Smoking is a widespread and deadly habit Americans have engaged in since the country was founded. Many came from countries where people enjoyed the same pleasure. It turns out that nicotine, found in tobacco products, is extremely addictive. Smoking has cost both lives and money in the U.S. The CDC says nearly 40 Americans use tobacco, mostly by smoking. The agency says that it is the “leading cause of preventable disease, disability, and death in the United States.”

The expense of smoking to the economy is colossal. Each year, America spends almost $225 billion to “treat smoking-related disease.” This is despite the fact that Luther L. Terry, M.D., Surgeon General of the U.S. Public Health Service reported on the dangers of smoking in 1964. Tobacco companies disputed the finding that smoking was dangerous for years. Suits against the cigarette companies eventually cost them $206 billion, based on a court decision handed down in 2006.

Like nearly all American health problems, the most negative effects of smoking are regional. 24/7 Tempo has reviewed data from several sources to determine which metropolitan statistical area — either individual cities or agglomerations of cities, sometimes across state lines — report the highest rates of adult smoking, self-reported fair or poor health, and incidence of lung and bronchus cancer.

To identify the city with the highest percentage of smokers, 24/7 Tempo reviewed data from the 2021 County Health Rankings & Roadmaps, a joint study by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, based on data from the 2018 Behavioral Risk Factor Surveillance System report from the Centers for Disease Control and Prevention (CDC). The list includes only metropolitan statistical areas with a population of at least 500,000 people based on annual estimates from the U.S. Census Bureau’s American Community Survey for 2019. Lung and bronchus cancer diagnosis rates per 100,000 are based on CDC cancer incidence statistics for 2017.

The MSA where the highest percentage of adults smoke is Youngstown-Warren-Boardman, Ohio-Pennsylvania. Here are the details:
> Adult smoking rate: 24.5%
> Adults self-reporting fair or poor health: 20% — #24th most out of 108 largest MSAs
> Lung and bronchus cancer incidence: 11.0 diagnoses per 100,000 — #11th most out of 108 largest MSAs

Click here to read American Cities Where The Most People Smoke

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