Little research has been done thus far on the association between smoking and apical periodontitis. The current study's goal was to determine whether tobacco use may be linked to periapical lesions' frequency or severity. 247 people in total, 81 current smokers, 63 past smokers, and 103 non-smokers participated in the study. The frequency of endodontic treatment was 58% overall, while the prevalence of apical periodontitis was 52%. The periapical state was expressed as the number and percentage of radiographically identifiable lesions as well as as a severity score. Smoking had no discernible effect on the prevalence of endodontic therapy or apical periodontitis. Controlling for age, the association between smoking and periapical lesions was not statistically significant. The mean number (percentage) of periapical lesions per person was 1.9 (6%) in current smokers, 1.5 (4%) in inform smokers, and 1.0 (3%) in non-smokers. The average degree of periapical damage across all teeth, or just teeth afflicted by periapical lesions, did not substantially differ between the smoking groups. It is determined that there is no evidence to support the notion that cigarette use causes apical periodontitis from the current observations