There are several life style choices which may impact fertility and thus national birth rate. Epidemiological cohort studies indicates that modification of life style habits, among them nicotine consumption can influence reproductive health. Influence of tobacco smoking on reproductive health has to be analyzed within the context of the influence of body mass index, caffeine and alcohol consumption, exercise, maternal and paternal age, and stress. Approximately 27% Polish women and 23% Americans smoke cigarettes during their reproductive years. Cohort studies directly showed the relationship between nicotine consumption and decrease in fertility among smoking women. Besides there is evidence that smoking leads to higher rate of congenital heart defects, limbs abnormalities, central nervous malformations among infants born to smoking mothers. Finally, the relationship between smoking and decreased fertility should be of great concern since Polish fertility rate has dropped from 1989 till 2007 year from 2,1 to 1,27 respectively. Programs focused on improvement in national birth rate should focus also on decrease smoking rates among women.