BackgroundMedical students are the first line active force to combat tobacco epidemic, but they may suffer from high smoking prevalence and wrong attitude themselves. The aim of the study was to assess the effect of current curriculum on smoking behavior of medical students in Kyrgyzstan.Methods20% random sample of all 6 years of the School of Medicine in Kyrgyz State Medical Academy were interviewed in spring 2016. The questionnaire included sections on tobacco products consumption and knowledge and attitude to counseling. We verified smoking status with exhaled CO measurement using Bedfont Smokelyzer.ResultsIn 618 students (48% female), the overall daily cigarette smoking prevalence was 21% (34% in males and 6% in females), being highest in years 1 and 3 and least in year 5 (prevalence difference 14%). With very low smokeless products and electronic cigarettes use prevalence, ever-smoking prevalence of waterpipe use was very high, reaching 85% in 6-year male students with alarmingly high prevalence in female students also. Only 74% students responded there was 100% evidence of harmful effects of tobacco, unchanged throughout the course of study.ConclusionsThe use of tobacco products, especially smoking waterpipe, in Kyrgyzstan medical students remains very high. Coupled with poor knowledge and high demand for more information, this demonstrates urgent need for more active and advanced training on tobacco control in medical school.