This literature review examines the relationship between smoking and post-COVID-19 syndrome. The study aimed to assess smoking as a potential risk factor for long COVID and explore underlying mechanisms. A systematic search of the PubMed/MEDLINE database identified 36 relevant articles published up to October 2023. The results indicate that smoking is associated with an increased risk of developing post-acute COVID-19 symptoms, particularly respiratory and cardiovascular issues. While some clinical conditions, such as dyspnea, cardiovascular symptoms, and cognitive or mental health impairment, show a strong association with smoking, the connection between smoking and upper-airway involvement is less clear. The available data support recommending smoking cessation as a clinical tool for the prevention of long COVID. Smoking is known to have complex effects on the renin-angiotensin system, potentially modulating the pathophysiology of long COVID. The review also highlights the need for further research to clarify the role of smoking in long COVID, considering the variability in study designs and data collection methods. Overall, the evidence suggests that smoking may play an etiologic role in the physiological manifestations of long COVID, including respiratory, cardiovascular, and possibly neurological symptoms. The study concludes that smoking cessation should be considered as a preventive strategy for long COVID.This literature review examines the relationship between smoking and post-COVID-19 syndrome. The study aimed to assess smoking as a potential risk factor for long COVID and explore underlying mechanisms. A systematic search of the PubMed/MEDLINE database identified 36 relevant articles published up to October 2023. The results indicate that smoking is associated with an increased risk of developing post-acute COVID-19 symptoms, particularly respiratory and cardiovascular issues. While some clinical conditions, such as dyspnea, cardiovascular symptoms, and cognitive or mental health impairment, show a strong association with smoking, the connection between smoking and upper-airway involvement is less clear. The available data support recommending smoking cessation as a clinical tool for the prevention of long COVID. Smoking is known to have complex effects on the renin-angiotensin system, potentially modulating the pathophysiology of long COVID. The review also highlights the need for further research to clarify the role of smoking in long COVID, considering the variability in study designs and data collection methods. Overall, the evidence suggests that smoking may play an etiologic role in the physiological manifestations of long COVID, including respiratory, cardiovascular, and possibly neurological symptoms. The study concludes that smoking cessation should be considered as a preventive strategy for long COVID.