The prevalence of tobacco use among persons with mental illnesses is 2 to 3 times that of the general population, and these individuals suffer significant related health disparities. Many people with mental illnesses contact tobacco quitlines for cessation assistance. With free telephone counseling and in some cases nicotine replacement therapy, quitlines offer a potentially effective resource for this population. However, quitlines are still trying to determine how best to meet these callers' unique needs. The authors discuss emerging practices regarding quitline services for persons with mental illnesses, as well as expert opinion for enhancing work with these individuals.