The 18 kDa translocator protein (TSPO) is mainly located in the outer mitochondrial membrane, widely spread throughout the body tissues and is abundant particularly in steroid-synthesizing organs. Cigarette smoke (CS) is considered as a major risk factor for the development of oral, lung, and cardiovascular diseases, as well as cancers. TSPO protein expression is elevated in cells exposed to CS, which subsequently results in increased TSPO-related cellular processes. CS-induced overexpression of TSPO may lead to interference with cellular functioning and eventually to tissue damage, and promotes the development of various pathologies, mainly oral, lung, and cardiovascular diseases. TSPO is involved in intra-cellular functions such as apoptosis, inflammation, proliferation, and regulation of mitochondrial membrane potential. Hence, the CS-induced upregulation of the TSPO expression may contribute to the development of malignant and non-malignant oral, lung and cardiovascular diseases, including tumor growth, progression, and metastasis. Therefore, TSPO may be a target for novel treatments for various CS-associated pathologies.