This project, "Web-based Smoking Cessation Intervention: transition from inpatient to outpatient," addresses smoking among hospitalized patients, whose rates are higher than among the general population. Hospitalization offers a unique opportunity to intervene, as it requires temporary abstinence and patients are focused on health concerns. Hypotheses: A tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home will be effective. Further, the investigators hypothesize that this approach will be cost-effective. Specific Aims: 1. To test the effectiveness of a web-based smoking cessation intervention. 2. To determine the cost-effectiveness of this approach. Research Design - Methods: A randomized two-arm follow-up design will be used to test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization. Patients randomized to this arm will be contacted by hospital staff, trained as 'transition coaches,' to engage in Decide2Quit, an interactive web-based program that offers personalized and tailored messages, e-group support, and text messages promoting tobacco abstinence. All hospitalized patients will receive standardized smoking cessation materials. As well, physicians can order nicotine replacement therapy via the hospital's electronic order system. The investigators primary outcome is biologically confirmed and self-reported tobacco abstinence at 6 months follow-up; the investigators will also assess self-reported quit rates at 3 and 12 months and variables hypothesized to predict quit success. We will measure health care utilization and quality of life to allow testing the cost-effectiveness of this program conducted from the perspective of a hospital, health care payers, patients and society. Significance of results: At study completion the investigators will know whether imbedding smoking cessation into usual hospital care, with minimal hospital-staff burden, and an interactive web-based tailored intervention program is an effective way to reduce smoking rates among hospitalized patients, and if it is cost-effective. This program will be an "off the shelf approach that could be disseminated easily.

Inclusion Criteria:

• 19 years of age or older
• Current smoker (at least one puff in the last 30 days)
• Regular (at least weekly) email/internet access
• Can read and speak English
• Can communicate well enough to provide meaningful responses to the screening questions and informed consent
• Well enough to participate (provide meaningful responses to the screening questions and informed consent)
• On standard or contact isolation only
• Cognitively able to participate (to provide meaningful responses to the screening questions and informed consent)
• Does not have another household member participating in this study

Exclusion Criteria:

• Under age 19
• Non-smoker
• Cannot read and speak English
• No email/internet access
• Cannot communicate well enough to provide meaningful responses to the screening questions and informed consent
• Too ill to participate (provide meaningful responses to the screening questions and informed consent)
• On isolation precautions other than standard or contact
• Cognitively unable to participate (to provide meaningful responses to the screening questions and informed consent)
• Has another household member participating in this study