A single puff of cigarette smoke is 35 ml. If the smoke of well over 100 billion cigarettes—the daily consumption in the United States—could be synchronized and conglomerated at one site, it would create a fitting distress signal symbolic of the magnitude of national health hazard of smoking. Obviously, even though millions have given up smoking, consumption of cigarettes is still on an extremely high level. According to authoritative reports, in the United States men over 25 are smoking less but this decline is counteracted by increase in smoking among teenagers and women. The subject of this writing pertains to 33 percent of women of childbearing age who are smokers. In particular, items relative to pregnancy, neonates and related topics will be presented. They represent valid indictment of smoking, based on substantial corpus delicti. Tokuhata, GK of the University of Tennessee (Arch Environ Health 17:353, 1968) recorded increased infertility and less frequent pregnancies in cigarette smokers. In his opinion, probably the ova are affected by smoking (prezygotic impairment of reproduction). Also, other studies with the Rubin insufflation test are suggestive of the adverse effect of smoking by interfering with ovum migration, ovum fertilization and ovum transfer at uterotubal junction into the uterus. Russel, CS et al (J Obst Gynec 73:742, 1966) noted increased occurrence of abortion, fetal death and stillbirth among smokers. Others state that the heavier the smoking the higher the rate of abortion. Also, Heron, HJ (New Zealand MJ 61:545, 1962) observed that neonatal mortality was higher in infants of women who smoked. It is thought that in onehalf of infant deaths in the United States, low birth weight is an underlying or contributory factor. It was pointed out at the 1975 World Conference on Smoking and Health that 5 percent of stillbirths in the United States was caused by smoking. Fabia, J (Canad MA J 109:1104, 1973) found that the risk of perinatal death was 24 percent higher in smokers than in nonsmokers. Reports indicate that prematurity of neonates is twice as high in women who are moderate or heavy smokers as in nonsmokers. Respective causal factors include reduced weight of the fetus (the heavier the smoking the smaller the newborn), constriction of the blood vessels, reduced weight of the placenta: Haberman, JA (Nat Forum on Management of Smoking Problems, Chicago, 1968) reported that reduced placental temperature was found by thermogram during smoking a single cigarette by women in the last trimester of pregnancy; inadequate supply of oxygen because of high COHb concentration in the blood (the latter may reach 4–6 percent in moderate smokers and 12 percent in heavy smokers, in contrast to 0.62–1.24 percent found in urban population); Moeschlin, S (Poisoning—Diagnosis and Treatment, New York, Grune & Stratton, 1965) states that iron and other heavy metals act as intracellular intermediate oxygen carriers; blockage of the latter within certain enzymes by CO results in intracellular hypoxemia; also, increased production of oxytocin, and early rupture of the membrane. Retardation of fetal growth by smoking has been observed in experimental animals and in humans. In gravid smokers the mean birth weight may be 6 to 8 ounces less than that of infants born to mothers who are nonsmokers. As a corollary it may be mentioned that MacCormack, WJ (Arch Ped 69:157, 1952) ascertained that smoking one cigarette caused destruction of 25 mg of vitamin C in the body. Vitamin C is essential for the synthetic processes of all cells and its lack lowers phagocytic activity of leukocytes. Butler, NR et al (Br Med J 4:573, 1973) found in a British National Child Development Study that children at ages 7 and 11 years manifested a deficit due to smoking. Those of mothers who smoked ten or more cigarettes a day were between three and five months retarded in reading, mathematics and general ability as compared with progenies of nonsmokers. Habituation to smoking is an extremely difficult challenge because more often than not the euphoria of smoking renders inveterate smokers oblivious of or indifferent to its hazards.