Abstract: Nicotinic acetylcholine receptors (nAChRs) are membrane-gated ion channel receptors. Acetylcholine interacts with these receptors; activates cell proliferation, apoptosis, and other downstream signaling pathways; participates in various pathophysiological processes in the lung tissue; and plays an important role in lung carcinogenesis. α7-nAChR is an important subtype of nAChRs that is involved in pneumonia development. It is involved in lung cancer cell proliferation, angiogenesis, metastasis, and inhibition of apoptosis. Nicotine, as an agonist of α7-nAChR, is significant in the research and development of drugs for the treatment of lung cancer. This article will review the role of α7-nAChR and its downstream signaling pathways in pneumonia and lung cancer, providing a basis for the formulation of anti-inflammatory strategies and research on new anticancer drugs.