• Biochemically confirmed 7-day point prevalent smoking abstinence [ Time Frame: 26 & 52 weeks ] [ Designated as safety issue: No ]
  
• Continuous abstinence since hospitalization [ Time Frame: 26 & 52 weeks ] [ Designated as safety issue: No ]
  

• Use of smoking cessation resources [ Time Frame: 26 & 52 weeks ] [ Designated as safety issue: No ]
  
• Self-efficacy in regards to smoking cessation [ Time Frame: 26 & 52 weeks ] [ Designated as safety issue: No ]
  
• Patient Satisfaction of the IVR system [ Time Frame: 26 weeks ] [ Designated as safety issue: No ]
  

Quitting smoking appears to be the single most effective intervention or treament to reduce mortality in patients with Coronary Heart Disease (CHD). However, despite interventions, almost two-thirds of smokers resumed smoking in the year after hospitalization for CHD related illnesses; one-third resumed smoking within one month. A critical challenge for institution-level programs is how to provide consistent patient follow-up and linkage to community-based smoking cessation resources. Interactive voice response (IVR) technology has the potential to improve follow-up with smokers after hospitalization and to enhance triage to clinical support for smoking cessation. IVR uses natural language to place automated out-going calls that can pose questions regarding smoking status and progress with smoking cessation, that is then dropped into a database. A counselor is then able to link with the database and obtain information about the patient's smoking cessation needs and provide support as appropriate. A randomized control trial (RCT) is planned to evaluate whether an IVR system for follow-up and triage helps smokers hospitalized for CHD, quit smoking over 26- and 52-week follow-up periods. Participants are randomized into either a Usual Care or IVR group. Both groups will receive in-patient counseling and offer of nicotine replacement therapy. The IVR group will additionally recieve a telephone call from the IVR system three, 14, 30, 60, 90, 120, and 150 days after hospital discharge. Variables that will be assessed at 26 and 52 weeks include: smoking status, both 7-day point-prevalent and continuous abstinence, as well as self-efficacy for smoking cessation, use of effective cessation resources and patient satisfaction (at 26 weeks).