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It is widely recognized that smoking rates among key and vulnerable populations surpass those of other groups. However, across much of the globe, support services often overlook this issue. Consequently, many will face mortality not due to their substance use or mental health conditions, but rather as a result of smoking-related diseases. This session aims to discuss the reasons for this oversight, with a particular emphasis on Eastern Europe and Central Asia, and to generate ideas for effective interventions to address this critical issue.