Prevention of smoking is a public health goal recognized worldwide. Though the role played by physicians is an important one, data in the literature indicate that medical school is a poor place to learn it. In 1997, we conducted a study among medical students at Monastir Tunisia to examine their smoking behavior and attitudes towards smoking and their participation in prevention. The study included 93.3% (N = 501) of the students in their 1st, 4th and 5th years of medical school. One-third of the students (33%) were smokers, including 15% occasional smokers. The students recognized the effect of smoking on coronary arteries and bronchi but two-thirds of them were unaware of its role in bladder cancer. The students did not warn their patients unless they had a disease related to smoking. Half of the students felt they were not sufficiently prepared for caring for smokers and desired specific training. These findings suggest medical school authorities should design and implement appropriate basic training aimed at better preparing medical students for their role in prevention of smoking.