Smoking is the leading cause of preventable death worldwide. Smoking cessation programs that include counseling and pharmacotherapy have been proved to be effective in achieving long-standing abstinence. Smoking cessation is associated with significant improvements in quality of life, mortality, life expectancy, and postsurgical complication rates. Contrary to general belief, smoking cessation close to the time of elective surgery does not increase the risk of pulmonary complications. Longer-term quit rates are generally higher in cohorts who quit in anticipation of surgery compared with those quitting for general health considerations. A team approach and adherence to the guidelines for smoking cessation improves long-term chances of success.