Cigarette smoking is generally considered to be the most important preventable cause of death in the United States. To determine the public health impact of smoking in the District of Columbia, the DC Commission of Public Health calculated smoking-attributable mortality, morbidity, and economic costs in this predominantly black population. In 1985, an estimated 933 district residents died from smoking-related diseases, resulting in 3535 years of potential life lost. Cigarette smoking contributed to approximately 13.5% of all District deaths in 1985 (N = 6921) and accounted for 30% of all deaths of persons over age 20, far exceeding the affect of other potentially preventable causes of mortality. Black residents, especially black men, shared a disproportionately greater burden of smoking-attributable mortality when compared with white residents. These smoking-attributable deaths resulted in over $110 million in direct medical and indirect morbidity and mortality costs to District of Columbia residents. The results indicate that cigarette smoking is a major contributing cause of the black-white disparity in health status in the District of Columbia.