This State Has America’s Biggest Smoking Population: Ranking All 50 States

Published: March 3, 2024 by 24/7 Tempo Staff

Despite anti-smoking efforts, tobacco use remains America’s leading cause of preventable death and disability according to the CDC. Each year, over 500,000 die prematurely from smoking or secondhand smoke exposure, and 16 million live with smoking-induced illnesses.

The South has a deep generational ties to tobacco farming. Of the top tobacco-producing states, only Pennsylvania lies outside the South. North Carolina grows the most tobacco – around 250 million pounds in 2022. Unsurprisingly, seven of the ten states with the highest smoking rates are in the South. Outside that region, the heaviest smoking occurs in Indiana, Ohio and Wyoming.

In 2021, the CDC reported 11.5% of U.S. adults (28.3 million people) actively smoked, with higher rates among men. Geographically, tobacco use inflicts greater damage in certain regions.

By percentage, West Virginia smokes the most, with almost one-fourth of adults lighting up. States on each coastline, and Utah and Colorado, have the lowest smoking rates in the United States.
Higher smoking habits translate into more adults with poor or fair health, lower life expectancy at birth, and premature deaths in mostly southern states. States such as Minnesota, Massachusetts, and Hawaii are among those places that score higher in terms of health, longer life expectancy, and fewer premature deaths. (This is the city with the most smokers in every state.)

50. Utah

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Adults who smoke regularly: 8.3%
Adults who are in poor or fair health: 10.9% — 11th lowest
Life expectancy at birth: 79.72 years — 9th highest
Premature deaths: 291 per 100,000 people — 5th lowest

49. California

Famous Lombard Street, San Francisco, California, USA

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Adults who smoke regularly: 9.0%
Adults who are in poor or fair health: 14.4% — 18th highest
Life expectancy at birth: 81.01 years — 2nd highest
Premature deaths: 288 per 100,000 people — 2nd lowest

48. New Jersey

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Adults who smoke regularly: 11.1%
Adults who are in poor or fair health: 10.8% — 8th lowest
Life expectancy at birth: 79.49 years — 14th highest
Premature deaths: 319 per 100,000 people — 15th lowest

47. Maryland

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Adults who smoke regularly: 11.1%
Adults who are in poor or fair health: 10.6% — 6th lowest
Life expectancy at birth: 78.58 years — 25th highest
Premature deaths: 358 per 100,000 people — 25th highest

46. Massachusetts

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Adults who smoke regularly: 11.4%
Adults who are in poor or fair health: 10.8% — 9th lowest
Life expectancy at birth: 80.19 years — 6th highest
Premature deaths: 288 per 100,000 people — 3rd lowest

45. Washington

Alaska+state+skyline | Downtown Seattle, Washington from Seattle-Bremerton Ferry, Seattle, Washington

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Seattle is a coastal seaport city and the seat of King County, in the U.S. state of Washington. With an estimated 652,405 residents as of 2013, Seattle is the largest city in both the State of Washington and the Pacific Northwest region of North America and the fastest-growing major city in the United States. The Seattle metropolitan area of around 3.6 million inhabitants is the 15th largest metropolitan area in the United States. The city is situated on a narrow isthmus between Puget Sound (an inlet of the Pacific Ocean) and Lake Washington, about 100 miles (160 km) south of the CanadaâUnited States border. A major gateway for trade with Asia, Seattle is the 8th largest port in the United States and 9th largest in North America in terms of container handling. The Seattle area had previously been inhabited by Native Americans for at least 4,000 years before the first permanent European settlers. Arthur A. Denny and his group of travelers, subsequently known as the Denny Party, arriv...