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