Although smoking tend to decrease in developed countries, it is increasing in developing countries. Smoking is causing poor health world-wide and reduce the lifespan of the smoker by about 15 years. Maternal smoking during pregnancy results in an increased incidence of respiratory disease and it programs the offspring to develop respiratory and other diseases later in life. Nicotine replacement is prescribed by some health professionals to assist pregnant smokers to quit the habit. Nicotine, like tobacco smoke also changes the program in the developing fetus and neonate that, for instance, control the development, aging and function of the respiratory system, to develop respiratory diseases in he long term. Consequently the susceptibility of the offspring to respiratory and metabolic diseases increases. Nicotine replacement is therefore not an option as a strategy to quit smoking. Other strategies, together with a a healthy lifestyle, such as adequate quantities of fruit and vegetables, should be adopted.