The morbidity and mortality of smoking-related illnesses is substantial. Cigarette smoking is the leading preventable cause of illness and premature death in the US. This public health problem is only magnified in patients with major mental illness and in particular in patients with bipolar disorder. It is estimated that dually diagnosed compromised more than 40% of the US tobacco market. Smoking cessation treatments (SCT’s) need to be developed and optimized for the dually diagnosed. To date, there are no FDA approved treatments or controlled evaluations of any SCT in bipolar disorder. This presentation will review prevalence rate of nicotine dependence in bipolar disorder, clinical correlates of bipolar illness and nicotine dependence, potential use of SCT’s in bipolar patients, and review a pilot feasibility study of varenicline in bipolar depression.