Background: Cigarette smoking is the prime cause of preventable disease and death worldwide. Objective: study the smoking pattern among the attendants at the family medicine outpatient clinics of Kasr Al-Ainy Teaching Hospitals, Cairo University. Methods: A cross-sectional study investigated the smoking pattern in a systematic random sample of 200(199 males + one female) smokers aging 16-79 years. After verbal consent, the participants were inquired about their demographic features, smoking motives (Horn questionnaire) and nicotine dependence (Fagerström questionnaire). Results: Most of participants were male (99.5%), married (79%), attracted to smoking by peer pressure (68%) & craving(93.5%) below the age of 18 years and for an average duration of 25 years (59%), highly nicotine dependent(59%) and referred to medication as the main method of smoking cessation (64.5%). Nicotine dependence was significantly associated with presence of smokers among family members or friends, previous attempt to quit smoking and addiction (p< 0.05). 73% of smokers tried, mostly self-motivated (98%), because of existing health problems (44.9%) and coping with stress from social & work problems (35.4%) to quit smoking 3 times before for an average duration of 5 months (73%). Conclusion: smoking seems peculiar to males, particularly married ones who often get motivated by craving and start smoking below 18 years. Starting smoking early in teenage might explain their high nicotine dependence and failure of quitting smoking. Therefore, smoking cessation program should be a top priority and targeted to prevent smoking in adolescence.