Smoking is the greatest avoidable cause of premature death and is one of the most difficult cardiac-risk factors to modify. One must identify the smokers and clearly and repetitively inform them that smoking is harmful to their health and that you want to assist them in stopping. Once patients are ready to stop and are willing to put in the effort, a quit date should be chosen. Close attention to behaviour modification and planning smoke-free activities are crucial. Enrolling family support leads to higher success rates. Nicotine replacement therapy and bupropion as chemical additions are valuable adjuncts. Dealing with relapses in a positive fashion and using the experience to learn how to quit smoking the next time is valuable. Smoking cessation remains difficult, but we now have better strategies to deal with the problem.