Background: Smoking is by far the most important cause of cancer that can be modified at the individual level. Asia has a high incidence of cancer incidence and death, while China has the highest incidence in Asia, and accounting for 27% of the world's cancer deaths. The purpose of the current study was to perform an evidence-based assessment of the burden of tobacco smoking-related cancers death in the Tianjin, China. Methods: A mortality case-control study to assess the risks of all-cause and major causes of cancer death attributable to smoking from 2010 to 2019. Results: Tobacco smoking was responsible for 23,709 (28.87%) cancer deaths among adult men and 8,648 (13.37%) among adult women in 2010 to 2019 in Tianjin. Lung cancer remains the largest cause of cancer death. In men, 49.06% of lung cancer, 27.55% of upper aerodigestive cancer, 10.11% of liver, 13.56% of kidney and other urinary cancer deaths were attributable to tobacco smoking. In women the proportion of ever-smoking-attributable lung cancer was 31.56%, 10.59% of upper aerodigestive and 10.56% of bladder cancer deaths. By year, smoking-attributable cancer deaths in men increased from 1817 in 2010 to 2695 in 2019; for women, the number remained stable at just over 800 per year. Conclusions: Approximately one in three cancer deaths in men and one in six cancer deaths in women would be potentially preventable through appropriate control of tobacco smoking in Tianjin. Effective control programs against tobacco smoking should be further implemented.