Introduction: Acute Respiratory Infection is an infection that occurs in the respiratory tract and is the main cause of death and mortality worldwide, especially in children aged 1-5 years. Air pollution from cigarette smoke is one of the substantial contributing factors to the incidence of ARI. It is estimated that 40-50% of children worldwide are regularly exposed to cigarette smoke, mainly from being around smoking parents. Toddlers who are exposed to cigarette smoke can get much higher substances of toxins and carcinogens than first-hand smoke. Children are more at risk for coughing, wheezing, excessive mucus production, and higher risk for various respiratory infections. Methods: This study used a literature review. of three international databases, there is Pubmed, EBSCO, and Sciencedirect with the keywords "Acute respiratory infection", " children under-five years", and "smoking behavior" that published between 2018-2022. The type of journal is the original and full text, and the design of this research is case-control and cross-sectional research. Result and discussion: There are 272 articles with the discovery of Pubmed 49 journals, EBSCO 72 journals, and Sciendirect is 151 journals. Then the researchers filtered through titles, research methods, and abstracts to find conformity with the relationship between smoke exposure from families of active smokers who have toddlers with the incidence of acute respiratory disease. A total of 17 articles can be employed in this study. Conclusion: It can be concluded that a smoking family can increase the incidence of Acute Respiratory Infection in under-five children.