Cigarette smoking remains one of the leading public health threats affecting adolescents in the United States. Previous research has established the link between psychiatric comorbidity and smoking and also linked early-onset smoking to psychopathology later in adolescence. The assessment of adolescent psychiatric patients should include an assessment for nicotine dependence and, likewise, adolescents with nicotine dependence should be assessed for other psychiatric disorders. Nicotine dependence assessment instruments are suggested. Pharmacological treatment options for nicotine dependence are reviewed, although little is known about the efficacy of pharmacological treatments for smoking cessation in adolescents. The authors suggest that the treatment of adolescent smokers include behavioral therapy in combination with pharmacological therapy, citing the potentially low risk involved and the available research on its efficacy with adult smokers. The authors also call for more research on smoking cessation in adolescent smokers. Figure, table, references