Bladder cancer is an international public health problem, and the incidence and mortality are closely tied to cigarette smoking. Urologists are, mostly, not involved in smoking cessation with their patients. The World Urologic Oncology Federation has launched a global initiative to incorporate smoking cessation into urological practice. We believe that urologists can readily be influenced to engage their patients, primary care physicians, and communities in bladder cancer prevention. The World Urologic Oncology Federation, a federation of 17 regional/national societies of urologic oncology around the world, is well positioned to lead this global effort. The results would be an extremely cost-effective program, which has the potential to substantially improve the health of the world's population.