“…Some studies have found that lifetime smoking is significantly related to an earlier onset of bipolar disorder, poorer functioning, increased lifetime history of suicide attempts, greater symptomatic severity, greater number of hospitalizations, greater comorbidity with other psychiatric disorders, and use of more types of medication (Cassidy, Ahearn, & Carroll, 2001;Waxmonsky et al, 2005;Ostacher et al, 2006;Berk et al, 2008). Smoking in bipolar disorder is also associated with poorer control of mood episodes, contributing to a greater severity of the illness (Law et al, 2009). Singh, Mattoo, Sharan, & Basu (2005) also found that quality of life in terms of physical health, psychological health, and environmental and social relationships was lower in bipolar patients with nicotine use disorder compared to bipolar patients without nicotine use disorder.…”