Sample size: We hypothesized that nicotine replacement therapy after ACS during hospitalization would improve the rate of smoking cessation rate comparing to that after hospitalization discharge from 32.7% up to 51% . This was considered realistic because of the previous study reported a rate of 51% among smokers who received the NRT in-hospital smoking cessation intervention (12) and 32.7% among patients receiving treatments after hospital discharge (13). The expected sample size of 68 participants would enable us to identify such an increase in the smoking cessation rate with a power of 0.80 and a two-sided p-value of <0.05. The proportion of patients who dropped out or withdrew was expected to be 30%. Hence a sample size of 89 was estimate to be adequate, we have included 99 consecutive patients (14). Computer randomization was performed, after consent was obtained. Blinding was not possible. Participants randomized to arm "A" have received a smoking cessation counseling and a Nicotine Replacement Therapy (NRT) during intra-hospital stay one day after SCA. Those in arm "B" have benefited a smoking cessation counseling during intra-hospital stay, while the NRT was offered on a mean of 14 days after SCA in the first clinical visit after hospital discharge. All patients received a regular follow-up visits in smoking cessation center after hospital discharge every 2 weeks. Of the 99 patients enrolled in the study, 44 (81.4 %) and 30 (66.6 %) patients had respectively completed the follow-up smoking cessation in arm A and arm B. Loss to follow up was equivalent in two arms (p=0.1) (Fig 1).