The aim of this study was to systematically assess the association between smoking and cardiovascular disease and disease progression among novel coronavirus pneumonia (COVID-19) cases. PubMed database and Cochrane Library database were searched by computer to seek the epidemiological data of COVID-19 cases and literatures regarding cardiovascular diseases from 1 Jan to 6 October 2020. Two researchers independently conducted literature screening, data collection and the assessment of the risk of bias of the studies included. RevMan 5.2 software was employed for meta-analysis. Funnel plot was adopted to assess the publication bias. On the whole, 21 studies comprising 7041 COVID-19 cases were included. As revealed from the meta-analysis, 14.0% (984/7027) of cases had a history of smoking, and 9.7% (675/6931) were subject to underlying cardiovascular diseases. Cases with a history of smoking achieved a higher rate of COVID-19 disease progression as opposed to those having not smoked [OR = 1.53, 95%CI: 1.29 -1.81, P < 0.00001], while no significant association could be found between smoking status and COVID-19 disease progression [OR = 1.23, 95%CI: 0.93 -1.63, P = 0.15]. Besides, smoking history elevated the mortality rate by 1.91-fold [OR = 1.91, 95%CI: 1.35 -2.69, P = 0.0002]. Moreover, underlying cardiovascular disease elevated the incidence of severe disease by 2.87-fold [OR = 2.87, 95%CI: 2.29 -3.61, P < 0.00001] and mortality by 3.05-fold [OR = 3.05, 95%CI: 1.82 -5.11, P < 0.0001] in COVID-19 cases. As demonstrated from the current evidence, smoking displays a strong association with COVID-19 disease progression and mortality, and intensive tobacco control is imperative. Moreover, cases with cardiovascular disease show a significantly elevated risk of disease progression and death when subject to COVID-19. However, the association between COVID-19 and cardiovascular disease, and the potential effect exerted by smoking in the development of the two still require further verifications by larger and higher quality studies.