The myths:

Five prevailing myths have contributed to continuing tobacco use among people with mental illness. The first is that tobacco is necessary self-medication for the mentally ill. The tobacco industry has fostered this belief by funding research and presentations on the self-medication hypothesis, supporting opposition to the JCAHO smoking ban, publishing articles in the lay press, and marketing cigarettes to people with mental illness.2

Nicotine is a powerful reinforcing drug that transiently enhances concentration and attention, regardless of the smoker's mental health status. But it has proved ineffective as an adjunctive treatment for mental disorders (e.g., depression, schizophrenia, and attention-deficit disorder), possibly because of the rapid decrease in drug response with repeated exposure. The reality is that tobacco is another problem, not a solution.

Myth number two is that people with mental illness are not interested in quitting smoking. Research argues otherwise: studies involving patients recruited from outpatient and inpatient psychiatric settings suggest that they are about as likely as the general population to want to quit smoking.1 In the United States, 20 to 25% of smokers report that they intend to quit smoking in the next 30 days, and another 40% say they intend to do so in the next 6 months. Furthermore, among smokers with mental illness, readiness to quit appears to be unrelated to the psychiatric diagnosis, the severity of symptoms, or the coexistence of substance use.

The third myth is that mentally ill people cannot quit smoking. Although treating tobacco dependence is challenging, several randomized treatment trials and systematic reviews involving smokers with mental illness have documented that success is possible. With a stepped-care intervention tailored to depressed smokers' readiness to quit, a 25% abstinence rate at 18-month follow-up was achieved — a rate significantly higher than that in the group that received usual care (advice to quit and referrals for help doing so) and similar to cessation rates in the general population.1 A cessation intervention integrated into treatment for post-traumatic stress disorder (PTSD) doubled patients' odds of quitting.3 And a meta-analysis of seven randomized controlled trials involving smokers with schizophrenia revealed a nearly threefold increase in abstinence rates 6 months after treatment among those who used bupropion.4

Fourth, many people believe that quitting smoking interferes with recovery from mental illness, eliminating a coping strategy and leading to decompensation in mental health functioning. Five randomized tobacco-treatment trials in patients concurrently receiving mental health treatment have found that smoking cessation did not exacerbate depression or PTSD symptoms or lead to psychiatric hospitalization or increased use of alcohol or illicit drugs.1

Finally, some argue that smoking, which is perceived as having distal effects, is the lowest-priority concern for patients with acute psychiatric symptoms. Yet people with psychiatric disorders are far more likely to die from tobacco-related diseases than from mental illness. Smokers know tobacco use has deadly consequences and expect health care professionals to intervene. Indeed, raising the issue of tobacco use with patients enhances the rapport between patients and clinicians.

There is growing evidence that smokers with mental illness are as ready to quit as other smokers and can do so without any threat to their mental health recovery. Evidence supports the use of most recommended cessation treatments in smokers with mental illness (see tableRecommended Treatments for Tobacco Dependence and the Evidence Base for Use in Smokers with Mental Illness.) http://www.nejm.org/doi/full/10.1056/NEJMp1105248

Downside of medications:

While taking medication for mental illness has plenty of positives, it can have negative aspects. The side effects associated with many of these medications can be excessive. Nausea, headaches, dry mouth, blurry vision, trembling, increased nightmares, and exhaustion are all relatively common when taking medication for mental illness. These drugs can also cause more serious health issues such as blurred vision, speech issues, hyperglycemia, diabetes, and recurring black-outs. Some antidepressants, antipsychotics, and mood stabilizers can also increase the tendency towards suicidal thoughts and actions. Anti-anxiety medications also pose the risk of dependency issues, making the close monitoring of their usage very important.

Especially when it comes to any type of antidepressant, medications for mental illness often do not work for those with mild cases. A study in 2006 found that those suffering from mild-to-moderate depression only received little more than a placebo effect from taking antidepressants. In fact, the study found that only 50% of these cases actually benefited from taking the drugs.

Other medication for mental illness may also have these drawbacks. For many patients, it can take months or even years to find the correct prescription and dosage for their specific issue. These medications have helped a large number of people improve their mental health, however. When prescribed by an experienced medical professional and monitored closely, these drugs can have a significant effect on a patient's life. http://www.wisegeek.com/what-are-the...al-illness.htm

I suppose some may view the choice as picking their poison. For me, the medications helped a lot more than the cigarettes, despite the side effects. What others do is their choice and we may agree to disagree.