A cross-sectional interview survey of tobacco use was conducted in Alexandria, Egypt, comparing current smokers with never smokers. Among men, the risk of current tobacco use was significantly higher among married participants (OR = 1.74), especially those with low educational or occupational status. In contrast, although few women smoked, tobacco use was significantly higher among those holding a university degree (OR = 15.33). Never smokers were significantly more knowledgeable than current smokers about tobacco-related health hazards. Never smokers had significantly better perceptions of the danger of tobacco use, susceptibility to health-related hazards and the benefits of being tobacco-free. Multivariate analysis revealed that tobacco use is independently predicted by participants' sex, age and educational attainment as well as their perceptions.