Tobacco smoke capability of stimulating local and systemic inflammation is considered to be a pathogenetic mechanism leading to the development of pulmonary and extrapulmonary diseases. The study was aimed at reviewing information concerning the pathomechanisms for the pro-inflammatory effect of tobacco smoke components, which lead to initiating cascade processes resulting in tissue damage. A retained lungs macrophages contributing to the development of local inflammatory response by the release of cytokines, proteases and radicals were shown. Cytokine release induced by tobacco smoke with intracellular signaling pathways, mainly NF-κB activation, is associated with this. Developing inflammatory process as a driving mechanism for further oxidants production was shown, which caused the intensification of inflammatory response. Tobacco smoke components stimulating cyclooxygenase-2 expression and an increase in prostaglandins and acute phase proteins synthesis were demonstrated. It was shown that most of the changes inflammatory mediators remains still high even when the damaging agent is removed. It is believed that aldehydes present in the environment that are components of the smoke can make a covalent bond with nucleophilic amino groups of lysine, arginine or histidine in proteins. They can cause radicals formation and weaken an intracellular antioxidant mechanisms. The glutathione depletion leading to change in cells redox status was demonstrated. Anti-inflammatory mechanisms impairments and intensification of neutrophils myeloperoxidase release causing vascular homeostasis disruption were shown. Myeloperoxidase can cause proteins oxidation and lipid peroxidation. Lipids peroxidation and increased acute phase proteins level associated with smoking, may exert a direct effect promoting the occurrence of cardiovascular diseases and play a role in pathogenesis of atherosclerosis and endothelial damage.