The rate of smoking is alarmingly high among persons with persistent mental illness and they are no less susceptible to the harmful effects of smoking. Nicotine is a potent, addictive drug which affects neurotransmitters. Smoking can affect psychiatric symptoms as well as blood levels of psychotropic and other medications. Most persons with mental illness are aware of the detrimental health risks of smoking and many are interested in quitting. Poor physical health is associated with efforts to quit. Personal commitment is important to successfully quitting.