According to the 2000 Surgeon General's Report, tobacco smoking remains the No. 1 cause of preventable disease and death in the United States. The report also states that quitting smoking reduces the risk of repeat heart attacks and death from heart disease by 50 percent or more. Smoking cessation is important in the medical management of many contributors to heart attack. These include atherosclerosis (fatty buildups in arteries), thrombosis (blood clots), coronary artery spasm and cardiac arrhythmia (heart rhythm problems). Quitting smoking also can help manage several other disorders, especially atherosclerotic peripheral vascular disease (fatty buildups in peripheral arteries) and chronic obstructive pulmonary disease. Smoking cessation interventions have been called the gold standard of cost-effective interventions. About 48 million Americans smoke cigarettes, but most smokers are either actively trying to quit or want to quit. Quitting smoking is the most important thing a person can do for his or her health. We can support a patient’s desire to quit smoking with education, relapse prevention strategies, learning alternate stress management tactics and emotional support for the process of quitting. Smoking cessation is an important part of an overall health program for all persons, and especially those with other complicating medical conditions such as chronic pain, heart disease, diabetes, etc.