Background & Objectives: This study was designed to examine relationships between smoking behavior and smoking attitudes among 6th-grade students in Korea in order to provide knowledge on school-based programs for preventing adolescent smoking behaviors. Methods: Questionnaires were administered to 464 students attending three public elementary schools in O city from June 13 to June 16, 2006. The total sample size is 458 (response rate = 98.7%). Data were statistically analyzed by frequency analysis, cross tabulation, and multiple regression. Results: First, smoking behavior was significantly influenced by the factors of gender, self-concept, family structure, sibling smoking, school achievement, relationship with teachers, satisfaction with school life, and smoking friends. Theprevalence of ever-smoking was 12.7% among 6th grade students in this study. Students were most likely to initiate smoking in the 5thgrade with curiosity and smoke at their own home. Second, students showed negative attitude toward smoking overall. From the detailed section, students respondednegatively about smoking in public places while they thought that adult smoking with moderate level was okay. Student who showed positive attitudes toward smoking in the present study were significantly related to the factors of self-concept, family environment, parental and sibling smoking status, school achievement, satisfaction with school life, and smoking friends. Third, Students who had tried cigarette smoking were likely to report less negative attitudes toward tobacco than non-smoking students. Fourth, this study found that smoking friends were the most significant predictor of positives smoking attitudes. Other factors significantlyassociated with smoking attitudes were gender, relationship with friends, self-concept, relationship with teachers, paternal smoking status. Conclusions: The study results suggest that smoking prevention programs focus on resisting peer influence and need to be community-incorporated and/or comprehensive from elementary to high school.