Objectives Tobacco use is prevalent among people living with bipolar disorder. We examined tobacco use, quit attempts, and tobacco-related attitudes and intentions among 685 individuals with bipolar disorder who smoked ≥ 100 cigarettes in their lifetime. Methods Data were collected online through the website of the Depression and Bipolar Support Alliance a mood disorder peer-support network. Results The sample was 67% female, 67% aged 26 to 50, and 89% Caucasian; 87% were current smokers; 92% of current smokers smoked daily, averaging 19 cigarettes/day (SD=11). The sample began smoking at a mean age of 17 years (SD=6) and smoked a median of 7 years prior to bipolar disorder diagnosis. Among current smokers, 74% expressed a desire to quit; intent to quit smoking was unrelated to current mental health symptoms, χ2(3)= 5.50, p=.139. Only 33% were advised to quit smoking by a mental health provider, 48% reported smoking to treat their mental illness, and 96% believed being mentally healthy was important for quitting. Ex-smokers (13% of sample) had been quit a median of 2.7 years; 48% quit “cold turkey.” Most ex-smokers (64%) were in poor or fair mental health when they quit smoking. At the time of the survey, however, more ex-smokers described their mental health as in recovery than current smokers (57% vs. 40%, χ2(3)=11.12, p=.011). Conclusions Most smokers living with bipolar disorder are interested in quitting. The Internet may be a useful cessation tool for recruiting and potentially treating smokers with bipolar disorder who face special challenges when trying to quit and rarely receive cessation treatment from their mental health providers.

Smoking is a major contributor to premature mortality among people with mental illness and substance abuse. Historically, the Substance Abuse and Mental Health Services Administration (SAMHSA) did not include smoking cessation in its mission. We describe the development of a unique partnership between SAMHSA and the University of California, San Francisco’s Smoking Cessation Leadership Center. Starting with an educational summit in Virginia in 2007, it progressed to a jointly sponsored “100 Pioneers for Smoking Cessation” campaign that provided grants and technical assistance to organizations promoting cessation. By 2013, the partnership established 7 “Leadership Academies,” state-level multidisciplinary collaboratives of organizations focused on cessation. This academic–public partnership increased tobacco quit attempts, improved collaboration across multiple agencies, and raised awareness about tobacco use in vulnerable populations.