Cigarette smoking is one of the major risk factors for coronary heart disease. The relationship between cigarette smoking and blood lipids and lipoproteins is reviewed in the context of the many potentially confounding factors such as alcohol and nutritional intakes, obesity, physical activity levels, and menstrual cycle periodicity. It appears that cigarette smoking is unfavorably associated with blood lipids and lipoproteins even after adjusting for these confounding factors in both men and women. Examining the studies on the effects of cigarette smoking on blood lipids and lipoproteins, the most consistent observation is the noted increase in postprandial TG in smokers. However, many studies have shown a rapid increase in high-density lipoprotein cholesterol concentrations 2 to 6 weeks after smoking cessation. The underlying physiological mechanisms for changes in lipids and lipoproteins remain inconclusive. It is clear that well controlled studies are needed to examine the effects of cigarette smoking on the blood lipids and lipoproteins. These studies should, in particular, focus on women, young adults and adolescents.