Purpose: This study evaluated changes in choroidal and macular thickness in healthy volunteers and chronic smokers. Methods: Thirty-three eyes of 33 chronic smokers (study group) and 33 eyes of 33 healthy controls who had never smoked were prospectively evaluated. Comprehensive ophthalmic assessment included slit lamp biomicroscopy, stereoscopic fundus examination, and intraocular pressure measurement. Spectral domain optical coherence tomography was used to measure choroidal and macular thickness 1 month before smoking cessation (smoking period) and after 3 months of smoking cessation (nonsmoking period). Results: The mean age of the participants was 41.88 +/- 6.52 years (range, 26-52), and the average smoking duration was 8.6 +/- 2.5 years (range, 5-16). The thickness of the paracentral choroid (nasal: 1,500 mu m, p=0.001 and temporal: 1,500 mu m, p=0.001) had significantly decreased after 3 months of smoking cessation. The thicknesses of the subfoveal choroid in the smoking and nonsmoking periods were not significantly different (p=0.194). The mean central macular thickness was 267.21 +/- 18.42 mu m in the smoking period and 268.42 +/- 18.28 mu m in the nonsmoking period (p=0.022). Conclusions: Smoking was associated with statistically significant changes in paracentral choroidal and central macular thickness in healthy volunteers. Pathological studies should be performed to evaluate the effects of smoking on posterior ocular structures.