Which U.S. state has the highest rate of smoking?
Despite a decline in the share of people who smoke, cigarette use remains the leading preventable cause of disease and death in the United States. That’s according to data released by the U.S. Centers for Disease Control and Prevention(CDC). The CDC estimates that more than 16 million people have at least one disease caused by smoking. It is estimated that in 2025, 9.1% of American adults aged 18 and over smoked cigarettes, down from 9.9% in 2024. Cigarette use has been declining steadily since 2019, when about 14% of American adults smoked.
Last Updated: October 1, 2026
About Source(s)
Source: The Centers for Disease Control and Prevention (CDC) collaborates to create the expertise, information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.
Notes: Estimated percentage of people aged 18 and over who currently smoke cigarettes.
Which state smokes the most?
Nationally, fewer than 1 in 10 adult Americans smoke, but the prevalence varies widely by state. According to the CDC, in 2023, the year for which the latest data is available, about 1 in 5 adults in West Virginia smoked cigarettes, making it the state with the highest share of adults who smoke. Tennessee followed, with 17% of adults reported as regular smokers. Oklahoma, Louisiana, and Mississippi round out the list of the five states where smoking is most common among adults.
Meanwhile, smoking is least common in Utah, where, in 2023, only 6% of adults reported smoking—joining it on the list of the five states where the fewest adults smoke are Hawaii (9%), Washington (9%), California (8.5%), and Connecticut (8.4%).
Last Updated: October 1, 2026
About Source(s)
Source: The Centers for Disease Control and Prevention (CDC) collaborates to create the expertise, information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.
Notes: Data compiled from state cigarette use rates published in U.S. state profiles by the CDC.
Do men smoke more than women?
Across all states for which data are available, there was a higher prevalence of men who smoke than women, except for West Virginia—21.4% for women versus 19.4 for men. The greatest discrepancy is found in New Jersey, where the share of men who smoke was six percentage points higher than that of women. In Montana, nearly the same proportion of men (12.4%) and women (12.3%) smoked cigarettes.
Last Updated: October 1, 2026
About Source(s)
Source: The Centers for Disease Control and Prevention (CDC) collaborates to create the expertise, information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.
What is the relationship between smoking and life expectancy?
Cigarette smoking harms nearly every organ of the body. It causes many diseases and reduces the health of people who smoke. The CDC estimates that cigarette smoking and secondhand smoke exposure cause more than 480,000 deaths each year in the United States, representing about 1 in 5 deaths in the country. Smoking also increases healthcare utilization, healthcare costs, and absenteeism.
Given how harmful smoking is, it’s not surprising to see a positive correlation between smoking rates and lower life expectancy. Among states, as smoking becomes more common, life expectancy tends to decline.
Last Updated: October 1, 2026
About Source(s)
Source: The Centers for Disease Control and Prevention (CDC) collaborates to create the expertise, information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.
Notes: Smoking rates are obtained from the CDC State Tobacco Related Disparities Dashboard Data, and life expectancy data is obtained from the U.S. State Life Tables reports published by the CDC.
