Smoking is an important cause of morbidity and mortality. Preventing and halting tobacco use are worthy strategies to improve the overall health of any population. Smoking and tobacco use begin during early adolescence, and most smokers try their first cigarette by age 12. A variety of psychosocial factors are involved in the initiation of tobacco use by adolescents. Strategies to prevent tobacco use should address these factors. Cessation efforts are hampered by nicotine addiction, which occurs in adolescents in a manner comparable to adults. Physicians and health care providers can assist adolescents in their attempts to quit tobacco use. A combination of counseling, peer and family support and, for some, nicotine replacement therapy, is the best approach to tobacco cessation. This paper reviews the findings of the major epidemiologic surveys of adolescent tobacco use and suggests strategies that health care providers can employ to reduce tobacco use among their adolescent patients.