Historically, tobacco use was primarily recreational and has been smoked in cigarettes, cigars and pipes, as well as smokeless forms of consumption, all of which are associated with adverse health effects. However, recent scientific investigations indicate that tobacco also contains several diverse secondary metabolites that may provide potential health benefits in the treatment of cancer and neurodegenerative diseases. Specifically, the leaf and flower of Nicotiana tabacum contain high amounts of the key flavor ingredient, cembranoids. Tobacco alpha- and beta-2,7,11-cembratriene-4,6-diols display potent anticancer activity. These compounds have also been found to inhibit phorbol ester-stimulated (32)P(i) incorporation into phospholipids, induction of Epstein-Barr virus early antigen and protein phosphorylation. This review focuses on the biocatalytic and semisynthetic studies of tobacco cembanoids and their anticancer activity.