The following recommendations are offered for evaluating and treating nicotine dependence among patients with schizophrenia.Assessment of patients's nicotine usage should be a routine part of psychiatric evaluation and treatment planning.Heavy smokers should be closely evaluated for other substance abuse.Clinicians should be aware that smoking cigarettes alters the metabolism of psychiatric medications and reduces blood levels of neuroleptics and some antidepressants and benzodiazepines.Clinicians should take intoaccount that both nicotine usage and withdrawal may alter the symptoms of schizophrenia and medication side effects.Smoke-free units should consider the impact of forced nicotine abstinence on patients who smoke and should establish goals and strategies for treating nicotine dependence.Researchers should consider the role of nicotine withdrawal and usage as an important covariate in studies of schizophrenia.Prospective, longitudinal research that assesses the relationship between nicotine dependence and schizophrenia is needed.