setting. CPAC resources were used to support sustainable system change related to smoking cessation, including: executive champions, project leads, monthly teleconference calls, cross-project evaluations, in-person knowledge exchange workshops, and common-core elements for planning, dissemination, and reporting to support adoption and implementation. Results: In 2016, ~$1.0M (USD) was provided to 7 provinces and 2 territories. Funds were used for primary projects related to planning (2 provinces and 2 territories), implementation (3 provinces), and evaluation (2 provinces). After 15-months of funding from CPAC, 6 provinces reported implementation of smoking cessation for ambulatory cancer patients. The remaining province and 2 territories funded by CPAC reported development of plans for adoption of smoking cessation for cancer patients in the future. Within provinces reporting implementation of smoking cessation for cancer patients, between 65-97% of ambulatory cancer patients were screened for smoking status; 22-80% of patients who reported smoking were offered a referral to cessation services, and 21-45% of cancer patients accepted a referral. Conclusions: Assisting local clinical authorities to address tobacco use in the cancer care setting can result in significant systems change within a relatively short period of time. Support for sustained adoption and scaling of efforts to adopt smoking cessation as a therapeutic intervention for cancer care are planned.