Historically, mental health providers have overlooked smoking in schizophrenia, based on the rationale that patients with serious mental illness already suffer from significant stress and disability and as such should be allowed to engage in smoking as an activity that is pleasurable though destructive. There is also historical precedent of mental health providers, particularly in patient settings, to use cigarettes as a way to manipulate patient behavior, such as rewarding good behavior with cigarettes or withholding cigarettes to encourage medication compliance. However, research showing that eliminating even one risk factor for disease can significantly improve long-term health outcomes has resulted in the dominant view among clinicians opposing smoking.[2][3]