Here Are the 15 Cities With the Highest Smoking Rates in America

Everyone knows all the dreadful things smoking does your body by now, and fewer people are lighting up because of it. Smoking rates in the United States are as low as they’ve ever been. Nearly 21% of adults smoked cigarettes in 2005, but that figure dropped to 15.5% in 2016, according to the CDC. However, some cities might want to brush up the signs you have lung cancer since they have the highest smoking rates in America, according to research from 24/7 Wall St.

We’re going to spend a lot of time in one part of the country, but we’ll break away when for a minute when we reach No. 3 on the countdown. We’ll use population figures as the deciding factor in the event of ties since the higher population indicates more smokers.

15. Topeka, Kansas

The Kansas state capitol building is located in downtown Topeka, a city with one of the highest smoking rates in America.

The Kansas state capitol building in Topeka. | fotoguy22/iStock/Getty Images

Smoking rate: 24.6%

Population: 126,587

Kansas’ capital city in the northeast portion of the state isn’t setting a good example when it comes to smoking. The rate of adults who light up is nearly 9% higher than the national average. This is the part where we remind Topeka smokers, and anyone else who lights up, all the health benefits you can achieve when you quit smoking.

Next: A sinful city that loves smoking, too.

14. Gulfport, Mississippi

Gulfport, Mississippi

Smoking is a big vice in Gulfport, Mississippi. | Rex_Wholster/ iStock/ Getty Images Plus

Smoking rate: 24.8%

Population: 71,822

Gulfport and fellow Mississippi coastal cities Biloxi and Pascagoula combine to have 24.8% of adults smoke cigarettes. Vanity makes Gulfport one of the most sinful cities in America, but the smoking rate isn’t doing anything to keep residents looking good. The negative effects of smoking start with the first puff, so people in these Mississippi cities have every reason to quit.

Next: A city with similarities to our previous stops.

13. Evansville, Indiana

Man smoking on a sidewalk.

Evansville has more smokers than most cities. | Jewel Samad/AFP/Getty Images

Smoking rate: 24.8%

Population: 118,930

Like the two cities we’ve already visited, Topeka and Gulfport, Evansville is a mid-size city in a largely rural state. And like the other two, it has one of the highest smoking rates in America. Nearly 25% of adults regularly light up, which is nearly 10% more than the national rate.

Next: Loose laws encourage people to light up.

12. Roanoke, Virginia

hand holding a cigarette.

Cheap smokes and lax laws help give Roanoke one of the highest smoking rates in the U.S. | Spencer Platt/Getty Images

Smoking rate: 24.9%

Population: 99,837

State capital Richmond houses the headquarters of tobacco company Phillip Morris, so it shouldn’t be surprising to see a Virginia city on our list. The state has some of the loosest tobacco laws in the country, including low taxes, and Roanoke has one of the highest smoking rates in America.

Next: Let’s visit another state with loose tobacco laws.

11. Columbus, Georgia

Columbus, Georgia, has one of the highest smoking rates of any city in the U.S.

Columbus, Georgia, is a city where many people smoke cigarettes. | SeanPavonePhoto/iStock/Getty Images

Smoking rate: 24.9%

Population: 194,058

We just came from Virginia, a state with loose tobacco laws, and Georgia is in the same boat. The taxes on a pack of cigarettes are next to nothing, and when you consider that the state is already one of the least expensive states to live in, you get a city like Columbus. Cheap living and cheap cigarettes give the city one of the highest smoking rates of any city in the country.

Next: We’re not shocked seeing this city make our list.

10. Winston-Salem, North Carolina

The skyline in Winston-Salem, North Carolina.

Winston-Salem seems destined to be a city with a high smoking rate. | Bryan Pollard/iStock/Getty Images

Smoking rate: 25%

Population: 244,605

North Carolina is nicknamed The Tar Heel State, so it’s not shocking to see it have a city with one of the highest smoking rates in the U.S. It’s even less surprising to see Winston-Salem be that city for a few reasons.

  • It houses the headquarters of R.J. Reynolds, which is one of the biggest tobacco companies in the world.
  • The two names in the city’s title are both brands of cigarettes.
  • Winston-Salem isn’t too far from Tobacco Road, the historic heart of the state’s tobacco industry.

Next: A city where smoking is just part of the problem.

9. Hickory, North Carolina

Pack of cigarettes

Hickory, North Carolina, and its neighbors have more smokers than other cities. | Lindsay Fox/ Commons

Smoking rate: 25.4%

Population: 40,611

After visiting Winston-Salem, we’re staying in North Carolina for our next stop. Hickory and the nearby cities of Lenoir (population 17,943) and Morganton (pop. 16,519) combine to have 25.4% of adults light up on a regular basis. Unfortunately, smoking is just part of the problem in Hickory. It’s one of the cities with the highest opioid addiction rates in America.

Next: Another knock against this cities reputation.

8. Huntington, West Virginia

Pregnant Woman Smoking Cigarette

Huntington and the rest of West Virginia love to smoke, even while pregnant. | Highwaystarz-Photography/Getty Images

Smoking rate: 27.2%

Population: 47,079

Huntington, which sits on the Ohio River near where Kentucky, Ohio, and West Virginia meet, has one of the highest smoking rates in America, but that’s just one of the knocks against its reputation.

In Huntington’s defense, smoking is a statewide problem in West Virginia. Despite all the health concerns, pregnant women still smoke cigarettes throughout the state.

Next: Let’s head up north.

7. Canton, Ohio

Canton, Ohio, has its fair share of smokers.

Canton has one of the highest smoking rates around. | Joe Raedle/Getty Images

Smoking rate: 27.5%

Population: 70,909

The NFL Hall of Fame in Canton celebrates athletic excellence, but adults in the city might not be cut out for even watching a football game. With a 27.5% smoking rate among people 18 or older, Canton has one of the highest smoking rates of any place in the United States.

Next: Smokers in this city might be confused about which state they live in.

6. Spartanburg, South Carolina

Packs of Camel cigarettes for sale.

Spartanburg’s smoking rate is more than 12% higher than it is nationally. | Justin Sullivan/Getty Images

Smoking rate: 27.6%

Population: 37,498

Spartanburg is closer to Charlotte, North Carolina, than it is to any other big city, and it has the smoking rate of its northern brethren. The city northwest South Carolina sees 27.6% of adults regularly smoke cigarettes, which is more than 12% higher than the national rate.

Next: Where have we heard this one before?

5. Fayetteville, North Carolina

pack of marlboro cigarettes

Adults in Fayetteville, North Carolina, love smoking. | Joe Raedle/Getty Images

Smoking rate: 27.8%

Population: 209,889

Oh, a North Carolina city with some of the highest smoking rates in America? Where have we heard that one before? Fayetteville is our third stop in The Tar Heel State so far, and it’s by far the worst smoking offender. Its rate is about 2.5% higher than in Hickory and almost 3% higher than in Winston-Salem, the other North Carolina cities on our countdown.

Next: Smokers in this city have easy access to cheap cigarettes.

4. Kingsport, Tennessee

Kingsport, Tennessee, has one of the highest smoking rates in America.

Kingsport, Tennessee, has one of the highest smoking rates in America. | NCubed/Wikimedia Commons

Smoking rate: 28%

Population: 53,374

Tennessee is one of the states where you’re more likely to die of cancer, and Kingsport isn’t doing anything to help the cause. The city, combined with nearby Bristol, Tennessee, combine to have one of the highest smoking rates in the U.S. Virginia, with its lax tobacco laws, sits just to the north, so cheap cigarettes are easy to get in Kingsport and Bristol, and that’s not helping, either.

Next: Ruined beaches are collateral damage due to smoking in this city.

3. Erie, Pennsylvania

loose cigarettes in a pile.

After smokers trashed the waterfront, Erie changed its smoking laws. | Matt Cardy/Getty Images

Smoking rate: 28.2%

Population: 97,369

Pennsylvania may have some surprisingly gorgeous beaches near Erie, but you might have to sidestep cigarette butts on your way into the water. The smoking rate in the city is nearly 13% higher than the national average. Residents complain about smokers trashing the waterfront, and legislators are doing something about it. New smoking ban laws passed in Erie County in late 2018 faced little opposition.

Next: A city in a state with its share of tobacco deaths.

2. Fort Smith, Arkansas

Pensive red-haired girl in bikini smoking on beach.

Tobacco kills a ton of people in Arkansas, including Fort Smith. |

Smoking rate: 28.3%

Population: 88,037

Smoking and cancer go hand-in-hand, so it shouldn’t come as any surprise that a state where tobacco kills the most people has a city with one of the highest smoking rates around. Fort Smith, which sits on the Arkansas River in the western part of the state along the Oklahoma border, sees more than 28% of adults admit to smoking on a regular basis.

Next: Smoking is just one public health problem here.

1. Lafayette, Louisiana

St. Johns Cathedral in Lafayette, Louisiana

St. Johns Cathedral in Lafayette, which has the highest smoking rate of any city in the U.S. | artiste9999/iStock/Getty Images Plus

Smoking rate: 28.3%

Population: 126,848

It would be bad enough if being destined for obesity was the worst public health problem in Lafayette, but it’s worse. The city tops the list of cities with the highest smoking rates, which is one reason why Louisiana is one of the states where the most people gets diagnosed with lung cancer. Lafayette is doing what it can to reverse the trend — it banned smoking in bars in 2017.

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