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Smith, 21, of Clarksville, Tenn., beat out finalists Meagan Yvonne Tandy of California; Cara Renee Gorges of Kansas; Helen Salas of Nevada; and Danielle Lacourse of Rhode Island.
Though crowning a new beauty queen was the focus of night, the pageant began by spotlighting outgoing Miss USA Tara Conner's highly publicized bout with alcoholism.
"It has been the most unforgettable year of my life and I'm back, and better than ever," Conner proclaimed after she took the stage at the Kodak Theatre in Hollywood to answer questions from cohosts Nancy O'Dell and Tim Vincent of Access Hollywood.
She also revealed her future plans included writing a book, doing correspondence work and some acting.
Before the show, Conner summed up her year to PEOPLE, saying: "The reign of Tara was miraculous. Literally, because I got sober during it, and that's the most important thing."
It's quite a turnaround for the embattled beauty queen, who almost lost her tiara in December after allegations of wild partying and heavy drinking emerged.
Donald Trump, who co-owns the Miss Universe and Miss USA pageants with NBC (where the pageant will stay for the next three years), told PEOPLE before the telecast, "We're very happy with Tara, very proud, and hopefully she will have set the example for many people that have problems with drugs and alcohol."
As for her successor, Conner offers this advice: "Be yourself and put your own flavor on the title. Don't feel like you have to be the 'Pageant Patty.'"
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