The aim of this study was to investigate the potential role of exercise in smoking cessation in women with severe mental illness (SMI).Semistructured interviews with 12 women diagnosed with SMI receiving smoking cessation treatment were conducted.Participants perceived three roles for exercise in assisting smoking cessation—addressing fears with preexisting chronic health conditions, emotion management and distraction, and weight management. Most participants identified health care providers (HCPs) as needing to play a supportive role in integrating exercise into smoking cessation attempts.Findings support a potential role for exercise in facilitating smoking cessation among women with SMI.HCPs should consider developing referral links with exercise specialists to facilitate smoking cessation in women with SMI.