In recent years, large campaigns have been organized for smoking cessation, health professionals have been educated about this topic and special treatment programs have been developed by the government for smokers. Although cigarette smoking is very frequent among patients with severe mental illness and it's a cause of morbidity and mortality, psychiatrists are not very eager for smoking cessation among psychiatric patients. However, in recent years, treatment studies have shown that with some modifications, conventional smoking cessation approaches may be quite beneficial among these severe mentally ill patients who are classically known to be failures in such treatments. In recent years, there have been developments in pharmacological approaches for smoking cessation, but neuropsychiatric side effects of these medications may be serious. Risk and benefit ratio for each patient should be taken into account while making a treatment plan.