<h3>Purpose</h3> Several studies report the negative consequences of tobacco smoking on ventricular assist device (VAD) patient outcomes, but it is not a contraindication for VAD implantation in destination therapy (DT) patients. This international survey seeks to assess the importance of smoking cessation in DT VAD recipients, as well as center support and strategies in place to achieve cessation <h3>Methods</h3> A survey was created using Survey Monkey® and sent to VAD centers worldwide. The survey consisted of 37 multiple-choice and open response questions. <h3>Results</h3> Of the 47 respondents, 18 (38%) centers implanted <50 LVADs per year, and 29 (62%) implanted >50 per year. Twenty-four (83%) larger-volume centers implant all patients indicated for DT regardless of smoking status, while five (17%) do not implant current smokers. Conversely, 14 (78%) smaller-volume centers implant all patients, while three (17%) do not implant current smokers, and one does not implant previous smokers. Twenty (69%) larger centers offered cessation programs prior to implant, as did 14 (78%) smaller centers. Twenty-three (79%) respondents from larger centers and 11 (61%) from smaller centers believed bridge-to-transplant (BTT) patients were more likely to achieve cessation than DT patients. Sixteen (55%) respondents from larger centers and 11 (61%) from smaller centers thought their center provides adequate support for cessation programs. Smaller centers were more likely to believe that tobacco smoking should be a deciding factor in DT evaluations (50% vs 21%, p = 0.055). <h3>Conclusion</h3> The importance of smoking cessation in DT VAD patients and the adequacy of center support varies by program. A considerable number of centers believed that tobacco smoking should be a deciding factor in DT evaluations. Open discussion regarding the role of tobacco cessation prior to LVAD implant should be encouraged. External confounder and sampling bias may affect these results, so further studies should be conducted for validation.