In 2000, of approximately 32 million persons who received health insurance coverage through Medicaid programs, an estimated 11.5 million (36%) smoked. One of the national health objectives for 2010 is to provide coverage by Medicaid in the 50 states and the District of Columbia (DC) for nicotine-dependence treatment. The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments to increase the number of smokers who successfully quit smoking. The 2000 Public Health Service (PHS) Clinical Practice Guideline also supports expanded insurance coverage for tobacco-dependence treatments. The amount and type of coverage for tobacco-dependence treatment offered by Medicaid has been reported previously for 1998, 2000, and 2001. In 2002, all states and DC were surveyed again about the amount and type of coverage they provided. This report summarizes the results of the survey, which indicate that as of December 31, 2002, 1) 36 Medicaid programs covered some tobacco-dependence counseling or medication for all Medicaid recipients, 2) four states offered coverage only for pregnant women, 3) two states offered coverage for all pharmacotherapy and counseling treatments recommended by the 2000 PHS guideline, and 4) seven states covered all recommended medications and at least one form of counseling. To improve the health of populations with disproportionately high rates of smoking, the 50 states and DC should provide coverage under Medicaid for all recommended tobacco-dependence treatments.