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Introduction: Health literacy plays a remarkable role in determining the status of people who smoke. In recent years, the smoking rate has been increased among university students. Therefore, this study aimed to determine the relationship between health literacy skills and adoption of preventive smoking behaviors among university students.
 
Materials & Methods: In this cross-sectional descriptive study, 347 students living in dormitories affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected through single-stage cluster sampling in 2016. The data were collected using the health literacy inventory for adults and a researcher-made questionnaire in order to assess the adoption of smoking preventive behaviors. The collected data were analyzed in SPSS software (Version. 16) through descriptive statistics and Pearson correlation coefficient. Ethics code: IR.TMU.REC.1394.172  
 
Findings: The mean scores of health literacy and the adoption of preventive smoking behaviors were 70.52±14.12 and 39.01±19.96, respectively, regarding the total score of 100. Moreover, there was a direct and significant relationship between health literacy (r=0.146) and dimensions of decision making and application of health information (r=0.161), reading (r=0.14), and appraisal (r=0.112) with the adoption of preventive smoking behaviors. However, this association was not statistically significant (P<0.05).
 
Discussion & Conclusions: The results show that special attention should be paid to health literacy and its influencing factors, especially in dormitories, in order to promote the adoption of preventive smoking behaviors among university students.