The majority of persons who become regular smokers begin smoking during adolescence, making this period critical for preventing tobacco use. Evidence suggests that anti-tobacco mass media campaigns that include paid television advertising reduce youth smoking. With development of anti-tobacco programs in all 50 states during the 1990s, spurred by funding from the 1998 Master Settlement Agreement with major cigarette manufacturers, CDC, and other sources, an increasing number of states instituted anti-tobacco media campaigns. This report summarizes trends in median state estimates for the average number of state-funded anti-tobacco television advertisements to which adolescents aged 12-17 years were exposed per month in 37 states and the District of Columbia (DC) during 1999-2003. The findings indicate that the median state estimate of the number of advertisement exposures per month increased from 0.04 in 1999 to 0.80 in 2002 but declined to 0.63 in 2003. The decline in estimated exposure from 2002 to 2003 is consistent with cutbacks in funding for state tobacco-prevention and -control programs during this period. Reduced exposure to state-funded anti-tobacco advertising might be contributing to the recent lack of substantial change in youth smoking prevalence from 2002 to 2004, which had been declining substantially since 1997. The majority of states need to implement additional measures to ensure that adolescents are adequately exposed to effective paid anti-tobacco advertisements as part of tobacco-prevention activities.