15 cities with the most smokers


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Editor’s note: This story originally appeared on Filterbuy.

The smoking problem in America is getting better but its costs are still incredibly high.

Cigarette smoking, in particular, takes a heavy toll on lives and money. According to data from the Centers for Disease Control (CDC), more than 480,000 people die annually from smoking. Medicare required to help smokers and lost productivity from smoking-related health problems exceed $300 billion in annual costs. In 2020, the CDC noted that 16 million people suffer from smoking-related diseases.

Although the nation’s smoking problem is costly, the good news is that national and local campaigns to stop smoking are working well. From 1995 to 2019, the prevalence of smoking in the United States decreased by about 30%. While nearly 1 in 4 Americans smoked in 2000, only 16% of the population claimed to be smokers in 2019.

Pressure to reduce smoking has led to positive results nationwide. However, the prevalence of smoking in the mid to late twentieth century still affects a large portion of the population. While only 16% of adults currently smoke some days or every day, about 40% of adults are current or former smokers.

Large cities with the largest number of smokers

West Virginia
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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 country-by-country disparities. California prohibits smoking from a variety of indoor and outdoor spaces. The dominant religion in Utah, 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 nation’s number one producer of Burleigh tobacco, a light, air-cured tobacco that is a key ingredient in cigarette blends. Louisiana is a niche producer of tobacco but has long suffered from high rates of smoking. In fact, nearly 30% of Louisiana high school students use tobacco, the CDC reported in March 2021.

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

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

To calculate which cities and states have more smokers, researchers at Filterbuy analyzed data on American adults from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. To qualify as a smoker, people must smoke at least 100 cigarettes in their lifetime and have currently smoked all or some days.

The following are the large US cities (population 350,000 or more) with the highest smoking rates.

15. Tampa, Florida

Tampa, Florida
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  • Percentage of adults who smoke: 19.1%
  • Percentage of adults in poor physical health: 13.9%
  • Percentage of adults with COPD: 7.5%
  • Percentage of adults with cancer: 5.5%
  • Percentage of adults who have had a stroke: 3.5%
  • Percentage of adults with coronary heart disease: 6.3%
  • Population: 407.599

14. Las Vegas, Nevada

Las Vegas homes
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  • Percentage of adults who smoke: 19.3%
  • Percentage of adults in poor physical health: 15.1%
  • Percentage of adults with COPD: 7.7%
  • Percentage of adults with cancer: 6.1%
  • Percentage of adults who have had a stroke: 3.3%
  • Percentage of adults with coronary heart disease: 6.8%
  • Population: 662368

13. Oklahoma City, okay

Oklahoma City skyline
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  • Percentage of adults who smoke: 19.6%
  • Percentage of adults in poor physical health: 14.1%
  • Percentage of adults with COPD: 7.5%
  • Percentage of adults with cancer: 6.1%
  • Percentage of adults who have had a stroke: 3.5%
  • Percentage of adults with coronary heart disease: 7.3%
  • Population: 662,314

12. Jacksonville, Florida

Jacksonville, Florida
Sean Pavone / Shutterstock.com
  • Percentage of adults who smoke: 19.7%
  • Percentage of adults in poor physical health: 13.9%
  • Percentage of adults with COPD: 8.2%
  • Percentage of adults with cancer: 6.0%
  • Percentage of adults who have had a stroke: 3.6%
  • Percentage of adults with coronary heart disease: 6.8%
  • Population: 920570

11. New Orleans, Los Angeles

New Orleans, Louisiana
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  • Percentage of adults who smoke: 19.8%
  • Percentage of adults in poor physical health: 13.7%
  • Percentage of adults with COPD: 7.5%
  • Percentage of adults with cancer: 5.5%
  • Percentage of adults who have had a stroke: 4.3%
  • Percentage of adults with coronary heart disease: 6.5%
  • Population: 389476

10. Wichita, KS

Wichita, Kansas
Sean Pavone / Shutterstock.com
  • Percentage of adults who smoke: 20.0%
  • Percentage of adults in poor physical health: 13.2%
  • Percentage of adults with COPD: 7.1%
  • Percentage of adults with cancer: 6.4%
  • Percentage of adults who have had a stroke: 3.3%
  • Percentage of adults with coronary heart disease: 6.7%
  • Population: 391731

9. Tulsa, okay

Tulsa Oklahoma
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  • Percentage of adults who smoke: 20.3%
  • Percentage of adults in poor physical health: 14.6%
  • Percentage of adults with COPD: 7.8%
  • Percentage of adults with cancer: 6.6%
  • Percentage of adults who have had a stroke: 3.7%
  • Percentage of adults with coronary heart disease: 7.5%
  • Population: 403166

8. Kansas City, Missouri

Kansas City, Missouri
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  • Percentage of adults who smoke: 21.1%
  • Percentage of adults in poor physical health: 13.6%
  • Percentage of adults with COPD: 7.2%
  • Percentage of adults with cancer: 6.0%
  • Percentage of adults who have had a stroke: 3.6%
  • Percentage of adults with coronary heart disease: 6.0%
  • Population: 497159

7. Columbus, Ohio

Columbus, Ohio
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  • Percentage of adults who smoke: 21.4%
  • Percentage of adults in poor physical health: 11.7%
  • Percentage of adults with COPD: 7.1%
  • Percentage of adults with cancer: 5.1%
  • Percentage of adults who have had a stroke: 3.1%
  • Percentage of adults with coronary heart disease: 5.6%
  • Population: 903,852

6. Baltimore, Maryland

Baltimore, Maryland
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  • Percentage of adults who smoke: 21.7%
  • Percentage of adults in poor physical health: 13.4%
  • Percentage of adults with COPD: 7.4%
  • Percentage of adults with cancer: 5.7%
  • Percentage of adults who have had a stroke: 4.4%
  • Percentage of adults with coronary heart disease: 6.0%
  • Population: 586131

5. Philadelphia, Pennsylvania

Philadelphia, Pennsylvania at dusk
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  • Percentage of adults who smoke: 21.8%
  • Percentage of adults in poor physical health: 14.8%
  • Percentage of adults with COPD: 7.3%
  • Percentage of adults with cancer: 5.8%
  • Percentage of adults who have had a stroke: 4.1%
  • Percentage of adults with coronary heart disease: 6.2%
  • Population: 1,578,487

4. Milwaukee, Wisconsin

Milwaukee, Wisconsin
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  • Percentage of adults who smoke: 23.1%
  • Percentage of adults in poor physical health: 16.0%
  • Percentage of adults with COPD: 6.8%
  • Percentage of adults with cancer: 5.3%
  • Percentage of adults who have had a stroke: 3.7%
  • Percentage of adults with coronary heart disease: 6.0%
  • Population: 589.067

3. Memphis, Tennessee

Memphis, Tennessee
Sean Pavone / Shutterstock.com
  • Percentage of adults who smoke: 24.3%
  • Percentage of adults in poor physical health: 17.4%
  • Percentage of adults with COPD: 9.3%
  • Percentage of adults with cancer: 5.6%
  • Percentage of adults who have had a stroke: 4.8%
  • Percentage of adults with coronary heart disease: 7.3%
  • Population: 649705

2. Cleveland, Ohio

Cleveland, Ohio
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  • Percentage of adults who smoke: 27.8%
  • Percentage of adults in poor physical health: 18.7%
  • Percentage of adults with COPD: 11.1%
  • Percentage of adults with cancer: 5.9%
  • Percentage of adults who have had a stroke: 5.6%
  • Percentage of adults with coronary heart disease: 9.0%
  • Population: 378,589

1. Detroit, Michigan

Detroit as seen from the air.
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  • Percentage of adults who smoke: 28.9%
  • Percentage of adults in poor physical health: 20.9%
  • Percentage of adults with COPD: 11.2%
  • Percentage of adults with cancer: 6.0%
  • Percentage of adults who have had a stroke: 6.2%
  • Percentage of adults with coronary heart disease: 8.9%
  • Population: 665369

Detailed and methodological results

A man uses a lot of data on his phone, tablet and laptop
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The data used in this analysis are from the Centers for Disease Control’s Behavioral Risk Factor Surveillance System. To determine which cities have the highest number of smokers, the researchers calculated the percentage of adults who smoke, defined as the percentage of adults aged 18 or over who reported having smoked 100 or more cigarettes in their lifetime and who currently smoke every day or some the days . In a tie, the city with the highest proportion of adults with poor physical health, defined as the percentage of adults aged 18 or over who experienced 14 or more days per month when their health was poor, ranked higher. To improve relevance, cities with a population of at least 100,000 people were included. In addition, cities were grouped into groups based on population size: small (100,000 – 149999), medium-sized (150,000 – 349999), and large (350,000 or more).

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