Smoking is the leading preventable cause of death worldwide. Smoking affects all systems of the organism. Smoking stimulates the sympathetic nervous system, increases blood pressure and albuminuria, and decreases renal function. Smoking increases renal functional loss in patients with chronic kidney disease. Moreover, smoking accelerates the course of atherosclerosis, causing cardiovascular complications and premature death. Smoking decreases graft survival in kidney transplant patients. As a result, all physicians and health care providers should acknowledge all patients who smoke about the deleterious effects of smoking and continuously motivate them to stop smoking.