The Objective of this study is to introduce a practically feasible multifaceted intervention in the preadmission clinic to help reduce smoking in preoperative surgical patients. The investigators aim to study the effectiveness of such a program in promoting positive change in smoking behavior among patients before surgery. The forced abstinence enforced on patients during hospital stay for their surgery can also be used to help smokers remain tobacco free long term. A significant percentage of surgical patients will be receptive to smoking cessation interventions in the preadmission clinic and will refrain from smoking at 24 and 52 weeks after starting the treatment.

Inclusion Criteria:

• The investigators will recruit patients who are assessed in preadmission clinic and scheduled for elective surgical procedures within the next 8 to 30 days.
• Patients should be 18 yrs of age, have smoked an average 10 cigarettes/day or more during the previous year and had no period of smoking abstinence longer than 3 months in the past year.

Exclusion Criteria:

• current pregnancy, breastfeeding;
• major depression, panic disorder, psychosis, or bipolar disorder within the prior year;
• use of nicotine replacement or bupropion within the previous 3 months;
• cardiovascular disease within the past 6 months;
• a serious or unstable disease within the past 6 months;
• drug or alcohol abuse or dependence within the past year;
• and use of tobacco products other than cigarettes or marijuana use within the previous month;
• participating in any other studies
• Patients who cannot understand English or have any form of cognitive impairment will be excluded.