Tobacco use leads to more deaths each year than any other single factor. This research examined teenagers' perceptions of anti-tobacco messages to determine which campaigns and educational approaches were most effective in preventing tobacco use among youth. Students from five rural high schools in western Pennsylvania were included in this survey-based study (N = 204). A total of 30 percent of the study population reported current tobacco use. Tobacco users held more negative perceptions of anti-tobacco messages than non-users. A majority of students held supportive views about anti-tobacco education programs that were facilitated by peer leaders. Existing anti-tobacco campaigns and education are essential components of tobacco control initiatives. Students' perspectives provide novel insights that educators and campaign designers should consider as they develop anti-tobacco programs. (Published Abstract)