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Smoking by cancer patients and survivors causes adverse cancer treatment outcomes, but little information is available about how smoking can affect cancer treatment costs. We developed a model to estimate attributable cancer treatment failure because of continued smoking after a cancer diagnosis (af ). Canadian health system data were used to determine the additional treatment cost for af for the most common cancers in Canada. Of 206,000 patients diagnosed with cancer annually, an estimated 4789 experienced af . The annual incremental c