In contemporary North America, about 20% of the population smokes tobacco. The number is small enough and the practice has been stigmatized enough over the last 50 years (since the science about health effects of smoking became widely known) that younger generations are accustomed to designated smoking areas and smoke-free public buildings. Tobacco use rates continue to fall as older smokers die off without as many younger consumers lighting up for the first time to take their place.
HOWEVER. If you're in a period piece, or a retro-future, or a pulp cyberpunk future, a crime-noir piece, or even an outdated Twenty Minutes into the Future from a past decade, you might have to put up with the fact that everybody smokes—especially men (it was uncommon for women to smoke until the 1920s when "masculine" behavior became more acceptable). If the setting dates to before the 1970s, ashtrays are going to be everywhere and there will be no such thing as a "non-smoking section" of a restaurant. If it's before the 1960s, smoking might even be seen as healthy and virile. During the period of peak tobacco use in America (late 50s-early 60s), more than 40% of the population smoked with some regularity.
Note that the extent to which smoking has been stigmatized varies from country to country, so this trope may still apply in modern media depending on country of origin. Eastern Europe and East Asia in particular have high contemporary smoking rates.
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Anime & Manga
Smoking is still comparatively commonplace in Japan, and so it is also quite common in anime. Having a character smoke (who is old enough to do so legally, obviously) says very little about them as a character, and background characters are fairly often seen with cigarettes as well. It's worth noting however that overall smoking rates in Japan have fallen sharply in the last ten years (after regulators started cracking down on it as public health issue), so depictions of smoking are also slowly changing. Men have always had much higher smoking rates than women in Japan so a female anime character's smoking habits are more likely to be significant than a male character's.
Black Lagoon is a prime example of this, having most characters smoke at least once during the series.
Rotton the Wizard is one of the non-smokers in the series. Being the smartest man in Roanapur in many ways, he'll probably live the longest.
Cowboy Bebop: In the future, everyone smokes IN SPACE. They're usually told that there's no smoking immediately after lighting up, however.
The Kildred from The Sky Crawlers all smoke, despite of the fact that they're all kids. Or maybe because of it, as they do not age and they keep "dying" and returning with new memories, so they don't really need to worry about something like lung cancer.
Baccano!, but seeing as it's primarily set in 1930s America, this should come as no surprise...
In ...Virgin Love and its related stories all the businessmen smoke, likely due to stress. It seems to be how they get through the workday as no one smokes when they're feeling good.
As noted in Real Life below, Product Placement meant that smoking was actually more ubiquitous in films and TV series pre-1970 than in reality.
Alien: The crew smokes. In a spaceship. All-oxygen artificial atmosphere? Limited oxygen supply?
Unless the atmosphere was very low pressure (and generally unsuitable for long stays), it would have an Earthlike composition of mostly nitrogen with a smaller fraction (20% at 1 bar, somewhat more at lower pressures) of oxygen. Oxygen is actually toxic in high enough concentrations.
In Real Life at the time they still allowed smoking on aeroplanes (high-altitude, recycled air). There was even a smoking room on the Hindenburg! Sometimes culture overrides sense.
Until last year American sailors were allowed to smoke on submarines.
Bad Timing: There is not one single scene where someone isn't seen smoking, lighting, or stubbing out a cigarette. All three actions often appear within the same scenes. A case of Everybody Chain Smokes.
On the distant mining planet of Screamers, anti-radiation medication is delivered via red-colored cigarettes. When radiation levels get too high, an announcement instructs all personnel to smoke their "radiation reds"
This is Lampshaded at one point, with a character commenting on how ironic it is that he has to smoke a cigarette to keep harmful toxins out of his lungs.
No one smokes in the film Thank You For Smoking, though Aaron Eckhart's character tries and fails a few times. Later he's nearly killed by being covered in nicotine patches. The trope is referenced when discussing a possible space movie that would try to make smoking appealing:
Nick: But wouldn't [the cigarettes] blow up in an all-oxygen atmosphere?
Jeff: ... Probably. But, you know, it's an easy fix. One line of dialogue: "Thank god we invented the, you know, whatever device."
Nowhere Boy. Seems that every other scene pretty much every character has a ciggy hanging from their mouth.
Ghostbusters. In the commentary for the film, Ivan Reitman said that he had watched both Ghostbusters I and II back to back to jog some memories and was astounded that almost no one lit up in the second one.
In The Hairy Bird, even though smoking is said to be prohibited on school grounds, it's shown that even the headmistress, Miss McVane, smokes.
In Videodrome there is rarely a scene, in the first half of the movie in particular, where the main character isn't lighting/smoking or putting out a cigarette. Several other characters are seen to smoke quite regularly throughout the film, but the lead is the most notable. His assistant even lights one up before he gets to the office, and gives it to him -along with a cup of coffee- straight from her mouth, before he goes into a meeting.
Robert Heinlein's 1941 serial/1958 novel Methuselah's Children is full of characters who smoke constantly. To make it worse, many of them are over a hundred years old. They're not some kind of immortals, protected from cancer, they're just naturally long-lived thanks to a long-running eugenics project. This was Ret Conned a few decades later in The Number of the Beast, where a character explains to visitors that they discovered an alternative to tobacco-based cigarettes which are non-addictive and non-cancerous.
Agatha Christie, oh so much. To the point where characters don't look down on other characters for not smoking...they look down on them for smoking different types of cigarette.
Seems you can't go anywhere in the world of Atlas Shrugged without finding some chain-smoking rich industrialists. The mystery behind a symbol on a cigarette box is even part of the plot.
Only the 'good' industrialists who succeed on talent. The 'bad' ones, who live off government favours and crony capitalism, don't smoke. Ayn Rand considered "fire at your fingertips" a positive symbol. In a real life Aesop, she developed lung cancer. See the Real Life section for more details.
In the Twenty Minutes into the Future novel Ghost From The Grand Banks, one of the characters makes a living out of retroactively subverting this trope: his company digitally edits vintage films and TV programs, erasing any evidence of smoking from scenes, so they'll be marketable to post-tobacco audiences.
Isaac Asimov's stories often feel less dated than many other Golden Age science fiction tales, but the fact that everybody smokes like a chimney is a dead giveaway.
A possible lampshading is in The Robots of Dawn, a sequel written in the eighties, where Baley has quit smoking.
In the Foundation series, endless examples of this, dating the novels when a daring woman character smokes among bearded peasants in the third book; there are also tobacco farms on Hari Seldon's homeworld and decorated cigar boxes as gifts and heirlooms.
The End of Eternity, though, has a character who smokes cigarettes and complains that his habit is hardly ever practiced or approved of in the vast majority of the many centuries in the future. And it was published in 1955.
Lucky Starr is a kids' series, so our heroes always decline cigarettes when offerred; but the habit is certainly popular among everybody else in the Solar System.
Most Golden Age mystery novels feature heroic smoking on the part of some characters, but the Ngaio Marsh Inspector Alleyn novels are in a league of their own. The only people not shown constantly smoking are the unsympathetic characters, and the general attitude to smoking is that it's a positive character trait.
Played for laughs in Mickey Spillane's Mike Hammer in which Stacey Keach played the title character, who always dressed like a 1950's Private Detective in fedora and trenchcoat with a permanent cigarette in his mouth, despite living in the 1980's where everyone kept telling him to stop smoking.
The Day of the Triffids the main character dedicates a paragraph or two of narration to lighting up every two to three pages until about two-thirds of the way through the book, when the general lack of supplies means he probably ran out.
In the novels featuring the Russian Investigator Arkady Renko, beginning with Gorky Park, Renko laments that an enemy could just drop cigarettes on the U.S.S.R. rather then bombs to kill everyone off. Everyone drinks, too. This is probably Truth in Television.
Interesting variation in Tom Clancy's novels, particularly the Jack Ryan series. Many of the characters, including the titular protagonist, don't normally smoke, but they start lighting up their cigarettes after the tension levels ratchet upward.
Richard K. Morgan's Altered Carbon subverts this trope. The genre is sci-fi detective noir where the main character is living in someone else's body. Although fulfilling many noir tropes, the main character is agitated to discover the body he is wearing is addicted to smoking. He spends most of the novel battling his addiction to cigarettes and only rarely embracing it.
Flip open a Philo Vance novel, and odds are Vance will either be lighting up a Regie cigarette or in the middle of smoking one. It's enough to make one wonder if author S S Van Dine was getting a price break in recompense.
Interesting use in Lucky Jim by Kingsley Amis- not only is this trope in play, but even the book's maddeningly prudish, hysterically posturing 'feminine' character smokes as much as the hero. A little period knowledge explains why the hero is always fretting about how many cigarettes he has left to last the week- cigarettes were still rationed in Britain in 1951, as the import and manufacturing base recovered from WW 2. It underlines the way that they're considered one of life's minor essentials in the period.
In Gaudy Night by Dorothy Sayers, heroine Harriet Vane offers a cigarette to cheer up a miserably drunk college girl who has sneaked into the dorm after curfew.
Subverted in City of Devils whose hero has a complete inability to light a cigarette without disaster.
Live Action TV
I Love Lucy: Not only did all four of the series leads smoke regularly (at least during the first five years of the show), many of the guest stars lit up.
By extension, a vast majority of TV comedic and dramatic series during the early years of television saw a majority of the people smoking, without restriction or being made an outcast. This was in an era where 40-plus percent of American adults smoked.
The Tonight Show: Especially during the Jack Parr and to a somewhat lesser extent the first 15-20 years of the Johnny Carson era, a large number of the guests smoked on-camera, without restriction. Even Parr, Carson and – to a lesser extent – Ed McMahon – smoked on-camera, although by 1980 or so, Carson and McMahon eventually stopped lighting up on the set.
Of course, it's not literally everyone. A few characters (Pete Campbell being the most notable) don't smoke. Word Of God states that the non-smoking characters are the ones whose actors were never smokers in Real Life; even though the cigarettes are herbal, this is apparently important to them.
The episode Far Beyond The Stars is set in the 1950s, where everyone... well, I'm sure you can guess.
Same thing in the episode Little Green Men, Earth 1947. Once the story reaches Earth, it's a smoke-fest for the next 30 minutes. Every human who has more than 2 seconds of screen-time is seen smoking at least once. The trope is played straight with a vengeance as an homage to old "alien menace" movies, and as part of a Take That at smoking. The Ferengi talk about how humans willfully ingest poison simply because it's addictive, and Quark even tells a General that Humans should stop smoking because it would kill them.
One really Up to Eleven moment shows one of the characters lighting up two cigarettes so that he can pass one to his girlfriend.
When Nog tells Quark that people bought and used tobacco mainly because it was so addictive, he gets greedy and starts overestimating what easy marks humans must be.
"If they'll buy poison, they'll buy anything!"
One of the episode's writers regretted how it came off, and said that if he had to do it over again, he would have Quark come back home with a craving for a cigarette.
Star Trek: The Original Series is somewhat notable for averting this. The network wanted to use this trope, but Gene Roddenberry refused, on the grounds that given the known health risks of smoking, people would have stopped doing it that far into the future.
Life On Mars: Even at crime scenes and morgues. And in hospitals.
Weirdly, it was totally OK to smoke in hospitals in the UK back then - they even came round with a trolley selling them!
In Absolutely Fabulous, in part. While Edina and Patsy's frequent smoking in Saffron's own home would still be legal in the UK today, it stands out glaringly when Eddie, Patsy and Magda smoke inside the private hospital (which, as noted above, was commonplace in British hospitals until recently), with the nurse bringing a trolley of cigarettes for them to buy. That said, smoking would probably not be advisable for Patsy right before her elective facial surgery.
Teachers has many of the main cast smoking, not only at the pub but also illicitly in the school toilets and in maintenance areas of the school grounds. As with many of the above examples, even the legal smoking areas depicted stand out to UK viewers, who have been unable to smoke in workplaces and public buildings (including pubs) since 2006.
Apparently Willie didn't listen to his Uncle Sam when he told him not to start smoking.
Speaking of which, here's a list of everyone of significance in Caprica who has smoked onscreen: Joseph Adama. Samuel Adama. Amanda Graystone. Daniel Graystone. That Philomon guy. And Sister Clarice is known to frequent a FantasticOpium Den. Hm. Looks like everyone who isn't in high school out of the main cast.
Most of the characters in Twin Peaks smoke, since it's a Fifties throwback.
Most of the people on Deadliest Catch smoke, and of the few who don't, most of those chew tobacco.
In the most recent season, one captain (Keith of the F/V Wizard) is trying to quit chewing tobacco at the guilt trip/urging of his daughter. And, while it's somewhat understandable people in a high-mortality profession like crab fishing view long-term risks like smoking differently, there's some indication Captain Sig of the Northwestern has changed his tune after Captain Phil of the Cornelia Marie suffers a pulmonary embolism one season, then a massive stroke and finally dies of a second embolism. Sig reacts to the news by throwing his pack of cigarettes across the wheelhouse.
Watch almost any cooking-based reality show that shows contestants during their breaks, and you'll see every single contestant smoking like a chimney. This is somewhat ironic, as pointed out by Gordon Ramsay (famous chef and host/judge of Hell's Kitchen). He does not smoke and has berated contestants for the habit, which deadens the sense of taste and actually makes them worse chefs than they would be otherwise.
It's pretty hard, if not impossible, to think of main character from Skins who doesn't smoke.
Jal in series 1/2, Katie in series 3/4. Though both succumbed to other drugs.
There's a scene in one episode where Katie has a drag of one of Effy's cigarettes.
The main characters rarely are shown smoking. This is notable because the series was filmed during a time when smoking was common and takes place in a time before anyone thought smoking was bad for your health. However, every major male character was seen smoking at some time in the series; Col. Potter confessed to enjoying 5 cigars a day for decades. Even Radar during the first and second seasons was seen smoking (and drinking whisky).
Camp Chef Igor can be seen with an actual cigarette in one episode. Also, there's a lot of smoking in the movie.
In UFO the characters regularly smoke in computer rooms, medical areas, SHADO's underground headquarters, the Skydiver submarines and even on Moonbase!
Most of the main characters in new BBC series The Hour are smokers.
In the show Undercover Boss many of the workers and a few bosses smoke. The biggest example is when the boss buys an ashtray for a lady who goes into the parking garage to smoke and throws the cigarettes on the ground.
Hogan's Heroes didn't normally show people smoking, but it did have a running joke in the form of Hogan stealing Klink's cigars whenever his back was turned, as well as frequent attempts to bribe Schultz with cigarettes.
Played with on How I Met Your Mother. People smoke when it becomes plot-relevant, most often cigars but sometimes cigarettes or...sandwiches. However, in fact they're pretty regular smokers, Future Ted just doesn't talk about it much because he's telling the story to his kids.
Poirot: True to the Agatha Christie novels, everyone smokes in the UK adaptation starring David Suchet. Sometimes they smoke so much it's hard to see through the blue haze.
Boardwalk Empire, which makes sense as the show is set in the early 1920's. In fact, the only characters of significance who doesn't smoke (that's old enough to, anyway) are Margaret, Richard who is physically incapable due to his war injuries, and Arnold Rothstein who also abstains from drinking. Everyone else is almost always using one or preparing to light one.
The shift of this trope across the years was pretty much the entire basis of short-lived British sitcom The Smoking Room, set in the early 00s when these were a fairly common feature of large workplaces- smoking at one's desk or the general break room having become felt to be obnoxious by the majority, but the laws against actually smoking in a workplace building not being passed yet. The whole premise was that people now mixed in the smoking room from different areas and levels who wouldn't otherwise speak to each other (with a strong subtext that this meant all the best and most interesting interactions went on in there, as was the writer's conviction.)
The original Mission: Impossible series had a lot of smoking, Cinnamon and Rollin especially. Became a plot point a couple of times, when doctored cigarettes were used to make marks more pliable.
In Call the Midwife, set in the East End of London in the late 50s, most of the characters - including pregnant mothers! - have a casual smoke every so often. It's even a bonding moment for Dr Turner and Sister Bernadette, who share a Henley cigarette after a particularly difficult delivery. He does seem a bit surprised when she takes him up on his lighthearted offer, but it's likely that's only because he's never seen her smoke before; the nuns are just about the only characters who aren't constantly lighting up.
Jenny Lewis specifically called this one an "anti-anti-smoking song." Make of that what you will.
In early Tom Waits songs, there are more references to Kents, Lucky Strikes, and the like than you can shake a stick at.
Grim Fandango, a LucasArts adventure game, is heavily influenced by film noir, and so everybody smokes like chimneys. The joke? It takes place in the Land of the Dead, so all the characters are already deceased. Walking, talking skeletons can't get lung cancer because they have no lungs.
In Starcraft it's ubiquitous. Among the Terrans, at least. Not sure the Protoss even breathe, but they don't have mouths.
Bioshock, being set in 1960. Although you rarely see another person smoking, there's plenty of boxes of Oxford Club and Nico Time lying around (that take away health but restore EVE).
The Saboteur, despite its cartoonish Dieselpunk aspect, actually stays true to the period as far as this trope goes. The player can even tap a button to have Sean light up if he's standing around doing nothing.
Deus Ex: While you will not see anyone actually smoking, cigs are a relatively common find throughout the game, and there are usually cigarette vending machines in public. In a nightclub, one NPC will ask you for a light. JC can smoke as well, but at the cost of 10 health points to the torso, making it at full health, chain smoking 10 packs in a row will kill you.
The prequel, Deus Ex: Human Revolution, plays this straight as well. Walk down the street of Detroit, or heck, even just step outside the Sarif Offices at the helipad, and you'll see all sorts of people smoking a cigarette. The player character, Adam Jensen is also a smoker as well, presumably to deal with the stress of becoming an augment. Of course, since he can get an aug upgrade that allows him to breathe in visibly green toxic gas with no ill effects, cigarette smoke is probably of no concern to him.
The fan-made prequel 2027 also features this. Matches and cigarettes are a common find.
In L.A. Noire, pretty much every character smokes except the protagonist. If you stand around for too long, your partners will light up a cigarette.
In Lucky Dog 1, practically all of the main characters smoke cigars or cigarettes with some having preferences for one over the other (Gian for instance only smokes cigarettes, while Luchino seems to like cigars). This is probably justified since the plot is following the lives of criminals in the 1930's. In fact, only two of the characters, Giulio and Bakshi don't ever seem to smoke.
Many characters in The Word Weary smoke (Harry the Hipster, Grace, John and Poor Trotmann) though it takes place in the present day. This is somewhat justified in that the main character works in a hookah lounge.
In Jennifer Babcock's C'est la Vie, Mona (who is French) smokes as if daring the entire USA to physically prevent her.
Although not in the show itself, The Flintstones did commercials extolling the great taste of Winstons.
An episode of The Cleveland Show had a flashback to America somewhere between the 20s and 40s. In the flashback literally everyone smoked, even a baby and a dog.
Though obviously not strictly true, within the USA, the West Coast has this impression of the rest of the country, and the rest of the country thinks this of the Southeast.
The majority of Bosnians smoke and only a couple restaurants and bars are smoke free. Pick up a couple random cigarette butts in tourist spots across Europe, chances at least one will have FDS (Sarajevo Tobacco Factory) written on it.
In Canada, smoking is thought to be more common among francophones and aboriginal people, which is borne out by statistics.
On the other hand, the sheer crowdedness of the country makes smoking something of a difficult proposition (when the sidewalks are packed, holding a smoldering stick of tobacco is a serious public-health risk), and so David Sedaris actually went to Japan to help him quit smoking. It worked, and Sedaris recommends the method...if you're willing to pay for the flight and a few months' living expenses in Tokyo (not cheap).
It's not entirely clear why David Sedaris would have come to Japan to quit, since attitudes towards smoking are relatively in the dark ages compared to the U.S. and Europe — you're still allowed to smoke in restaurants and directly outside of buildings, if not inside them, cigarettes are relatively cheaper, and... to be honest, only some small parts of Tokyo are always that crowded, and while Tokyo may be the center of the universe, it isn't the entire universe. There are vast tracts of inaka here, usually translated as "the countryside" but more accurately rendered as "the middle of [expletive] nowhere" where you won't see another soul, let alone a bus, for hours on end. However...
Starting in 2008, the ubiquitous cigarette vending machines in Japan started requiring an ID card certifying the buyer as over 20 to vend, and this year a huge tax hike prompted droves of people to quit... and if the news reports are accurate, an unusually large percentage of the quitters have been successful so far. On the other hand, there were also news reports of people buying two months' salary worth of cigs in advance of the price hike, and cigarettes are still about a buck and a half to two dollars cheaper than in the States.
"I suspect that the Pokémon "Koffing" isn't a symbol of the evils of pollution — he's Japan's Joe Camel, hooking kids on the power and might of smoke."
Most of the Middle East, where smoking is a status symbol (someone smoking cigarettes is more or less saying, "hey, look, I literally have money to burn!") and a cultural tradition (no cafe is complete without hookahs). The very word "tobacco" (along with alcohol, in fact) has an Arabic root.
Almost all the higher-ups in Ayn Rand's Objectivist movement smoked, likely because Everybody Smokes in Atlas Shrugged. One character refers to the fire of a cigarette as the fire of the mind and of creative ideas. According to Murray Rothbard, a former Objectivist, non-smokers are generally looked down on by the Objectivist movement. Ayn Rand argued that despite studies showing correlations between smoking and lung cancer, there was no evidence that an individual smoker would get lung cancer. Not surprisingly, Ayn Rand would later get lung cancer.
Smoking is extremely popular in Mainland China. One of the first things that you notice when you cross the border from Hong Kong into Shenzhen is the smell of cigarettes. However one curious thing about Hong Kong is that packs of cigarettes must by law have a rather graphic picture of the consequences of smoking.
This is true in many countries. It doesn't always help (Egypt also requires pictures—although they aren't always graphic, some are—but that's done nothing to reduce the smoking rate).
As a former newsagent's assistant, that's true - the pictures are also highly collectable.
Interestingly, while most men in China smoke, very few women do. As a result, Western women who do smoke can find themselves getting odd or disgusted looks from Chinese women when they light up.
You'll see this trope in any Veterans' Administration office or VA hospital. US Veterans have about a 12% higher tobacco use rate than the general American population.
The inclusion of packs of cigarettes (usually Lucky Strike) in C-rations from WWII to Vietnam no doubt contributed to smoking addiction among US service members during this period. Lucky Strike's signature dark green pack was changed to white in 1942. In a famous advertising campaign that used the slogan "Lucky Strike Green has gone to war", the company claimed the change was made because the copper used in the green color was needed for World War II. However, the truth of the matter was that the white package was introduced to modernize the label and to increase the appeal of the package among female smokers. The war effort became a convenient way to make the product more marketable while appearing patriotic at the same time.
Providing free cigarettes to soldiers was common in many countries during World War II, as it was seen as being a major factor in troop morale.
During WWII, when most countries in Europe rationed virtually everything that was imported (and a lot that wasn't) for civilians, cigarette coupons were included among the book of allocations. (In some countries only for men, though in Britain it was for all adults)
US Soldiers today, especially those stationed overseas in combat zones, have a higher rate of smoking then their civilian counterparts. Cigarettes are much cheaper in the Middle East and Central Asia, the situation is very stressful, and soldiers have a lot of free time to kill between patrols.
Many tobacco companies invested heavily in motor sports sponsorship after general TV advertising was banned. Since most of the drivers and crew chiefs smoked at the time, it was not seen as inappropriate in the way it is today.
In 1972 Winston cigarettes began sponsoring NASCAR races, renaming them the Winston cup series. This ended in 2003 when Nextel took over.
Marlboro was once a major sponsor in the Indy car series. Today, with stricter limitations on advertising, only a few cars/drivers still display the logo.
The Hard Rock and Heavy Metal music scenes and the Visual Kei scene, at least up to a certain point in time. While now both have a fair percentage of nonsmokers and quitters, a walk down the Sunset Strip or a few minutes in the parking lot or outdoor backstage of some clubs in Los Angeles on a show night (since No Smoking indoors is the law there) or going to any club live in Japan, you will breathe in enough secondhand smoke to raise your cancer risk. And some Visual Kei rockers will still list their favorite brand in interviews...
Actors. Not Theater actors, but Film/TV actors. When on set, you'll be hard pressed to find more than 1 or 2 who don't smoke. A good example is the Mad Men entry up there - although they do smoke herbal cigarettes, Word Of God noted that the people who don't smoke in the show are the ones who haven't smoked in real life. That's about 3 characters/actors, which gives an idea as to just how ubiquitous it is among the acting community.
In-patient psychiatric facilities have a bewildering number of ashtrays for MEDICAL ESTABLISHMENTS...until you see just HOW MANY of the residents smoke. Overall, people who have been diagnosed with a mental illness have a tobacco use rate twice that of the general American population (40% as opposed to 20%). When the rate is broken out by type/severity of illness, there are groups with current smoking rates well over 50% and lifetime use rates over 80%. Generally, more systemic mental illnesses like schizophrenia or bipolar disorder correlate to higher smoking rates than less severe disorders like dysthymia or social phobia, and number of diagnoses is directly correlated to tobacco use as well. So people who are ill enough to end up in in-patient treatment are VERY likely to be either current or ex- smokers. It's important to note that correlation does not equal causation, so it's not currently known whether this connection means that mental illness predisposes someone to tobacco use (possibly as a form of self-medication), smoking predisposes a person to mental illness, or if some unknown underlying trait separately predisposes a person to smoking AND to mental illness.
What is currently known about tobacco use for self-medication: As a mild stimulant, nicotine combats some of the "deadening" side effects of powerful psychiatric drugs like neuroleptics. Some ADD/ADHD sufferers use nicotine (often in combination with caffeine) as an over-the-counter alternative to prescription stimulant drugs like Adderall. Patients with depressive symptoms may use nicotine to counteract the fatigue and lethargy caused by the disease. Contrary to popular belief, nicotine does very little for anxiety or agitation as it IS a stimulant. The calming effect many smokers attribute to tobacco is due instead to the INTENSE cravings nicotine causes finally being satisfied.
Another argument along the same lines: General drug use follows the same pattern, so it's quite safe to assume that mentally ill people seek altered states of mind to alleviate their sickness.
There is some evidence to suggest that smoking ultimately intensifies depression, rather than alleviating it. This is good news for psychiatrists who might otherwise feel reluctant to encourage patients to quit on the grounds that the habit helps them cope from day to day.