To determine the prevalence and pattern of smoking amongst Pakistanis. SAMPLING DESIGN: A two stage stratified sample design was adopted for the survey, Primary Sampling Units (PSU's) and Secondary Sampling Units (SSU's). Urban and Rural, Pakistan 1990-94. Stratified systematic sample of 9441 males and females aged 15 years and above. Smokers were defined as, subjects who were currently smoking and who had smoked > or = 100 cigarettes/beedis or chillum/huqqa in their life time. In Pakistan 21.6% (36% males and 9% females) of 9441 subjects were smokers. In urban areas it was 20.7% and in rural 22.0%, males were predominant in both urban and rural areas. Proportion of smokers who used cigarette/beedi were significantly higher in males (60%) while chillum/huqqa were more in females (62%). Prevalence increased with age upto 64 years, after which it declined but in urban females it continued to rise with age. Among both males and females; illiterate, married individuals with poor general health were more likely to smoke. These factors were 2 to 3 times more in males and 2 to 5 times more in females who were more likely to be smokers than those who were literate, single individuals with good general health. Smoking was more prevalent in illiterate, married persons and those with poor general health.