A meta-analysis of smoking cessation inter- ventions in hospitalized patients identified that intensive counseling interventions initiated in hospital with supportive contacts for at least 1 month after discharge increase smoking cessa- tion rates compared with usual care (RR, 1.37 CLINICAL STATEMENTS AND GUIDELINES Kleindorfer [95% CI, 1.27 1.48]), with comparable findings in patients with CVD (RR, 1.42 [95% CI, 1.29 1.56]) and interventions initiated in rehabilitation nicotine replacement therapy to the interven- tion increased cessation rates compared with intensive counseling alone (RR, 1.54 [95% CI, High-quality evidence supports combined pharmacotherapy (nicotine replace- ment therapy, varenicline, or bupropion) and behavioral interventions compared with usual care, brief advice, or less intensive counseling in smoking cessation (RR, 1.83 [95% CI, 1.68 1.98]) in health care and community settings.140 Group behavior therapy programs for smoking cessation are superior to self-help programs but are not superior to individual counseling of In stroke trials, multibehav- ioral interventions have been associated with a greater likelihood of smoking cessation in the STOP trial (Stroke Prevention Trial in Sickle Cell and an increase of 17% in cessation rates compared with usual care (P=0.001) in the INSPiRE-TMS trial (Intensified Secondary Prevention Intending a Reduction of Recurrent Events in TIA and Minor Stroke Patients).142 2. Registry-based stroke studies point to an 2-fold increase in recurrent stroke rates for smokers. The Nanjing Stroke Registry Program (N=3069) reported 9.5% recurrence rates at 2.4 years. With nonsmokers as the reference, adjusted HRs for stroke recurrence were 1.93 (95% CI, 1.43 2.61) in persistent smokers, stroke, and 1.16 (95% CI, 0.75 1.79) in for- mer smokers, delineating the effects in smok- ers, former smokers and quitters. 