Objective. In this study, we attempted to clarify recent changes in the prevalence of smoking among Japanese physicians and factors related to smoking among physicians. Method. We conducted three self-administered questionnaire surveys on members of the Japan Medical Association in 2000, 2004, and 2008. In each survey, 3000 male and 1500 female physicians were randomly selected. Results. The total number of effective responses was 3771 in 2000, 3633 in 2004, and 3486 in 2008. The prevalence of smoking among male physicians decreased significantly from 27.1% in 2000 to 21.5% in 2004, and then to 15.0% in 2008 (p<0.01). The prevalence of smoking among female physicians was 6.8%, 5.4%, and 4.6%, in 2000, 2004, and 2008, respectively (p = 0.07). With regard to factors associated with being a current smoker, the odds ratios were significantly high for "male gender," "greater number of days on call/night shift," and "habit of daily alcohol consumption." Conclusions. The prevalence of smoking among Japanese male physicians has shown a declining trend. When planning antismoking measures for physicians, the number of days on call/night shift as well as the habit of daily alcohol consumption must be taken into consideration. (C) 2010 Elsevier Inc. All rights reserved.