Background: Tobacco consumption is increasing among women across the globe at alarming rates. Without effective intervention, the smoking prevalence among women will nearly triple over the next generation. These trends are potentially more threatening when considering how tobacco intersects women's lives, regardless if they use tobacco products or not. Aim: A review and analysis of the literature is conducted to examine the scope of tobacco's global effect on the multiple dimensions of women's health. Method: Medline (1990–2003), Cumulative Index to Nursing and Allied Health Literature (1990–2003) and World Health Organization databases were searched for related topics. Keywords for searches included global health, tobacco, women and nursing. Findings: The epidemiology and prevalence of tobacco use among women are presented and its impact on women globally. Using an ecological perspective, the consequences of tobacco are analysed within the contexts of health, social, environment, economic and policy as it relates to women, their families and their communities. Implications: Nurses are in prime positions to empower individuals, families, communities and nations in the prevention and treatment of tobacco use. Health for all women continues to be a call for equity and social justice. Recommendations are provided for nursing practice, education, theory, research and policy to address this global health concern.