OBJECTIVE: To describe the delivery of smoking preventive counseling to preadolescent, adolescent, and young adult patients in an Arab population, and to examine counseling behavior according to physician demographic characteristics and perceived barriers to counseling. METHODS: A cross-sectional mail survey was carried out among general practitioners (GPs) in private practice in the Emirates of Sharjah, Dubai and Abu Dhabi. RESULTS: Of 391 eligible GPs, 218 (56%) completed the questionnaire. Overall 29, 50 and 65% of GPs offered preventive advice to preadolescents (9-12 years), adolescents (13-19 years) and young adults (20-24 years), respectively. Lack of patient educational materials was cited by 71.8% of GPs as a very important barrier to offering smoking prevention counseling, followed by lack of community resources (66.5%) and lack of time (62.2%). Older age, male gender, and having knowledge of the stages of change were positively associated with offering preventive advice. CONCLUSION: Physician self-reports of their smoking prevention counseling practices suggest there is opportunity for improvement. More training and support is needed to improve and encourage physician adherence to current smoking prevention counseling guidelines. PRACTICE IMPLICATION: More research is needed to determine the most effective method to improve delivery of preventive care by GPs, and to communicate appropriate preventive or cessation messages.