Inclusion Criteria:  are ≥18 years of age are scheduled to undergo surgery within 28 days or are hospitalized for surgery are a current smoker (>100 cigarettes lifetime consumption and self-report of smoking every day or most days in the last 30 days) and not currently using any smoking cessation treatment and, provide informed consent to participate.  Exclusion Criteria:  are deemed unreliable for study procedures or follow-up are pregnant or breastfeeding or expecting to become pregnant during the study follow-up period have a documented allergic reaction to cytisine had myocardial infarction, severe angina or stroke/transient ischemic attack within the preceding 2 weeks.