Offering tobacco cessation interventions to TB patients is highly desirable due to the interaction between TB and tobacco use and the potential benefits of quitting. However, implementing such interventions in TB programmes remains a challenge and an under-researched area. Using two initiatives to implement tobacco cessation within TB programmes in Nepal and Pakistan as case studies, the authors describe these challenges and highlight lessons learnt in the process. This research is supported by the Department for International Development’s COMDIS–HSD Programme which is led by the University of Leeds