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    Cities With the Most Residents Who Smoke

    Cities With the Most Residents Who Smoke

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    By David Heacock

    America’s smoking problem is getting better but its costs remain incredibly high.

    Cigarette smoking, in particular, leads to staggering losses of life and money. More than 480,000 people die every year from smoking, according to CDC data. The medical care required to assist smokers and the lost productivity that result from smoking-related health issues exceeds $300 billion in yearly costs. And, the CDC noted in 2020 that 16 million people deal with smoking-related illnesses.

    Though the country’s smoking problem is costly, the good news is that national and local campaigns to end smoking are working. From 1995 to 2019, the prevalence of smoking in the United States dropped by approximately 30%. Whereas nearly one in four Americans smoked in 2000, only 16% of the population claimed to be smokers in 2019.

    Cities With the Most Residents Who Smoke -Infographics of Line graph showing a steady decline in adult smoking rates in the U.S. from the 1990s through 2018.

    The push to reduce smoking has produced positive nationwide results. However, smoking’s prevalence in the mid- to late-20th century still affects a significant portion of the population. While only 16% of adults currently smoke some days or every day, about 40% of adults identify as current or former smokers.

    Cities With the Most Residents Who Smoke -Infographics of Bar chart illustrating that about 40% of adults in the U.S. are either current or former smokers, with the majority never having smoked.

    A regional analysis of the country reveals that the Southeast has the highest concentration of smokers, while the West has the lowest concentration. For example, California and Utah have the lowest percentage of adults who smoke at 10.0% and 7.9%, respectively, while West Virginia, Kentucky, and Louisiana have the highest percentage of smokers at 23.8%, 23.6% and 21.9%.

    A variety of factors contribute to these regional and state-by-state disparities. California bans smoking from a wide variety of indoor and outdoor spaces. Utah’s dominant religion, Mormonism, encourages its members to abstain from tobacco.

    West Virginia, the state with the highest percentage of smokers, has relatively lax smoking laws. Likewise, Kentucky is the country’s premier producer of burley tobacco, a key component of cigarette tobacco blends. Louisiana is a niche producer of tobacco but has long struggled with high smoking rates. In fact, nearly 30% of Louisiana high school students use tobacco, the CDC reported in March 2021.

    Cities With the Most Residents Who Smoke -Infographics of Cities With the Most Residents Who Smoke -Infographics of U.S. map showing smoking prevalence by state, with West Virginia, Kentucky, and Louisiana having the highest smoking rates.

    As the states with the most residents who smoke grapple with solutions, smokers are paying a heavy price. The correlation between smoking and chronic obstructive pulmonary disease (COPD), and smoking and strokes is incredibly high. Coronary heart disease and other poor health indicators are also linked to smoking, according to the CDC.

    Cities With the Most Residents Who Smoke -Infographics of bar chart illustrating that about 40% of adults in the U.S. are either current or former smokers, with the majority never having smoked.

    While states in the Southeast have the highest percentage of residents who smoke, at the city level, it’s locations in the Midwest that stand out. Ohio, Michigan, and Indiana are home to many of the small, midsize, and large cities with the highest smoking rates among adults.

    To calculate the cities and states with the most smokers, researchers at Filterbuy analyzed data on American adults from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). To qualify as a smoker, subjects must have smoked at least 100 cigarettes in their lifetime and currently smoke all or some days. Only cities with at least 100,000 residents were included in the research, and cities were grouped according to population size: small (100,000–149,999), midsize (150,000–349,999), and large (350,000 or more).

    Here are the U.S. cities with the highest smoking rates.

    Cities With the Most Residents Who Smoke -Infographics of List of U.S. small and midsize cities with the highest percentage of adult smokers, highlighting Dayton, OH and Akron, OH as top cities.

    Large Cities With the Most Residents Who Smoke

    Cities With the Most Residents Who Smoke -Infographics of List of Florida cities like Tampa show regional differences in smoking behavior.

    Photo Credit: Bonnie Fink / Shutterstock

    Tampa, FL

    Cities With the Most Residents Who Smoke -Infographics of Nevada's urban centers are noted for higher smoking prevalence.

    Photo Credit: Sean Pavone / Shutterstock

    Las Vegas, NV

    Cities With the Most Residents Who Smoke -Infographics of Oklahoma city with significant adult smoking populations.

    Photo Credit: Sean Pavone / Shutterstock

    Oklahoma City, OK

    Cities With the Most Residents Who Smoke -Infographics of Jacksonville, FL part of a state with mixed smoking trends and notable urban smoking rates.

    Photo Credit: Sean Pavone / Shutterstock

    Jacksonville, FL

    Cities With the Most Residents Who Smoke -Infographics of Louisiana ranks high for smoking rates among U.S. states.

    Photo Credit: Sean Pavone / Shutterstock

    New Orleans, LA

    Cities With the Most Residents Who Smoke -Infographics of Wichita, KS — Kansas is represented in the list of cities with a high percentage of smokers.

    Photo Credit: Sean Pavone / Shutterstock

    Wichita, KS

    Cities With the Most Residents Who Smoke -Infographics of Oklahoma ranks among states with elevated smoking prevalence in urban areas.

    Photo Credit: Sean Pavone / Shutterstock

    Tulsa, OK

    Cities With the Most Residents Who Smoke -Infographics of Downtown view of Kansas City, KS — one of the midsize U.S. cities with high smoking rates among residents.

    Photo Credit: Sean Pavone / Shutterstock

    Kansas City, MO

    Cities With the Most Residents Who Smoke -Infographics of Skyline of Columbus, OH — Ohio is home to several cities with high adult smoking percentages.

    Photo Credit: Sean Pavone / Shutterstock

    Columbus, OH

    Cities With the Most Residents Who Smoke -Infographics of Skyline of Colorful skyline of Baltimore, Maryland at dusk, a city frequently ranked high in smoking statistics.

    Photo Credit: Sean Pavone / Shutterstock

    Baltimore, MD

    Cities With the Most Residents Who Smoke -Infographics of Skyline of Skyscrapers of Philadelphia, Pennsylvania, a major city with a large population of tobacco users.

    Photo Credit: Sean Pavone / Shutterstock

    Philadelphia, PA

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    Cities With the Most Residents Who Smoke -Infographics of A bright cityscape of Milwaukee, Wisconsin, which reports a significant number of adult smokers.

    Photo Credit: Sean Pavone / Shutterstock

    Milwaukee, WI

    Cities With the Most Residents Who Smoke -Infographics of Urban skyline of Memphis, Tennessee, where smoking remains a persistent public health challenge.

    Photo Credit: Sean Pavone / Shutterstock

    Memphis, TN

    Cities With the Most Residents Who Smoke -Infographics of Downtown Cleveland, Ohio with green parks in the foreground, among the U.S. cities with elevated smoking prevalence.

    Photo Credit: Sean Pavone / Shutterstock

    Cleveland, OH

    Cities With the Most Residents Who Smoke -Infographics of Skyline view of Detroit, Michigan at sunset, a city known for high smoking rates among residents.

    Photo Credit: Sean Pavone / Shutterstock

    Detroit, MI

    Detailed Findings & Methodology

    The data used in this analysis is from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). To determine the cities with the most residents who smoke, researchers calculated the percentage of adults who smoke, defined as the percentage of adults aged 18 years or older who report having smoked ≥100 cigarettes in their lifetime and currently smoke every day or some days. In the event of a tie, the city with the higher percentage of adults in poor physical health, defined as the percentage of adults aged 18 years or older that experienced 14+ days in a month when their health was not good, was ranked higher. To improve relevance, only cities with at least 100,000 residents were included. Additionally, cities were grouped into cohorts based on population size: small (100,000–149,999), midsize (150,000–349,999), and large (350,000 or more).