Objectives: This study was performed to examined the effectiveness evaluation of peer education program on smoking prevention and cessation for elementary school students. Methods: Data were collected from 60 students in a rural area through self-administrated questionnaires. Child-leaders participated the peer education program to assist their friend, parent, and adult in community to quit the smoking for 4 weeks. Results and Conclusions: Major conclusions were as follows : 1. The peer education program on smoking prevention and cessation for elementary school students was reinforce to increasing the tobacco knowledge and the cessation skill, learning the communication skill, and improving the empowerment. 2. Image of tobacco, intention of smoking in future, recommendation for smoking cessation, pro of smoking. con of smoking, and level of assert in post-test were higher than those in pre-test. 3. There were significant differences in image of tobacco, con of smoking, and level of assert by grade between the pre-test and the post-test of peer education program. But intention of smoking in future, recommendation for smoking cessation, and pro of smoking were not related to effectiveness of peer education program. 4. Child-leaders for smoking prevention and cessation performed the their task to 1.4 persons per student. 5. Participating students were satisfied with the contents of program, the usefulness of educational materials, and preference of parents, but they were not satisfied with the usefulness of task note, learning time, and lecture room.