Tobacco use is a major preventable cause of premature death and disease worldwide. In this article I briefly review the extent of the problem highlighting current policies that are effective in its control. I provide information on prevalence of tobacco use and tobacco smoke exposure (TSE) among children and adolescents worldwide along with mortality data and economic data. I summarize the public policies that have been shown to be effective in reducing tobacco initiation and TSE in children using as a framework the MPOWER recommendations from the World Health Organization (WHO). I review each one of these policies – monitoring, smoke-free environments, treatment of tobacco dependence, health warnings on packages, bans on advertising, promotion and sponsorship, and tobacco taxation- and explain how they can prevent smoking among children and adolescents and their exposure to tobacco smoke. Finally, I discuss the role of the pediatrician in understanding these policies and help in their implementation.