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. The conditions precipitating the need for CABG and the surgery itself may also reinforce the smoker s perceived vulnerability to the harms of tobacco use, motivating the patient to engage in an attempt at smoking cessation.299 In a Scandinavian cohort of patients undergoing cardiac surgery, approximately one half of current smokers gave up smoking after surgery. These changes in smoking behavior were most likely to occur during the first 6 postoperative months.300 As a result, CABG can serve as a teachable moment during which smoking ces- sation strategies may be highly effective. Smoking cessation strategies should begin with a full assessment of tobacco use and exposure. For instance, a cli- nician should determine the duration of smoking, the num- ber of cigarettes smoked daily, and the amount of time that passes between the patient waking up and having his or her first morning cigarette. Every smoker should be asked if he or she is interested in quitting smoking. If motivated to quit, smokers should have access to appropriate resources to assist in smoking cessation. For smokers who are not ready to quit, the clinician should assess the patient s perspective of the impact of smoking on his or her health. Education should then be provided to ensure that the patient has a full understand- ing of the adverse effects of continued smoking (including the effects of secondhand smoke on others) and the expected benefits associated with quitting. In addition, the clinician can use interviewing techniques to facilitate and engage intrinsic motivation within the patient to facilitate smoking cessation. 