Consumer Products

This Is The State With The Most Smokers

How bad is the smoking problem in the U.S.? Horrible, but not as bad as it used to be. Nearly 500,000 Americans die prematurely because of the effects of smoking or secondhand smoke, according to the CDC.

About 40 million Americans smoke and almost five million of these are young people in middle school or high school. A portion of their consumption is via e-cigarettes. The cost to the economy of medical treatment for people who smoke is over $200 billion a year.

The only good news about smoking is that it has declined almost every year since 1963. At that point, a full 42% of adults used tobacco products, according to the American Lung Association.

Using data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program, 24/7 Tempo identified the state with the most smоkers. States are ranked on the adult smоking rate — or the share of adults who smоke every day or most days and have smоked at least 100 cigarettes in their lifetime.

Smоking rates vary from less than 10% to over 25%, depending on the state. States with the lowest smоking rates are disproportionately concentrated in the West, while Southern states account for the largest share of states with higher than average smоking rates.

Given the proven detrimental effects of smоking, it is perhaps not surprising that some important health outcome measures tend to be worse than average in states with higher smоking rates. For example, in most of the 25 states with higher than average smоking rates, the share of adults who report being in fair or poor health is greater than the 16.5% share nationwide.

The correlation between smоking rates and life expectancy is even stronger. In all but three of the 25 states with the highest smоking rates, the average life expectancy at birth is below the 79.2 year national average

The state with the most smokers is West Virginia.

> Smoking rate: 26.9%
> Adults reporting poor or fair health: 23.6% (the highest)
> Premature deaths per 100,000: 504.8 (the highest)
> Life expectancy at birth (years): 74.79 (the lowest)

Methodology: To determine the state with the most smokers, 24/7 Tempo reviewed the share of adults that are current smokers from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report. While the CHR report is from 2021, adult smoking rates are from 2018.

States were ranked based on the adult smoking rate. Additional information on the share of adults reporting poor or fair health, the number of deaths among residents under age 75 per 100,000, and average life expectancy at birth are also from the 2021 CHR and also for periods before the pandemic.

Click here to read States With The Most Smokers.