Cigarette smoking is highly prevalent among persons with serious mental illness (SMI), 35.5% at a rate double that of the population without SMI (18.6%). Smoking worsens the comorbid medical conditions of individuals with SMI, further contributing to their shortened lifespan, difficulty with psychiatric conditions (depression and psychosis), and interactions with numerous psychotropic medications. Smoking cessation is possible and can be successful though not offered to persons with SMI consistently.