Tobacco smoke is complex mixture, which is major source of toxic chemicals. Smoking is a risk factor for osteoporosis and osteoporotic fractures. According to WHO estimations, 5.4 million premature deaths are derivative to tobacco smoking. The most frequent causes of tobacco-related death are chronic obstructive pulmonary disease, heart disease and several types of cancer. Smoking negatively associated with the bone mineral density of the entire hip and femoral neck, and the exposure time was negatively associated with the bone mineral density of the total hip, femoral neck, spine, lumbar and the whole body. Smoking decreases the mechanical strength of the regenerating bone and postpones the mineralization, Indirect actions on adrenocortical hormones, sex, intestinal calcium absorption, vessels, oxygen supply, vitamin D, increased incidence of fractures and the loss of bone mineral content.