Nicotine replacement therapy, bupropion, and var- enicline may be considered as adjuncts to smoking cessation counseling during CABG hospitalization, but their use should be carefully considered on an individualized basis (Class IIb; Level of Evidence B). Cardiac Rehabilitation Outpatient CR is a medically supervised, exercise-based pro- gram that is designed for patients with recent cardiovascular events to optimize overall health status and to minimize the risks for future adverse outcomes.317 325 In a meta-analysis of 48 trials involving CAD patients, CR was associated with a 26% risk reduction in the rate of cardiovascular mortality and a 20% risk reduction in overall mortality.321 Moreover, a strong, inverse dose-response relationship has been observed between the number of CR sessions attended and long-terms rates of MI and death.326 On the basis of this compelling evi- dence, CR has been strongly recommended for patients with several different cardiovascular diseases,327 including those recovering from recent CABG.3,317 The benefits of CR such as improved survival have been reported for all types of CAD patients, including younger and older patients, as well as men and women, independently of the nature of CAD diagnosis, the form of CR, and the dose of exercise intervention.317 325 The very first CR programs were launched in the 1960s, at a time when patients with cardiovascular disease were warned These initial CR programs, imple- mented for post-MI patients recovering in hospital, consisted of graded exercise programs. After a demonstration of their safety and success, these programs were later expanded into the outpatient setting.328 Over the years, CR programs have continued to adapt and to address the broad range of factors affecting cardiovascular outcomes, which has allowed them to evolve from purely supervised exercise programs to compre- hensive secondary prevention programs. 