The high prevalence of tobacco smoking amongst people with bipolar disorder has been well documented. The adverse consequences of tobacco smoking on physical health and financial burden have been well established. New evidence from clinical studies has found an association between tobacco smoking and adverse outcomes in bipolar disorder. In a 24-month, naturalistic, longitudinal study of 240 people with bipolar disorder or schizoaffective disorder it was found that daily smokers had poorer scores
on the CGI-Depression (p=0.034) and CGI-Overall Bipolar (p=0.026) scales, and had lengthier stays in hospital (p=0.012), compared to non-smokers. In another study which investigated post hoc the results of drug trials for the treatment of mania by analysing participants according to smoker status, non-smokers showed superior treatment outcomes on both the YMRS (P=0.002) and CGI-BP (P<0.001) scales, and longer time to discontinuation for any cause utilising Kaplan-Meier survival curves. Encouraging patients with bipolar disorder to quit smoking may improve physical health and well-being as well as mental health.