We are learning more and more about the effects of smoking on orthopaedic conditions such as osteoporosis and osteoarthritis and on healing of fractures and tendons.- Smoking seems to have a slight protective effect on osteoarthritis.- Smokers have a higher risk of postoperative complications such as wound infection, death and prosthesis-related complications.- If smokers stop smoking preoperatively, the risk of general postoperative complications can be reduced, but this is yet to be proven for prosthesis-related complications.- Smoking patients experience slower healing of fractures and tendons and often have less favourable outcomes.- It is important to discuss the negative effects of smoking on the treatment of orthopaedic disorders with the patient.