Although significant progress has been made since then, tobacco use remains a leading modifiable cause of death in the United States, with 21.3% of adult men and 16.7% of adult women still engaging in cigarette smoking.1 In patients who have had CABG, smoking can adversely affect both short- and long-term clinical outcomes. Early after surgery, smokers have an increased rate of atelectasis and pneumonia and an increased requirement for mechanical ventilation and intensive care support.290,291 In addition to an increased risk of pulmonary complications, smoking is associ- ated with an increased risk of deep sternal wound infections in adults who undergo cardiac surgery.292 Smokers have a higher prevalence of myocardial ischemia293 and require repeat coronary revascularization procedures more frequently.294,295 Specifically, smoking is associated with a higher rate of saphenous vein graft disease.165,296 Interestingly, despite the higher rates of morbidity in smok- ers, early mortality rates are not significantly different in smokers compared with nonsmokers. On the other hand, sig- nificant differences have been observed in long-term mortality On the basis of 30-year follow-up data, self- reported smoking cessation after CABG was associated with a life expectancy gain of 3 years, and smoking cessation had a greater effect on reducing the risk of mortality than any other intervention or treatment.295 Although smoking cessation should be addressed in all the postoperative period after CABG may be a particularly effective time to use smoking cessation strategies. Smokers undergoing CABG are hospitalized and therefore subject to the smoke-free policies of medical institu- tions, and they are also free of the usual cues to smoke. 