Issues: Tobacco smoking in drug and alcohol treatment centres is highly prevalent. In Australia, it is reported that between 77–95% of people entering drug and alcohol treatment smoke tobacco which is ﬁve times greater than that reported for the general adult population (15.1% in 2010). People with substance abuse disorder report higher rates of nicotine dependence and smoke more cigarettes per day than the general population. As a result, people seeking treatment for substance abuse experience greater tobacco-related burden of illness. Despite evidence to show that clients are interested in quitting and that addressing smoking while in treatment does not harm other drug treatment outcomes, most treatment centres continue to fail to provide cessation support to clients that smoke. There is a need for strategies which address system-level barriers within the treatment setting. Organisational changes for smoking cessation involve four core components: (i) implementing a system of identifying and recording smoking status; (ii) providing education, resources and feedback to promote staff intervention to support quit attempts; (iii) dedicating staff to provide tobacco-dependence treatment; and (iv) promoting organisational policies that support and provide tobacco dependence services. Approach: A review of the literature examining the effectiveness of organisational change strategies for integrating smoking cessation into treatment settings. Key Findings: This is a work-in-progress and ﬁ nal outcomes will be presented at APSAD. Implications: Implications for practice will be discussed and elements to aid implementation of organisational change will be presented.