Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent outpatient mental health service. At the time of the interview, 37.6% were smokers according to the study definition, with 25.8% scoring high or very high on the Fagerstrom Test for Nicotine Dependence. Smoking was more likely if patients had conduct disorder or cannabis/alcohol dependence or abuse, but no difference was detected between smokers and nonsmokers in relation to attention-deficit/hyperactivity disorder, depression, or anxiety disorders. Only 15.1% of patients were given a chart diagnosis of nicotine dependence. (Contains 2 tables.)