Background: Smoking is one of the largest public heath problems and a cause of major concern not only among European members such as Greece but also worldwide. Greece over the past years has been suffering from a smoking epidemic with dramatic consequences on the economy and the cost of health services. Therefore, the purpose of this study is to describe the extent of tobacco usage, the methods used to control tobacco consumption, and the main reasons of anti-tobacco legislation failure over the past decades in Greece. Methods: Data were collected from the international PubMed database and from the Greek database, Iatrotek, during January 2006 and the tobacco legislation was discussed with other counterparts in Greece and was rechecked with the Greek ministry of Health and Social Welfare. Results: Currently Greece has the highest smoking prevalence not only among members of the European Union but also among all members of the OECD. Recent epidemiological studies estimate that 40% of the adult population are daily smokers, with one in two adolescents in certain areas also current smokers. Although anti-smoking policies do exist, and have been enforced over the years, many factors have contributed to their failure with a pro-tobacco culture and an increasing number of adolescent smokers exacerbating the problem. Conclusions: It is obvious that the strict enforcement of a nationwide anti-tobacco policy must be a priority on the national health agenda, if we are to ever effectively combat the high prevalence of smoking in Greece.