Cigarette smoke is a complex mixture of 4,000 chemical compounds, including 43 known carcinogens. It is well known that smoke acts as the initiator and promoter in the process of carcinogenesis, and the risk of cancer is directly proportional to the amount and duration of smoking. Tobacco is the cause of 30% of all cancer deaths and one of the major risk factors for coronary heart disease, along with high blood pressure and hyperlipidemia. Cigarette smoking is estimated to be responsible for more than 20% of all coronary heart disease deaths in men over 86 years of age and for approximately 45% of such deaths in men aged less than 65 years. About 80% of mortality from chronic obstructive lung disease is attributable to cigarette smoking, and the age-adjusted death rate for COPD is 10-times higher in current smokers than in nonsmokers. Peptic ulcer disease, osteoporosis, skin wrinkling, and retarded fetal growth are all associated with cigarette smoking.