The purpose of this study was to understand the knowledge and attitude changes of psychotic outpatients after participating in a smoking cessation intervention. Convenience sampling was used to collect data from 44 same diagnosis patients at a psychiatric center in central Taiwan. Data were collected from October 1 to December 31, 1998. Twenty-two patients were randomly assigned to the experimental and 22 to the control group. Patients in the experimental group were divided into 2 groups and attended 6 sessions on smoking abstinence. Sessions included 20 minutes of instruction on the hazards of smoking and 30 minutes of support group discussion. Additionally, posters, pamphlets, and the “smoking dummy” were used to enhance the effect of smoking cessation. One nurse was trained to record activities during group intervention. The quantitative data were analyzed using chi-square and t-test. For the qualitative data, themes were categorized and group interactions were analyzed after each session. The results showed that those in the experimental group demonstrated better knowledge of techniques for quitting smoking. Qualitative analysis revealed that the experimental group participants increased the knowledge about smoking abstinence but not their attitudes. Study findings suggest that smoking intervention programs should be individualized and the stability of the psychiatric patients' condition assessed prior to program participation. Multiple educational materials and role-play are needed during smoking intervention programs to improve understanding of the harmful effects of smoking. Most psychotic patients may have low motivation to quit smoking and less self-control than mentally healthy people. Thus, they may need more time and persistent effort to change their attitudes about smoking.