Nicotinism remains one of the main causes of morbidity and mortality both in Poland and worldwide. A particularly vulnerable group of patients are people with respiratory diseases – chronic obstructive pulmonary disease and asthma especially. Smoking cigarettes is associated with a worse prognosis and a difficult treatment process of the underlying disease. Anti-smoking therapy has limited effectiveness. One of the strategies that breaks through to the mainstream is harm reduction management. One of the methods available today include among others systems for heating tobacco. However, attention is drawn to the risks associated with double smoking of both traditional cigarettes, as well as the use of ‘heat-not-burn’ systems. Management of nicotine-dependent patients and lung disease requires a multi-profile, holistic approach individually tailored to each patient.