The fact that tobacco smoking has came in focus over the past 10 years as an important factor in periodontal disease pathoginesis. One possible reason is the fact that the classic view of one etiological factor(the plaque) and predestinate reaction (the local response) has challenged. As a consequence periodontal disease are currently understood to be more complex by nature than previously conceived and several interrelated factor must be considered to coexist in complicated interplay. In this perspective, the role of tobacco, particularly tobacco smoking, is an interesting and may be typical example.