Special Report

The County with the Lowest Smoking Rate in Every State

Cigаrette sales climbed in the U.S. in 2020 for the first time in two decades. Americans bought a total of 203.7 billion cigаrettes last year, up from 202.9 billion the year before, according to a Federal Trade Commission report. The uptick coincided with increased cigаrette promotional and ad spending by tobacco companies.

Smоking is the leading cause of preventable death in the United States, claiming nearly half a million American lives annually, according to the Centers for Disease Control and Prevention. Another 16 million Americans are living with a serious illness caused by smоking.

Though the risks associated with smоking and tobacco use are well established, 42.4 million American adults — or 16.6% of the adult population — regularly smоke cigаrettes. In some parts of the country, however, residents are far more likely to take the dangers associated with smоking seriously.

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 county with the fewest smоkers in each state. Counties and county equivalents are ranked on the adult smоking rate — the share of the 18 and older population who smоke every day or most days and have smоked at least 100 cigаrettes in their lifetime.

Though each county on this list has the lowest smоking rate in its state, the share of adults who are smоkers varies considerably, from 7.1% to 21.0%.

Given the proven detrimental effects of smоking, it is perhaps not surprising that some important health outcome measures tend to be better than average in places with lower smоking rates. For example, in most counties on this list, the share of adults who report being in fair or poor health is below the share of adults statewide who do.

The correlation between smоking rates and life expectancy is also strong. In nearly every county on this list, average life expectancy at birth is above the comparable statewide average.

Click here for the county with the lowest smоking rate in every state