Smoking is considered as a major health problem causing a public health threat, which is gradually increasing all over the world leading to high mortality and morbidity. The present study was conducted to estimate the prevalence of smoking, its motivating factors and its relation with the academic performance of the students of Medicine and Science colleges of Al-Baha University in Al-Baha, Saudi Arabia. A cross-sectional survey was conducted during the period from the beginning of December 2015 to the end of February 2016 in Al-Baha University, Al-Baha, Saudi Arabia. Simple random sampling technique of male undergraduate students from the medicine and science colleges was used. Presenting a pretested online questionnaire for 552 under graduated male students for data collection. The students’ age ranged between 18 and 26 years and their mean age was 21.5 years ±1.6 SD. The overall prevalence of smoking was estimated to be 46.4%. More than one third of the smokers (38%) were smoking because of boredom and imitating their friends, followed by 23% of them because of study overload, imitating their friends, because of boredom and imitating their families. Smoking was more prevalent among science college students rather than faculty of medicine students (P-value < 0.001) and significant associations were found between type of college and number of cigarettes smoked per day (P-value < 0.001), when the student initiated smoking (P-value = 0.001), and motives of smoking (P-value < 0.001). Moreover, smoking was more prevalent among students in the fifth and sixth level of the study (P-value < 0.001) and significant associations were found between level of the study and number of cigarettes smoked per day (P-value = 0.001), when the student initiated smoking (P-value < 0.001), and motives of smoking (P-value < 0.001). Inconsistent with previous studies, we found that smoking was more prevalent among the students with the average and very good academic grade (P-value < 0.001). Moreover, significant association between academic achievements and when the student initiated smoking was found (P-value < 0.001). The prevalence of smoking was very high among the study population and the initiation of the smoking earlier with high number of cigarettes smoked per day was alarming. Imitating their friends, boredom, study overload and imitating other family’s members were found as the main motives of the students to smoke. Unlike previous studies’ findings, smoking found to be more prevalent among students with good academic performance and the prevalence increase steadily with the presence of smoking relatives. Health and higher education authorities need to design an appropriate and effective antismoking promoting program addressing its motivating factors and rapidly increasing prevalence. Health laws should be the cornerstones for any organized tobacco control activities, which are urgently needed to prevent the coming smoking-related health catastrophes. It is of high concern to change the students understanding about the future adverse effects of smoking even if it is associated with good academic achievements.
 

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