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To assess effectiveness of smoking cessation advice to asbestos workers at statutory medical examinations.Workers are required to be examined every 2 years while continuing potential exposure to asbestos, including cessation advice if smokers. Records of 170 workers seen between 1986 and 2004 in Kent and Canterbury Hospital were reviewed. Respiratory symptoms, signs, lung function, radiological findings and smoking status were analysed.At initial visit 109 (64%) were smokers. Thirty-four of these attended twice. Despite verbal advice, including emphasis on respiratory abnormalities detected in 62%, only three (9%) had ceased smoking by self-reporting at the second visit.Despite appropriate counselling regarding the potential risks of asbestos exposure and smoking, the cessation rate among asbestos workers was disappointingly low. Further measures to encourage asbestos workers to enter smoking cessation programmes should be considered.