Care providers should continue to assess smoking habits in lung cancer patients in the post-operative period given its disproportionate impact on long-term outcomes after potentially curative treatment for early-stage lung cancer. A retrospective cohort study, using a uniquely compiled Veterans Health Administration (VHA) dataset of patients with clinical stage I non-small cell lung cancer (NSCLC) undergoing surgical treatment between 2006 and 2016, defined persistent smoking (as individuals who continued smoking 1 year after surgery) and characterised its relationship with disease-free survival and overall survival. The study report, published in CHEST,  found that persistent smoking at 1 year after surgery was associated with significantly shorter overall survival.  However, persistent smoking was not associated with inferior disease-free survival.