Smoking can cause lung and other cancers, coronary heart disease, stroke, chronic respiratory disease, and other diseases. In 2008, CDC reported that cigarette smoking and exposure to secondhand smoke resulted in an estimated 443,000 deaths and 5.1 million years of potential life lost (YPLL) annually in the United States during 2000-2004. This report presents state-specific average annual smoking-attributable mortality (SAM) and YPLL estimates for the same period among adults aged >/=35 years. The report also compares 2000-2004 average annual SAM rates per 100,000 population with rates for 1996-1999. The analysis was based on data from CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) system. Substantial variation in average annual number of deaths attributed to smoking during 2000-2004 occurred among the states (range: 492 [Alaska] to 36,687 [California]). From 1996-1999 to 2000-2004, declines in SAM rates occurred in 49 states and the District of Columbia (DC), reflecting progress made in lowering smoking prevalence in the United States during the past 40 years. Rates declined in men in 49 states and DC, but declined in women in only 32 states. To reduce SAM rates further, comprehensive evidence-based approaches for preventing smoking initiation and increasing cessation need to be implemented fully, and states should fund tobacco control activities at the level recommended by CDC.