According to WHO there is an estimated one billion smokers in the world today, out of which about 4.9 million die each year as a result of tobacco use. It is also projected that given the current use of tobacco it would be the leading cause of death and disability by 2020. Studies point to growing numbers of smokers in developing countries and that tobacco consumption is growing at a faster rate in Africa than in any other part of the world. ( Ait-Khaled, Bulletin of the WHO 2001). Globally, tobacco use and exposure to second hand tobacco smoke are major risk factors for coronary heart diseases, cerebrovascular diseases, lung and other cancers, and chronic obstructive pulmonary diseases (COPD). Also smoking during pregnancy is associated with adverse outcomes such as low birth weight babies, premature deliveries, spontaneous abortions, stillbirths and neonatal deaths. The majority of adult smokers initiate the use of tobacco before the age of 18 during their adolescent years. Recent trends show that the smoking prevalence rates among adolescents is rising; and that age of initiation is decreasing. If these patterns continue, tobacco use will result in the death of 250 million children and young people alive today, many of them in developing countries. Thus, adolescents and school-aged children should be a primary focus for intervention strategies