Although there are extensive antismoking efforts in the United States, smoking is a largely ignored health issue in Taiwan. In fact, tobacco advertising has increased dramatically since U.S. tobacco was first imported in 1987. We compared estimates of smoking prevalence of 83,281 Americans and 5,023 persons in Taipei, Taiwan, in 1986-1988. Among men, current smoking prevalence was higher in Taipei (49%) than in the United States (29%). In contrast, former smoking prevalence among men was substantially lower in Taipei (5%) than in the United States (32%). Young adults and those with lower and middle education levels had the highest smoking prevalence in both surveys. Among women, the current smoking prevalence was only 8% in Taipei, compared to 25% in the United States. The former smoking prevalence among Taipei women (1%) was also lower than among U.S. women (18%). Our findings indicate the need for expanding antismoking efforts in Taiwan, especially among men and among persons with lower and middle education levels.