Introduction: In Romania, there are no nationally representative descriptive data about tobacco smoking among university students in medical training. Aims: To develop and generally implement the smoke free university project in Romania, starting with the University of Medicine and Pharmacy Târgu Mureș, by involving students as volunteers in primary data collection, evaluation, project planning and implementation. Methods: Our long term intervention project is based on partnership with the university leaders, and the local student organizations. The first step of the project was gaining baseline data about the smoking prevalence, and testing willingness to participate in the smoke free university project. The questionnaire we used was based on Global Health Professions Student Survey methodology with our additional items concerning the projected plans of intervention. The target population was the total actual number of students (n = 4,151) of all years and faculties (medicine, dentistry, pharmacy, nursing). 76.0% (3,203) participated (71.4% females and 28.6% males). We used the IBM-SPSS program for descriptive statistical evaluation. Results: There were 143 volunteers recruited for further preventive interventions. Th e overall prevalence of current smokers was 34.1% (31.6% among females and 40.0% among males). Related to faculties, the prevalence was 33.7% in medicine, 38.7% in dentistry, 29.5% in pharmacy and 33.9% in nursing. With increasing years, the smoking prevalence became higher (1st year 32.0%, 6th year 39.1%). The current use of other tobacco products than cigarettes was 14.2%. Concerning only the university compound, every fourth student 26.9% admitted that he/she smoked cigarettes and 5.1% used other tobacco products in the last year. Every fifth current smoker (20.6%) declared that he/she smoked cigarettes inside the university buildings and 47.4% rejected any smoke-free university policies. Conclusions: Our study indicates a high prevalence of smoking among students of our university. Every third student is a current smoker, and every fourth smoked cigarettes in the university compound. The first steps of enforcing any smoke free regulations must be consulted previously with our volunteering students. The second step should be gaining support by the whole community. Research funding: Research reported in this publication was supported by the Fogarty International Center and the National Cancer Institute of the National Institutes of Health under Award Number R01TW00928001. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.