A questionnaire study was performed in 2008 to evaluate consumption and knowledge regarding tobacco smoke amongst secondary school students (9th grade and 13th grade) in Brescia (Italy). Overall, 1,495 students completed the questionnaire (89.5% of the selected sample). The questionnaire was anonymous and self-administered. 29.4% of males and 36.2% of females attending 9th grade reported smoking at least one cigarette per week. In 13th grade, the percentage of males and females who reported smoking at least one cigarette per week were 37.7% and 42.2% respectively. 13.2% and 17.4% respectively of males and females attending 9th grade reported being habitual smokers (i.e smoking every day or almost). In 13th grade , 27.4% and 30.7% of males and females reported being habitual smokers. Most students attending grade 13 tried smoking for the first time between ages 12 and 15 years (mean age 13.6 years). Tobacco smoking was found to be associated with personal alcohol consumption and with smoking habits of family and friends. Results were compared to a previous survey conducted in 1989 with the same methodology. An increase of the proportion of smokers was observed in the present study as compared to the 1989 study. The increase was observed in both grades especially amongst females.