OBJECTIVES: The prevalence of cigarette smoking is increasing in Pakistan, making it a strong case for addressing tobacco as a risk factor at all levels of prevention. We designed a survey by formulating a questionnaire that addressed the attitudes, perceptions and habits of smokers who have tried to quit and failed, or those who have never tried to quit. METHODS: This was a telephonic survey, conducted in 120 of the 671 smokers who agreed to participate, from June 2007 to November 2007. 23 major cities of Pakistan were selected randomly. Descriptive Statistics were used. RESULTS: A total of 89.2% smokers agreed that they are concerned about the health risks associated with smoking. Currently, 14.2% of smokers are being diagnosed with Hypertension, 6.6% with Diabetes Mellitus and 5% with Cardiovascular Disease. 57.5% of the smokers are not aware, how to stop smoking; 35.9%, who have never tried to quit smoking, told that they didn’t know where to turn for help. A total of 23.1% didn’t receive enough support from their friends or family also their doctor never raised this issue; 64.2% smokers have admitted that quitting smoking is the hardest thing they have ever tried to do. Withdrawal symptoms 50.6% and craving 41.8% were the major reasons for failure. A total of 62.7% rarely tell people when they are trying to quit smoking. A total of 90.2% smokers are not aware of the role of a smoking cessation specialist; 88% of the prescription medications. The only strategy known to them, 77.8% are relying on their will power to quit. 63.9% agreed that they would consult doctors if they needed help to quit smoking. CONCLUSIONS:It is essential that the doctor-patient dialogue on smoking takes place to ensure smokers are motivated and supported with appropriate advice, tools and medications to help them quit. It’s equally important that doctors raise the issue with their smoking patients