Tobacco smoking is a major health risk factor which may influence the development and course of occupational skin diseases. So far, the results of studies investigating associations between tobacco smoking and the prevalence of hand eczema have been inconsistent, also in occupational settings. However, some studies indicate that hand eczema related to the work place is more severe and persistent in smokers than in non-smokers. Therefore, smoking cessation may be an important target for prevention and management of hand eczema and should be encouraged.