Nearly one in five deaths in those aged 35 and over are due to smoking, according to Government figures.
Out of 501,000 adult deaths in England and Wales in 2004, an estimated 89,000 (18%) were caused by smoking.
Statistics from the The Information Centre for Health and Social Care also showed that more than half a million hospital admissions a year are due to smoking.
Of those, around 24,500 were due to respiratory diseases and 40,000 were due to cancer. In total, 85% of deaths from lung cancer (around 24,000) were caused directly by smoking, the figures showed.
Of all deaths, those from smoking were higher among men (23%) than among women (13%).
A survey published by the centre also showed that children who miss school are much more likely to smoke, drink and take drugs.
In all, 559,800 hospital admissions during 2004 were thought to be due to smoking, an analysis of hospital data showed. That accounted for 6% of the 10 million general admissions for those aged 35 and over, the centre said.
Smoking caused one in four of all admissions (106,000) for heart disease, it added.
Lung cancer was the disease with the highest proportion of admissions due to smoking, followed by other smoking-related cancers like upper respiratory and oesophageal.
Between 2004 and 2005, 12% of admissions for age-related cataracts (people aged 45 and over) were attributed to smoking, as were 11% of admissions for hip fractures (in people aged 55 and over).
