The upper aerodigestive tract is the first compartment of the human body that takes contact with the harmful components of the tobacco smoke. The passage of the smoke, whether in an active or even passive smoker determines some alterations in the ENT area, which is directly exposed to the harmful action of the tobacco smoke. In this study we intend to analyze the relations between the ENT pathology exemplified at all levels (nasal, laryngeal, ear) and the tobacco smoke. Based on some studies, this paper describes the alterations that occur at the level of the nasal fossae, oral cavity, larynx and pharynx, and also at the level of the ear. The article analyses the relationship between these alterations and the determined pathology. Based on the statistic studies, we relate the active and passive smoke with the possibility of the development of neoplasia in some organs of the ENT area. In conclusion we insist on the necessity that the medical publications as well as the mass media to incriminate smoking as the most relevant risk factor in the development of cancer in the upper mentioned organs, in the twenty first century where tobacco is considered a worldwide epidemic.