Background: A lack of offspring caused by sterility of one or both partners is an increasing social problem that concerns 10-19% of couples. This percentage is even higher if we take into consideration those couples who cannot have healthy offspring in spite of being able to conceive a baby. The aim of the paper was to analyze the awareness of the effect of smoking on reproductive failures in couples with infertility or habitual abortions, and in couples experiencing miscarriages and having a child or children with congenital defects. The couples underwent cytogenetic, and in some cases, molecular analysis in the Genetic Outpatient Clinic at Dr. A. Jurasz University Hospital in Bydgoszcz. Material and Methods: The studied group consisted of 201 couples. In the medical documentation analysis the following aspects were taken into consideration: the patient's age, family history, genetic determinants, infections, environmental and occupational factors, which might have caused reproductive failures in the examined couples. Results: 26.4% of women admitted cigarette smoking, they most often represented the group of couples having a child born with defects; 46.8% of men admitted smoking and they most often represented the group of couples that experienced habitual abortions. Conclusions: Although it is obvious that cigarette smoking during gestation period is extremely harmful to the mother and the fetus and may significantly contribute to reproductive failures, public awareness of this problem is still insufficient and smoking habit is unfortunately widespread among pregnant women. Med Pr 2009;60(2):117-123