This Is the City With the Most Smokers in Every State

Even as smoking has fallen in the U.S., with about only one in eight adults puffing on a cigarette daily, there still are cities in the nation where the often fatal habit persists to a degree that is higher than the statewide average.

Cigarette smoking continues to be the leading cause of preventable disease, disability, and death in the U.S. Smoking tobacco is blamed for more than 480,000 deaths per year in the U.S., according to Centers for Disease Control and Prevention data. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease.

With the exception of Logan, Utah, the percentage of smokers in the city in every state with the most smokers on our list is at least 13% or above, 1.5 percentage points above the national average of 11.5% of all adults.

There are 44 cities on our list where the percentage of adults who smoke regularly exceeds the state average. Forty-two cities top the statewide average in deaths per 100,000 people and the percentage of adults in poor health. In some cases, the percentage difference is nearly 10 points. Life expectancy in 38 cities on our list is lower than the statewide average.

Cities in the South appear frequently in the 10 worst cities for smoking, premature death, poor health, and life expectancy. Five of the 10 cities where adults smoke regularly are in the South and their rates are 22% and above. All are over their state’s average.

Seven of the 10 cities in our list with higher number of premature deaths per 100,000 are in the South, with at least 426 per 100,000, and all are above their state’s average.

In terms of poor health, nine of the 10 cities with the worst health are in the South, with at least 18.6% of adults reporting poor health. All but one of these cities was above their state’s average.

Finally, six of the 10 cities on our list with lower life expectancy are in the South and all 10 have life expectancy lower than their state’s average. (Here is a list of all 50 states rank by longevity. See where you state falls.)

Here is a list of the city in every state with the most smokers:

Alabama: Dothan

• Adults smoking regularly: 21.2% (state: 19.5%)
• Premature death rate: 481 per 100,000 people (state: 500 per 100,000 people)
• Adults in poor or fair health: 20.2% (state: 18.9%)
• Life expectancy: 75.1 years (state: 74.84 years)

Alaska: Anchorage

• Adults smoking regularly: 16.4% (state: 18.0%)
• Premature death rate: 362 per 100,000 people (state: 364 per 100,000 people)
• Adults in poor or fair health: 11.5% (state: 12.2%)
• Life expectancy: 78.8 years (state: 78.62 years)

Arizona: Lake Havasu City-Kingman

• Adults smoking regularly: 21.0% (state: 13.7%)
• Premature death rate: 515 per 100,000 people (state: 360 per 100,000 people)
• Adults in poor or fair health: 16.7% (state: 14.5%)
• Life expectancy: 75.5 years (state: 79.06 years)

Arkansas and Arkansas-Oklahoma: Pine Bluff and Fort Smith

• Adults smoking regularly: 23.1% (state: 21.6%)
• Premature death rate: 596.94 and 494.16 per 100,000 people (state: 478 per 100,000 people)
• Adults in poor or fair health: 22.8% and 20.1% (state: 19.4%)
• Life expectancy: 72.87 and 75.36 years (state: 75.49 years)

California: Visalia

• Adults smoking regularly: 15.6% (state: 9.0%)
• Premature death rate: 382 per 100,000 people (state: 288 per 100,000 people)
• Adults in poor or fair health: 22.8% (state: 14.4%)
• Life expectancy: 77.8 years (state: 81.01 years)

Colorado: Pueblo

• Adults smoking regularly: 17.6% (state: 12.6%)
• Premature death rate: 497 per 100,000 people (state: 298 per 100,000 people)
• Adults in poor or fair health: 15.5% (state: 10.2%)
• Life expectancy: 75.1 years (state: 79.98 years)

Connecticut: Norwich-New London

• Adults smoking regularly: 15.5% (state: 12.6%)
• Premature death rate: 332 per 100,000 people (state: 298 per 100,000 people)
• Adults in poor or fair health: 10.3% (state: 11.0%)
• Life expectancy: 79.5 years (state: 80.11 years)

Delaware: Dover

• Adults smoking regularly: 20.0% (state: 15.8%)
• Premature death rate: 409 per 100,000 people (state: 371 per 100,000 people)
• Adults in poor or fair health: 14.6% (state: 12.8%)
• Life expectancy: 77.1 years (state: 78.01 years)

Florida: Homosassa Springs

• Adults smoking regularly: 23.4% (state: 15.5%)
• Premature death rate: 543 per 100,000 people (state: 351 per 100,000 people)
• Adults in poor or fair health: 16.3% (state: 13.3%)
• Life expectancy: 74.5 years (state: 79.69 years)

Georgia: Albany

• Adults smoking regularly: 21.1% (state: 16.3%)
• Premature death rate: 557 per 100,000 people (state: 400 per 100,000 people)
• Adults in poor or fair health: 20.0% (state: 15.1%)
• Life expectancy: 73.6 years (state: 77.31 years)

Hawaii: Kahului-Wailuku-Lahaina

• Adults smoking regularly: 14.0% (state: 12.2%)
• Premature death rate: 270 per 100,000 people (state: 289 per 100,000 people)
• Adults in poor or fair health: 11.0% (state: 10.3%)
• Life expectancy: 82.9 years (state: 82.26 years)

Idaho: Pocatello

• Adults smoking regularly: 18.2% (state: 14.2%)
• Premature death rate: 388 per 100,000 people (state: 311 per 100,000 people)
• Adults in poor or fair health: 13.6% (state: 11.8%)
• Life expectancy: 77.0 years (state: 79.19 years)

Illinois: Danville

• Adults smoking regularly: 22.1% (state: 12.8%)
• Premature death rate: 512 per 100,000 people (state: 352 per 100,000 people)
• Adults in poor or fair health: 16.7% (state: 12.3%)
• Life expectancy: 74.6 years (state: 78.62 years)

Indiana: Terre Haute

• Adults smoking regularly: 23.7% (state: 20.2%)
• Premature death rate: 463 per 100,000 people (state: 420 per 100,000 people)
• Adults in poor or fair health: 16.9% (state: 15.1%)
• Life expectancy: 75.8 years (state: 76.51 years)

Iowa-Nebraska-South Dakota: Sioux City

• Adults smoking regularly: 17.5% (state: 16.8%)
• Premature death rate: 400 per 100,000 people (state: 340 per 100,000 people)
• Adults in poor or fair health: 13.2% (state: 12.0%)
• Life expectancy: 77.0 years (state: 78.74 years)

Kansas: Wichita

• Adults smoking regularly: 18.9% (state: 17.2%)
• Premature death rate: 422 per 100,000 people (state: 373 per 100,000 people)
• Adults in poor or fair health: 13.4% (state: 12.8%)
• Life expectancy: 76.6 years (state: 77.81 years)

Kentucky: Bowling Green

• Adults smoking regularly: 22.1% (state: 22.2%)
• Premature death rate: 452 per 100,000 people (state: 491 per 100,000 people)
• Adults in poor or fair health: 18.9% (state: 19.5%)
• Life expectancy: 76.2 years (state: 75.08 years)

Louisiana: Houma-Thibodaux

• Adults smoking regularly: 22.3% (state: 18.9%)
• Premature death rate: 457 per 100,000 people (state: 485 per 100,000 people)
• Adults in poor or fair health: 19.6% (state: 19.0%)
• Life expectancy: 75.9 years (state: 75.22 years)

Maine: Bangor

• Adults smoking regularly: 20.2% (state: 18.0%)
• Premature death rate: 395 per 100,000 people (state: 344 per 100,000 people)
• Adults in poor or fair health: 12.6% (state: 11.1%)
• Life expectancy: 77.1 years (state: 78.56 years)

Maryland-West Virginia: Hagerstown-Martinsburg

• Adults smoking regularly: 20.4% (state: 11.1%)
• Premature death rate: 464 per 100,000 people (state: 358 per 100,000 people)
• Adults in poor or fair health: 15.1% (state: 10.6%)
• Life expectancy: 75.5 years (state: 78.58 years)

Massachusetts: Springfield

• Adults smoking regularly: 15.4% (state: 11.4%)
• Premature death rate: 354 per 100,000 people (state: 288 per 100,000 people)
• Adults in poor or fair health: 12.8% (state: 10.8%)
• Life expectancy: 78.3 years (state: 80.19 years)

Michigan: Battle Creek

• Adults smoking regularly: 22.5% (state: 19.3%)
• Premature death rate: 481 per 100,000 people (state: 385 per 100,000 people)
• Adults in poor or fair health: 15.5% (state: 14.7%)
• Life expectancy: 75.2 years (state: 77.48 years)

Minnesota-Wisconsin: Duluth

• Adults smoking regularly: 20.5% (state: 14.3%)
• Premature death rate: 346 per 100,000 people (state: 280 per 100,000 people)
• Adults in poor or fair health: 11.7% (state: 10.0%)
• Life expectancy: 78.4 years (state: 80.4 years)

Mississippi: Hattiesburg

• Adults smoking regularly: 19.4% (state: 20.7%)
• Premature death rate: 512 per 100,000 people (state: 543 per 100,000 people)
• Adults in poor or fair health: 18.6% (state: 18.7%)
• Life expectancy: 75.1 years (state: 73.89 years)

Missouri-Kansas: St. Joseph

• Adults smoking regularly: 22.2% (state: 18.6%)
• Premature death rate: 437 per 100,000 people (state: 426 per 100,000 people)
• Adults in poor or fair health: 16.2% (state: 15.2%)
• Life expectancy: 76.4 years (state: 76.64 years)

Montana: Great Falls

• Adults smoking regularly: 18.6% (state: 17.5%)
• Premature death rate: 417 per 100,000 people (state: 353 per 100,000 people)
• Adults in poor or fair health: 12.9% (state: 12.1%)
• Life expectancy: 77.1 years (state: 78.37 years)

Nebraska: Grand Island

• Adults smoking regularly: 17.3% (state: 14.5%)
• Premature death rate: 361 per 100,000 people (state: 328 per 100,000 people)
• Adults in poor or fair health: 12.8% (state: 10.2%)
• Life expectancy: 77.9 years (state: 79.02 years)

Nevada: Carson City

• Adults smoking regularly: 18.4% (state: 14.1%)
• Premature death rate: 505 per 100,000 people (state: 379 per 100,000 people)
• Adults in poor or fair health: 16.3% (state: 16.7%)
• Life expectancy: 74.4 years (state: 78.11 years)

New Hampshire: Manchester-Nashua

• Adults smoking regularly: 14.1% (state: 14.7%)
• Premature death rate: 311 per 100,000 people (state: 307 per 100,000 people)
• Adults in poor or fair health: 10.9% (state: 10.8%)
• Life expectancy: 79.4 years (state: 79.59 years)

New Jersey: Vineland-Bridgeton

• Adults smoking regularly: 19.1% (state: 11.1%)
• Premature death rate: 509 per 100,000 people (state: 319 per 100,000 people)
• Adults in poor or fair health: 17.8% (state: 10.8%)
• Life expectancy: 74.6 years (state: 79.49 years)

New Mexico: Farmington

• Adults smoking regularly: 22.6% (state: 16.9%)
• Premature death rate: 547 per 100,000 people (state: 437 per 100,000 people)
• Adults in poor or fair health: 17.7% (state: 13.8%)
• Life expectancy: 74.0 years (state: 76.88 years)

New York: Elmira

• Adults smoking regularly: 19.1% (state: 12.3%)
• Premature death rate: 431 per 100,000 people (state: 307 per 100,000 people)
• Adults in poor or fair health: 12.5% (state: 11.8%)
• Life expectancy: 76.4 years (state: 80.26 years)

North Carolina: Hickory-Lenoir-Morganton

• Adults smoking regularly: 21.0% (state: 17.0%)
• Premature death rate: 432 per 100,000 people (state: 384 per 100,000 people)
• Adults in poor or fair health: 14.6% (state: 13.5%)
• Life expectancy: 76.4 years (state: 77.68 years)

North Dakota-Minnesota: Grand Forks

• Adults smoking regularly: 17.8% (state: 17.9%)
• Premature death rate: 353 per 100,000 people (state: 343 per 100,000 people)
• Adults in poor or fair health: 11.6% (state: 11.6%)
• Life expectancy: 78.5 years (state: 78.77 years)

Ohio: Mansfield

• Adults smoking regularly: 26.0% (state: 20.2%)
• Premature death rate: 473 per 100,000 people (state: 420 per 100,000 people)
• Adults in poor or fair health: 16.4% (state: 14.5%)
• Life expectancy: 75.6 years (state: 76.52 years)

Oklahoma: Lawton

• Adults smoking regularly: 20.7% (state: 19.6%)
• Premature death rate: 487 per 100,000 people (state: 477 per 100,000 people)
• Adults in poor or fair health: 18.0% (state: 17.3%)
• Life expectancy: 75.4 years (state: 75.54 years)

Oregon: Grants Pass

• Adults smoking regularly: 19.1% (state: 13.6%)
• Premature death rate: 432 per 100,000 people (state: 311 per 100,000 people)
• Adults in poor or fair health: 15.8% (state: 12.7%)
• Life expectancy: 76.4 years (state: 79.7 years)

Pennsylvania: Johnstown

• Adults smoking regularly: 20.8% (state: 16.7%)
• Premature death rate: 449 per 100,000 people (state: 366 per 100,000 people)
• Adults in poor or fair health: 14.4% (state: 13.1%)
• Life expectancy: 75.8 years (state: 78.02 years)

Rhode Island-Massachusetts: Providence-Warwick

• Adults smoking regularly: 15.6% (state: 14.1%)
• Premature death rate: 331 per 100,000 people (state: 314 per 100,000 people)
• Adults in poor or fair health: 12.5% (state: 11.8%)
• Life expectancy: 79.0 years (state: 79.37 years)

South Carolina: Sumter

• Adults smoking regularly: 21.4% (state: 19.1%)
• Premature death rate: 543 per 100,000 people (state: 434 per 100,000 people)
• Adults in poor or fair health: 18.8% (state: 15.9%)
• Life expectancy: 74.3 years (state: 76.44 years)

South Dakota: Rapid City

• Adults smoking regularly: 18.0% (state: 19.0%)
• Premature death rate: 350 per 100,000 people (state: 353 per 100,000 people)
• Adults in poor or fair health: 10.8% (state: 10.4%)
• Life expectancy: 78.4 years (state: 78.19 years)

Tennessee: Morristown

• Adults smoking regularly: 24.5% (state: 19.7%)
• Premature death rate: 522 per 100,000 people (state: 478 per 100,000 people)
• Adults in poor or fair health: 17.6% (state: 15.7%)
• Life expectancy: 74.4 years (state: 75.33 years)

Texas-Arkansas: Texarkana

• Adults smoking regularly: 21.1% (state: 13.3%)
• Premature death rate: 540 per 100,000 people (state: 362 per 100,000 people)
• Adults in poor or fair health: 19.1% (state: 15.7%)
• Life expectancy: 74.2 years (state: 78.39 years)

Utah-Idaho: Logan

• Adults smoking regularly: 9.9% (state: 8.3%)
• Premature death rate: 247 per 100,000 people (state: 291 per 100,000 people)
• Adults in poor or fair health: 12.7% (state: 10.9%)
• Life expectancy: 81.1 years (state: 79.72 years)

Vermont: Burlington-South Burlington

• Adults smoking regularly: 13.0% (state: 14.4%)
• Premature death rate: 263 per 100,000 people (state: 309 per 100,000 people)
• Adults in poor or fair health: 9.1% (state: 10.6%)
• Life expectancy: 81.0 years (state: 79.67 years)

Virginia: Staunton

• Adults smoking regularly: 19.3% (state: 13.9%)
• Premature death rate: 377 per 100,000 people (state: 335 per 100,000 people)
• Adults in poor or fair health: 14.3% (state: 12.4%)
• Life expectancy: 78.3 years (state: 79.07 years)

Washington: Longview

• Adults smoking regularly: 18.9% (state: 11.6%)
• Premature death rate: 409 per 100,000 people (state: 296 per 100,000 people)
• Adults in poor or fair health: 14.5% (state: 11.8%)
• Life expectancy: 77.3 years (state: 80.21 years)

West Virginia: Beckley

• Adults smoking regularly: 25.8% (state: 24.0%)
• Premature death rate: 645 per 100,000 people (state: 528 per 100,000 people)
• Adults in poor or fair health: 21.7% (state: 20.0%)
• Life expectancy: 71.9 years (state: 74.26 years)

Wisconsin: Janesville-Beloit

• Adults smoking regularly: 18.4% (state: 16.1%)
• Premature death rate: 373 per 100,000 people (state: 324 per 100,000 people)
• Adults in poor or fair health: 12.1% (state: 12.4%)
• Life expectancy: 77.6 years (state: 78.87 years)

Wyoming: Casper

• Adults smoking regularly: 20.3% (state: 19.4%)
• Premature death rate: 411 per 100,000 people (state: 368 per 100,000 people)
• Adults in poor or fair health: 12.2% (state: 11.5%)
• Life expectancy: 76.6 years (state: 78.08 years)