The purpose of this study was to investigate the smoking habits of Greek elementary school students, their attitudes towards smoking, and their perceptions of the health consequences of tobacco use. Data were obtained from 1,092 elementary school students who completed a 24-item questionnaire designed for this study. Results indicated more older students smoked than younger ones and boys significantly outnumbering girls. Most of the students believed that people smoke for pleasure and relaxation or due to psychological problems and that people do not smoke primarily because of health or aesthetic reasons (smelling badly). Students' attitudes towards smoking were significantly related to their parents' educational status or the students' smoking behavior. Furthermore, students' negative attitude towards smoking was strongly associated with their age. Finally, it was found that age and parental educational status affected students' knowledge of the health effects of tobacco use. (Contains 4 tables.)