The objective of this study was to determine the attitude of general dentists towards smoking cessation and prevention in their child and adolescent patients in Riyadh, Saudi Arabia. A questionnaire was utilized to record demographic information and the dentists' opinion about their responsibility, effectiveness, and confidence in smoking cessation and prevention. A total of 208 general dentists completed the questionnaire. About two-thirds (62.5%) of the respondents thought to "some extent" or "considerable extent" that it was their responsibility as dentists to help children and adolescents in smoking cessation. A majority (69.3%) also thought it was part of their responsibility (with varying degrees) to prevent smoking in children and adolescents. However, the respondents were not very optimistic about the effectiveness of their counseling in smoking cessation, as 37.0% thought their counseling would "not be effective at all" and 38.5% only "moderately effective." The majority (59.2%) of the respondents were either "not at all confident" or only "somewhat confident" in their ability to help children and adolescents in smoking cessation. Slightly more than one-third (35.6%) of the respondents had attended a formal course/training in smoking cessation and prevention. It can be concluded the majority of general dentists consider smoking cessation and prevention as part of their responsibility. However, there is clear evidence of a lack of confidence and doubt about the effectiveness of their smoking intervention efforts.