Tobacco Use Disorder

The majority of patients with schizophrenia currently smokes or has smoked in the past, at much higher rates than seen in the general population. Psychiatry needs to make smoking cessation a priority and help their patients quit smoking and remain quit. In this chapter, I discuss the assessment of smoking and treatment tools for successful smoking cessation for patients with serious mental disorders. Emphasis is placed on the use of pharmacotherapy, particularly varenicline, and opt-out care, with treatment being the default option in a chronic disease model. E-cigarettes may be a harm reduction option for patients seriously addicted to cigarettes.