As a preliminary step toward incorporating a tobacco education and intervention program into our undergraduate medical curriculum, this study was designed to assess students' smoking-related behaviour, knowledge and attitudes towards tobacco, and perceptions of their future role as doctors in smoking intervention. A cross-sectional, study was conducted in the university year 2001/2002 on a representative sample of male medical students enrolled in 4th and 5th years at Alexandria University. A total of 320 students across the 2 years completed the survey. The smoking rate among medical students was 17.5% (10.9% smoked daily and 6.6% occasionally). The awareness of harmful effects of smoking and knowledge about the causal role of tobacco in the development of specific diseases were deficient. The intention to perform smoking intervention in the future as doctors seemed unsatisfactory. About 85% of the students thought that doctors should carry out smoking cessation advice depending on the disease, while the rate of those who thought so irrespective of the disease did not reach 44%. Current smokers thought less actively about smoking intervention than non-smokers. Nearly two-thirds of students (65.3%) felt they were not sufficiently prepared for caring or counseling smokers, and only 31.9% of students were convinced of the effectiveness of the doctor's advice to stop smoking. Seventy-seven and half percent of them desired specific training in smoking intervention. Non-smokers were more in favour of legislative actions to discourage tobacco use than current smokers. These findings suggest that medical school authorities should design and implement an appropriate basic training aimed at better preparing medical students for their future role in prevention of smoking. Specific teaching of medical students about smoking-related diseases and a patient-centered smoking cessation intervention is required to provide future medical practitioners with the knowledge and skills they need to effectively intervene with smokers.