Abstract Background: Tobacco use is an epidemic known as “the brown plague” affecting one billion lives in the 21st century and 80% in developing countries. Prevalence of smoking is especially high in patients with psychiatric illness with an ongoing debate over which comes first. Studies about nicotine consumption in psychiatric patients are few from developing countries. Hence, this study is designed to identify socio-demographic and diagnostic correlates of nicotine use. Aims and Objectives:- To estimate the pattern of nicotine use and determine the association between socio-demographic profile, onset of nicotine use, it’s use as a coping mechanism, psychological association with nicotine use in psychologically ill patients. Material and methods:- A cross-sectional study including 101 patients with nicotine use and psychiatric illness were administered a semi structured questionnaire, Fagerstrom Test for Nicotine Dependence(FTND) and nicotine dependence syndrome scale. Data analyzed with mean, standard deviation, chi- square, ANOVA Results:-Nicotine use was more common in middle age group with alcohol dependence followed by depression. Nicotine use was not associated with background, socioeconomic status, gender. Majority tried to quit for health but what kept them with nicotine were drive, stereotypy, continuity, priority. Conclusions:- Nicotine is a commonly abused substance in psychiatric patients without a clear demarcation about the cause effect relationship. The existing study gives few insights into reasons for nicotine intake which was more so among the productive age group. Hence, there is a need for further research about psychotropic drug interactions with nicotine use and focus on integration of nicotine cessation into treatment of other psychiatric disorders rather than separate deaddiction clinics to alleviate the illness burden.