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CDC BRFSS data shows adult cigarette smoking ranged from 6.9% in Utah to 22.3% in West Virginia in the most recent state-level release, with the national rate at 13.2%. Smoking remains concentrated in Appalachia and the South.
Source: CDC U.S. Chronic Disease Indicators (CDI), measure "Current cigarette smoking among adults," data source: Behavioral Risk Factor Surveillance System (BRFSS), data year 2022 (most recent complete state-level release available via the CDC open-data API as of June 2026). Values are age-adjusted prevalence (%), Overall stratification. Retrieved from data.cdc.gov resource hksd-2xuw: https://data.cdc.gov/resource/hksd-2xuw.json?question=Current+cigarette+smoking+among+adults&yearstart=2022&stratification1=Overall&datavaluetype=Age-adjusted+Prevalence
Per-state values were pulled directly from the CDC open-data API (data.cdc.gov, U.S. Chronic Disease Indicators, resource hksd-2xuw) for the measure "Current cigarette smoking among adults," filtered to year 2022, Overall stratification, and "Age-adjusted Prevalence" data-value type, with BRFSS as the listed data source. Each value was transcribed exactly as returned by the API; none were estimated or interpolated. The table covers all 50 states plus the District of Columbia. The U.S. aggregate (13.2%) and territories (Guam, Puerto Rico, U.S. Virgin Islands) returned by the same query are excluded from the state ranking. Age-adjusted prevalence is used because it is the standard CDC measure for cross-state comparison, removing differences driven by states' age structures. The national single-digit figures (10.8% in 2023, 9.9% in 2024) reported elsewhere come from the National Health Interview Survey (NHIS), a separate, non-comparable survey, and are not used here.
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Cigarette smoking among American adults continues to fall, but where you live still shapes the odds dramatically. According to the CDC's U.S. Chronic Disease Indicators, drawn from the Behavioral Risk Factor Surveillance System (BRFSS), adult cigarette smoking prevalence ranged from 6.9% in Utah to 22.3% in West Virginia in the most recent complete state-level release (2022 data). The national age-adjusted rate stood at 13.2%.
The geography of smoking is strikingly consistent year over year. The heaviest burden sits in Appalachia and the South: West Virginia (22.3%), Arkansas (19.9%), Tennessee (19.2%), Mississippi (18.1%), Missouri (17.8%), Ohio (17.7%), and Kentucky (17.6%) anchor the top of the list. These states share lower median incomes, historically tobacco-friendly policy environments, weaker indoor-smoking restrictions, and — in several cases — a legacy tobacco-growing economy.
At the other end, the lowest-prevalence states cluster on the coasts and in the Mountain West's Utah: Utah (6.9%), Maryland (9.8%), California (9.9%), Washington (10.1%), and Connecticut (10.3%). Utah's outlier status is widely attributed to the large share of residents who abstain from tobacco for religious reasons, while California has decades of aggressive tobacco control, high cigarette taxes, and broad smoke-free laws.
Most states fall in a band between roughly 12% and 16%. The Upper Midwest and Plains (Wisconsin 15.0%, Kansas 15.1%, Iowa 15.5%, North Dakota 15.8%) sit modestly above the national average, while large, diverse states such as Texas (12.0%), Florida (12.0%), Illinois (12.8%), and New York (11.5%) land at or below it. The District of Columbia (11.0%) tracks with the lower-prevalence states.
These figures are self-reported survey estimates from BRFSS, a telephone-based system, and can be affected by social-desirability bias and response patterns that differ across states. Values are age-adjusted to allow fair comparison between states with different age structures. Crucially, the measure captures cigarette smoking only — it excludes e-cigarettes/vaping, cigars, hookah, and smokeless tobacco, so total tobacco use in every state is higher than shown.
National single-digit smoking figures sometimes cited in the news (about 10.8% in 2023 and 9.9% in 2024) come from the separate National Health Interview Survey and are not directly comparable to these BRFSS state estimates, which use different methods and a different reference period. For year-over-year state tracking, BRFSS remains the standard source. This page presents population statistics only and is not medical advice.
% of adults who currently smoke cigarettes (age-adjusted)
| # | |||
|---|---|---|---|
| 1 | 51 | Utah | 6.9 |
| 2 | 50 | Maryland | 9.8 |
| 3 | 49 | California | 9.9 |
| 4 | 48 | Washington | 10.1 |
| 5 | 47 | Connecticut | 10.3 |
| 6 | 46 | Hawaii | 10.5 |
| 7 | 44 | Massachusetts | 10.7 |
| 8 | 44 | New Jersey | 10.7 |
| 9 | 43 | Colorado | 10.9 |
| 10 | 42 | District of Columbia | 11 |
Source: CDC U.S. Chronic Disease Indicators, measure "Current cigarette smoking among adults," data source BRFSS, year 2022 (most recent complete state-level release). Age-adjusted prevalence, Overall. Retrieved from data.cdc.gov resource hksd-2xuw: https://data.cdc.gov/resource/hksd-2xuw.json?question=Current+cigarette+smoking+among+adults&yearstart=2022&stratification1=Overall&datavaluetype=Age-adjusted+Prevalence . U.S. overall = 13.2%. Self-reported survey estimates; cigarettes only.
Per-state values were pulled directly from the CDC open-data API (data.cdc.gov, U.S. Chronic Disease Indicators, resource hksd-2xuw) for the measure "Current cigarette smoking among adults," filtered to year 2022, Overall stratification, and "Age-adjusted Prevalence" data-value type, with BRFSS as the listed data source. Each value was transcribed exactly as returned by the API; none were estimated or interpolated. The table covers all 50 states plus the District of Columbia. The U.S. aggregate (13.2%) and territories (Guam, Puerto Rico, U.S. Virgin Islands) returned by the same query are excluded from the state ranking. Age-adjusted prevalence is used because it is the standard CDC measure for cross-state comparison, removing differences driven by states' age structures. The national single-digit figures (10.8% in 2023, 9.9% in 2024) reported elsewhere come from the National Health Interview Survey (NHIS), a separate, non-comparable survey, and are not used here.
Data source: CDC U.S. Chronic Disease Indicators (CDI), measure "Current cigarette smoking among adults," data source: Behavioral Risk Factor Surveillance System (BRFSS), data year 2022 (most recent complete state-level release available via the CDC open-data API as of June 2026). Values are age-adjusted prevalence (%), Overall stratification. Retrieved from data.cdc.gov resource hksd-2xuw: https://data.cdc.gov/resource/hksd-2xuw.json?question=Current+cigarette+smoking+among+adults&yearstart=2022&stratification1=Overall&datavaluetype=Age-adjusted+Prevalence
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HealthVetted. (2026). Adult Smoking Rates by U.S. State (2026). HealthVetted. https://healthvetted.com/research/us-smoking-rates-by-state
"Adult Smoking Rates by U.S. State (2026)." HealthVetted, 2026, https://healthvetted.com/research/us-smoking-rates-by-state.
<p>Source: <a href="https://healthvetted.com/research/us-smoking-rates-by-state">Adult Smoking Rates by U.S. State (2026)</a> by <a href="https://healthvetted.com">HealthVetted</a>.</p>
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