Tobacco kills 1 person every 6 seconds [1]¹¹¹¹¹¹ but it rarely makes headlines. Smoking is a risk factor for 6 leading causes of death [2]. Richard peto in his study in 1994 found that average loss of life for all cigeratte smoker was about 8 years and for those who died were 16 years [3]. A 3 inch cigarette can lessen your life by 3 minute. Smoking statistics according to WHO indicate more than a billion smokers till May 2010 [4].

Among one billion Indians, about 300 million adults use tobacco in various forms (47% of men and14% of women use tobacco in India) .Each year nearly one million people die of tobacco related morbidity in India and thousands of million exchequers is wasted [5]. According to WHO, mortality statistics have predicted a 10 fold rise in 21^st century compared to 100 million lives lost to smoking in the previous century. Tax increase by 10 % worldwide can prevent a minimum of 10 million tobacco related deaths [2].

In spite of this, we have not succeeded in rendering effective precautionary measures against smoking. Tobacco companies have long targeted youth as “replacement smokers” to take succeed those who quit or die. The industry knows that addicting youth is its future. Although anyone who uses tobacco can become addicted to nicotine, people who do not start smoking before age 21 are unlikely to ever begin [6].

Smoking is rampant among medical students all over the world. Without proficient preventive measures the numbers are steadily rising in countries like India. In a study across 15 medical colleges lifetime prevalence of cigarette smoking in medical students was reported to be 28.2%. Over one fourth (27.2%) of medical students initiated daily cigarette smoking before age 15 [4].

The ever demanding medical curriculum along with increasing career competition contributes to anxiety making medical students vulnerable to smoking. However medical students as future healthcare providers have to be torchbearers of a healthy lifestyle. Ideally they have to practice what they preach. In 2003, India passed an act banning smoking in public places.

The ministry of health and family welfare is now focusing on measures to ensure effective implementation and enforcement of this act.

Our study found that 44% got influenced by friends in initiating smoking, 16% by stress of studies and 20% by movies and others. Ranjeeta Kumari in her study revealed that tobacco use is mostly initiated due to peer pressure (78%). The other important factors responsible were curiosity and the effect of family members [8]. In this study 56% of smoker said they smoke for relaxing effect. Medical

students having strenuous schedules and burdened with their academics are more likely to be overstressed. The response of more than half of participants answering the reason for continuing smoking as to relax is evident here. This study shows us that alcohol accounted most for adverse habits associated with smoking but drugs were equally used by medical students. This indicates the vulnerability of medical students to these habits.

In this study 95% smokers tried to quite the smoking. Kerala study [7] found that only 16% of medical students had attempted to quit while Turkish study [11] found that 22.4% of medical students who smoke were not interested in quitting. This study found that 1/3^rd students are not aware of legislation related to smoking. Almost of all the students who were smokers tried to quit smoking. This shows the willingness of the smokers to quit and also their failure in cessation of smoking.

Students are trying to quite the smoking, support from friends and family could contribute significantly in helping them. Awareness regarding legislation related to smoking should be incorporated in students counseling activities. These findings emphasize the need for prevention programme targeted to young age. Handing over an addiction free society in inheritance to later generations is the need of the hour and urgent efforts should be aimed towards prevention of smoking.