Smoking cessation after CABG is associated with a sub- stantial reduction in subsequent MACE, including MI and death. Data from the randomized portion of the CASS study showed 10-year survival rates of 82% among the 468 patients who quit smoking after CABG and only 77% in the 312 who continued to smoke (P 0.025).645 Those who continued to smoke were more likely to have recurrent angina and to require repeat hospitalization. Data from the CASS registry demonstrated 5-year mortality rates of 22% for those who continued to smoke and only 15% for those who successfully quit smoking after CABG (RR: 1.55; 95% CI: 1.29 to 1.85).646 Similar favorable outcomes with smoking cessation were reported from the MRFIT (Multiple Risk Factor Inter- vention Trial), in which the impact of smoking cessation on MACE was assessed after 10.5 years of follow-up in 12 866 men; the risk of death was greater among smokers than non- smokers (RR: 1.57).647 Notably, the risk of dying from cardiac causes was lower for those who successfully quit than for nonquitters after only 1 year of smoking cessation (RR: 0.63), and it remained so in those who quit for at least the first 3 years of the study (RR: 0.38).647 The beneficial effects of smoking cessation after CABG seem to be durable during long-term follow-up (ie, even 30 years postoperatively).648 650 In fact, smoking cessation was associated with a reduction in mor- tality rate of greater magnitude than that resulting from any other treatment or intervention after CABG.649 In these long-term follow-up studies, patients who continued to smoke had significantly higher rates of MI, reoperation, and death. Smoking is a powerful independent predictor of sudden cardiac death in patients with CAD (HR: 2.47; 95% CI: 1.46 to 4.19). 