Mapped: Smoking Rates by State, From 6% to 20%
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Key Takeaways
- West Virginia has the highest adult smoking rate in America at 20.4%, while Utah has the lowest at 6.0%.
- Smoking rates remain highest across Appalachia and parts of the South.
- Several Western and Northeastern states now report single-digit smoking rates.
Cigarette smoking has declined significantly in the United States over the past several decades, but it remains one of the leading causes of preventable death.
According to the Centers for Disease Control and Prevention (CDC), smoking and exposure to secondhand smoke contribute to roughly one in five deaths nationwide each year.
This map highlights the share of adults who smoke in every U.S. state based on CDC data.
West Virginia and Kentucky Lead the Nation
West Virginia has the highest smoking rate in the country, with 20.4% of adults reporting that they smoke.
Kentucky follows at 17.6%, while Tennessee ranks third at 17.0%.
| Rank | State | Adults who smoke |
|---|---|---|
| 1 | West Virginia | 20.4% |
| 2 | Kentucky | 17.6% |
| 3 | Tennessee | 17.0% |
| 4 | Oklahoma | 15.8% |
| 5 | Louisiana | 15.7% |
| 6 | Mississippi | 15.6% |
| 7 | Missouri | 15.3% |
| 8 | Alaska | 15.3% |
| 9 | South Dakota | 15.2% |
| 10 | Ohio | 15.0% |
| 11 | Arizona | 15.0% |
| 12 | Pennsylvania | 14.9% |
| 13 | Indiana | 14.5% |
| 14 | Alabama | 14.2% |
| 15 | Nevada | 14.2% |
| 16 | Maine | 14.0% |
| 17 | Wyoming | 14.0% |
| 18 | Kansas | 13.9% |
| 19 | Iowa | 13.7% |
| 20 | Michigan | 13.6% |
| 21 | North Dakota | 13.4% |
| 22 | North Carolina | 13.2% |
| 23 | Montana | 12.4% |
| 24 | New Mexico | 12.2% |
| 25 | Minnesota | 12.2% |
| 26 | South Carolina | 12.1% |
| 27 | Nebraska | 12.1% |
| 28 | Wisconsin | 12.0% |
| 29 | Georgia | 12.0% |
| 30 | Delaware | 11.4% |
| 31 | Vermont | 11.3% |
| 32 | Texas | 11.3% |
| 33 | Virginia | 10.9% |
| 34 | Illinois | 10.8% |
| 35 | Oregon | 10.6% |
| 36 | Florida | 10.5% |
| 37 | Idaho | 10.4% |
| 38 | New Hampshire | 10.4% |
| 39 | Colorado | 10.2% |
| 40 | Arkansas | 10.0% |
| 41 | Massachusetts | 9.8% |
| 42 | District of Columbia | 9.8% |
| 43 | Rhode Island | 9.5% |
| 44 | New York | 9.3% |
| 45 | New Jersey | 9.1% |
| 46 | Maryland | 9.1% |
| 47 | Hawaii | 9.0% |
| 48 | Washington | 9.0% |
| 49 | California | 8.5% |
| 50 | Connecticut | 8.4% |
| 51 | Utah | 6.0% |
These states have long struggled with elevated tobacco use rates due to a combination of economic, cultural, and historical factors.
The Appalachian region has been closely linked to tobacco production and consumption for generations.
Although smoking rates have declined over time, the region continues to record some of the nation’s highest levels of tobacco use.
The South and Midwest Remain Above Average
Several Southern and Midwestern states rank near the top of the list.
Oklahoma, Louisiana, Mississippi, Missouri, and Ohio all report smoking rates of 15% or higher.
Many of these states also face higher rates of smoking-related illnesses, including heart disease, cancer, and chronic respiratory conditions. These states also tend to have lower life expectancy rates.
Utah Stands Out as the Lowest-Smoking State
At the other end of the spectrum, Utah reports the nation’s lowest adult smoking rate at just 6.0%.
Connecticut, California, Washington, Hawaii, Maryland, and New Jersey also rank among the states with the lowest smoking prevalence.
Utah’s exceptionally low rate is often attributed to cultural and religious influences, along with longstanding public health efforts.
Meanwhile, California’s rate of 8.5% reflects decades of aggressive anti-smoking campaigns and tobacco-control policies that have helped reduce cigarette use across the state.
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