Stigma is a barrier to lung cancer screening uptake internationally. Stigma can negatively impact participant’s engagement at multiple points in the screening and assessment pathway. People who currently smoke experience stigma, whilst dealing with nicotine addiction and sense blame from other people related to the perceived self-inflicted poor health. Stigma associated with current smoking can also contribute to misreporting of smoking status to health professionals, which is commonly observed in smoking cessation clinical trials. This may contribute to low screening uptake by potential participants due to inaccurate smoking status in electronic health records held in primary care. This presentation will explore the latest evidence from real-world screening programs and issues specific to stigma and lung cancer screening, including how smoking cessation interventions might be appropriately and sensitively introduced throughout the screening pathway.