The aim of the study was to determine if a culturally sensitive smoking prevention program would have short-term impacts on smoking intentions among Aboriginal children. Two schools with high Aboriginal enrollment were selected for the study. A grade 4 classroom in one school was randomly assigned to receive the culturally sensitive smoking prevention program. A grade 4 classroom in the second school received a standard smoking prevention program delivered in this jurisdiction. Children in each classroom were tested pre- and post-intervention to measure attitude changes about smoking. There was a significant reduction in intentions to smoke among Aboriginal children who received the culturally sensitive smoking prevention program. The small overall sample size precluded a direct comparison of the efficacy of the culturally sensitive and standard programs. The present findings suggest a smoking prevention program that has been culturally adapted for Aboriginal children may reduce future smoking intentions among Aboriginal grade 4 students. Further research is needed to determine the extent to which school smoking prevention programs adapted to respect the long-standing use of tobacco in Aboriginal cultural traditions may be more effective than standard programs in reaching Aboriginal youth.