A survey of 2120 adults in Alexandria, Egypt, studied the determinants and patterns of tobacco cessation among ever smokers. Ever smokers were 30.7% of respondents; only 3.5% had given up smoking (quit ratio of 11.4%). The quit ratio was significantly lower for ex-daily smokers (7.5%) than for ex-occasional smokers (44.8%). Among current smokers, 56.3% were between the contemplation and preparatory phases for quitting, whereas 25.1% were in the action phase of attempting to quit, for an average duration of 2.5 months, before relapsing. Health concerns were the motive for all ex-smokers and 95.0% of attempters, but craving for nicotine was the commonest reason for relapse. Tobacco cessation was predicted by older age of tobacco initiation, shorter duration of use, presence of health problems and a perception of the benefits of quitting.