The purpose of this study was to explore smoking behaviors and attitudes among adolescents. A self-administered questionnaire was used to sample adolescents presenting for health care to physicians belonging to MIRNET, a network of family physicians collaborating on research across Michigan. The questionnaire was anonymous and was completed before the visit. Physicians or office nurses were asked to complete a brief face sheet on their patient's demographic information and smoking status, which was linked to the questionnaire through a code number. Twenty-seven percent of female patients and 16% of male patients were smoking and 57% had tried smoking. Knowledge regarding health risks of smoking was high, and the major reasons given for starting to smoke were curiosity and peer behavior. Current smokers reported greater alcohol and marijuana use and cited problems with stress and anxiety, peer behavior, boredom, and the influence of smoking parents and relatives as factors in continuing to smoke. Patients' suggestions for successful smoking cessation focused on peers, explicit messages through pictures, and medication.