The relationship between smoking and respiratory disease has long been established and smoking is recognised as a risk factor for chronic obstructive pulmonary disease (COPD) (Fletcher and Peto, 1977), lung cancer (Doll et al, 2004) and interstitial lung diseases (Bradley et al, 2008), as well as contributing to the symptoms of asthma (Siroux et al, 2000). However, when working with patients who have lived with their disease for some time, or who may feel it is too late to benefit from change, it is important to do more than simply reiterate the risks. The link between continued smoking, progression of respiratory disease, exacerbation of the condition and the detrimental effects of continued smoking on the efficacy of some treatments should also be communicated. This article looks at the risks of smoking, as well as providing guidance for community nurses on how to bring up the topic with their patients in a non-confrontational manner.