Trial of Integrated Smoking Cessation, Exercise and Weight Management in Serious Mental Illness: TRIUMPH

Inclusion Criteria: * Diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or recurrent major depression meeting criteria for serious mental illness * Fagerstrom Test for Nicotine Dependence of ≥3 and daily cigarette smoking for at least the past 6 months (on days that cigarettes were available) * On stable psychotropic medication for mental illness for at least 30 days (i.e., antipsychotic medication for those with schizophrenia spectrum illness, mood stabilizer for those with bipolar disorder) * Competent and willing to give informed consent * Completion of baseline data collection * Willing to participate in smoking cessation intervention that includes combination of evidence-based behavioral (group and individual sessions) and pharmacotherapeutic smoking cessation aids Exclusion Criteria: * Serious cardiovascular event (e.g. myocardial infarction, stroke) within the past 6 months * Serious unstable medical condition that limits life expectancy * Pregnant, breastfeeding, or planning a pregnancy during study period. * Alcohol or illicit substance use disorder if not sober/abstinent for ≥ 30 days * Planning to leave mental health program or move out of geographic area within 18 months Review by treating psychiatrist required for those with inpatient psychiatric hospitalization within six months of enrollment.