A broad range of non-neoplastic pulmonary lesions is associated with cigarette smoking including airway diseases with airflow limitation, vascular alterations and interstitial lung diseases characterized by diffuse radiographic abnormalities and restricted lung volumes. This article focuses on the pathology of smoking-related emphysema, alterations of large airways, alterations of pulmonary vessels, respiratory bronchiolitis associated interstitial lung disease (RB-ILD), desquamative interstitial pneumonia (DIP), and eosinophilic granuloma (EG).