Cigarette smoking is the single most alterable risk factor contributing to premature morbidity and mortality, accounting for approximately 430,000 deaths in the United States. Smoking nearly doubles the risk of ischemic stroke. Numerous prospective investigations have demonstrated substantial decrease in coronary heart disease mortality for former smokers, and similar rapid decreases in risk with smoking are seen for ischemic stroke. The Framingham Heart Study concluded that smoking made a significant independent contribution to the risk of stroke. Tobacco-use screening and brief intervention is one of the three most valuable clinical preventive services that can be offered to patients (Maciosek,2006). Patients who receive even brief smoking-cessation advice from their care providers are more likely to quit, and addressing smoking habits and initiating cessation efforts during hospitalization is a reasonable intervention to promote the patient’s medical recovery. National guidelines strongly recommend smoking cessation counseling for smokers hospitalized with AMI, heart failure, pneumonia and ischemic stoke. Despite these recommendations, smoking cessation counseling is often not provided. And every 24 hours, thousands of youngs become smokers.