The previous assumptions that have hampered efforts toward smoking cessation are now beginning to fall under the weight of accumulating evidence. "These patients do not want to quit." In fact, they do, and at rates (70%–80%) comparable to those in the general population (3, 5). "They are not able to quit." But many do, and with only slightly less success than the general population (7). "If they quit, their mental health or substance abuse conditions will worsen" (8). Recent research has called that assumption into question. Mental health conditions can be stable or even improve (5, 9), alcoholics who stop smoking are more likely to stay sober (5), and hospital wards that go smoke-free have fewer aggressive incidents and more staff time freed up for therapeutic encounters (5). Psychiatrists not familiar with smoking cessation may ask if it is worth the effort, compared, for example, to the 33% remission and 47% response rates of treating depression with an SSRI (10). Given that smoking causes half of smokers to die prematurely, and often with a miserable terminal illness, even a small decrease in smoking rates would be worth the investment. The published range of successful quit rates, from 10% to 30%—with one study showing a 1-year 50% quit rate for depressed patients—greatly exceeds the 3%–5% success rate from unaided cessation (3, 5). Thus, although many cessation attempts will fail, the benefits are so great as to be worth the effort.