AbstractBackgroundEven though the prevalence of tobacco smoking has declined in the general population and among white‐collar workers, the prevalence of tobacco smoking among blue‐collar workers remains unacceptably high. Blue‐collar workers experience greater exposure to workplace toxins which can add to, or even multiply, their risk of adverse health effects from tobacco smoking. Among blue‐collar workers, workers in the restaurant, bar, and gaming industries are exposed to much higher levels of environmental tobacco smoke (ETS) than are office workers, and are at increased risk of cancer and cardiovascular diseases even if they are non‐smokers themselves.MethodsThe literature on health risks, and the disparity between white and blue collar workers in smoking prevalence, and the literature on various tobacco control strategies provide the sources on which this review is based.ConclusionsOver the past 20 years, the accumulating scientific evidence about smoking as an occupational hazard has prompted the implementation of various educational, economic, and legal tobacco control strategies. Am. J. Ind. Med. 46:161–169, 2004. Published 2004 Wiley‐Liss, Inc.