Which U.S. states smoke most and least?
Before I tell you the results, make a guess at what percentage of adults you think are cigarette smokers (a) in your state and (b) in the whole of the US?
The data are from a survey called the Behavioral Risk Factor Surveillance System (BRFSS) which is organized by CDC. It obtains a representative sample of adults in each state, and asks them loads of questions about health-related behaviors.
In 2007 (latest year data is available for), the median state cigarette smoking prevalence was 19.7%, of whom only 14.5% were daily smokers and 5.2% smoke somedays.
The states with the lowest smoking rates were Utah (11.7), California (14.3), Massachusetts (16.4), Minnesota (16.5), Washington (16.8), Oregon (16.9), Rhode Island (17), Hawaii (17) and my home state of New Jersey (17.1).
At the other end, the states with the highest smoking rates are: Kentucky (28.2), West Virginia (26.9), Oklahoma (25.8), Missouri (24.5), and Tennessee (24.3).
I find that most people overestimate the proportion of people who smoke, often by a large amount. How did you do?
So here in the United States we have some states where smoking is twice as common as in others. The main factors influencing this are the strength of tobacco control policies such as excise taxes, clean indoor air legislation, media campaigns and smoking cessation services. Utah is a bit of an outlier in that the smoking prevalence there is largely determined by the high proportion of people following the Mormon religion.
Clearly an individual smoker’s ability to quit, or the chances that your kids might start smoking is highly influenced by the environment in which we live. If you live in Kentucky, almost one in three people smoke, cigarettes are cheap, and there are few services to help smokers quit. In California only one in ten people are daily smokers, you are not allowed to smoke in any indoor public place, and there have consistent media campaigns warning about the health effects of smoking. These differences have a massive impact on the health profiles in these states, such that people living their life in Kentucky are more likely to die of lung cancer than people in California.
So if you want a healthy life for you and your kids, either advocate for tobacco control policies in your state, or move to a state that already has them.
Data on the 2007 BRFSS can be found and searched at: