The elasticity of the arteries is determined by the histological composition of the arterial wall and plays a central role in in regulating globally the cardiovascular function. The stiffening of the arteries is a physiological, age-related process, with detrimental though effects on the central and peripheral hemodynamics. It is known that the arterial stiffening may be accelerated in the presence of various mechanical, oxidative or metabolic stress factors. Specifically, the exposure to tobacco smoke (active or passive) promotes arterial stiffness, enhances wave reflections to the aorta and provokes microvascular endothelial dysfunction, explaining (at least partially) the association between smoking and cardiovascular events. Among other toxic substances contained in tobacco, nicotine plays a pivotal role in the smoke induced vascular dysfunction by affecting both arterial stiffness and the central hemodynamics. Due to its central role in modulating the cardiovascular function, arterial stiffness (and its hemodynamic consequences) has a significant, independent role in predicting cardiovascular events. This has been demonstrated in different groups including patients with essential arterial hypertension, coronary artery disease, end-stage renal disease, aortic valve stenosis and in the general population. The combination of arterial stiffness with geometrical and functional data of the cardiovascular system gave birth to detailed mathematical models, capable of describing blood propagation phenomena throughout the arterial tree. These models offer unique opportunities to study complex physiological interactions, such as the impact of different component of left ventricular afterload on the evaluation of aortic valve stenosis or the interplay between cardiac output and systemic pressure waveforms. Apart from elucidating complicated pathophysiological mechanisms, the use of these patientadjustable models offers comprehensive diagnostic and therapeutic solutions that can be easily integrated in the everyday clinical practice, paving the way for personalized treatment in the era of individualized medicine.