Smoking is one of the most influential risk factors for longevity and contributes significantly to regional and international mortality differences. This article illustrates the regional patterns and trends of life expectancy, smoking prevalence and lung cancer mortality in Germany. Based on cause-deleted life tables, we show that life expectancy is particularly affected by smoking in the northern part of western Germany. The current distribution of smoking prevalence among young adults, however, suggests a rise in smoking-attributable mortality in eastern German men and women and a re-widening of the east-west gap in longevity in the near future. Therefore, the effectiveness of prevention measures to stem the ‘smoking epidemic’ needs to be increased, especially in eastern Germany.