Purpose: The reduction of tobacco use among medical students is a potentially powerful strategy to reduce tobacco use among future health professionals, who in turn, can have significant impact on tobacco use among patients as well as the general population in China. The goal of this study is to update information on the prevalence of cigarette smoking among Chinese medical students and to assess modifiable factors for smoking reduction. Design/methodology/approach: Presented in the paper are descriptive, associative and path model analyses of survey data collected among 758 medical students in year one through year three from Hainan Medical College, Hainan, China. Findings: Among the total 758 participants, 66.9 percent of males and 26 percent of females smoked and 26.5 percent of males and 1.6 percent of females had smoked in the past 30 days. The median monthly expenditure on cigarettes was 30 Chinese Yuan (approximately US$4.25). The likelihood of smoking increased with male gender, more advanced year group, poor academic performance, perceived peer smoking, and depressive symptoms, after controlling for covariates. Originality/value: Findings reported in this study provide further insight into the smoking prevalence among medical students in China as well as adding to knowledge about several potentially modifiable factors that are related to smoking. Data collected in this study are likely to prove valuable in prioritizing tobacco control among Chinese medical students, as they are future medical doctors, and their smoking behaviors will have strong influence on their patients as well as the general public. (Contains 4 tables and 1 figure.)