Nearly half a million Americans annually die as a result of smoking, the leading cause of preventable death in the United States. Another 16 million Americans are living with a serious illness caused by smoking. Smoking also has an economic impact, including more than $225 billion each year spent on medical expenses to treat the smoking-related illness in the U.S. and over $156 billion in lost productivity.

Though the risks associated with smoking and tobacco use are well established and widely understood, 42.4 million American adults — or 16.6% of the adult population — smoke every day or most days and have smoked at least 100 cigarettes in their lifetime.

States where large shares of the population smoke often have below average health outcomes, and vice versa — and in at least one key measure, that pattern holds in California. Average life expectancy at birth in the state is 81.7 years, compared to 79.2 years nationwide.

All data used in this story is from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report.

 

Rank State Adults who smoke (%) Avg. life expectancy at birth (years)
1 West Virginia 26.9 74.8
2 Kentucky 24.1 75.6
3 Arkansas 23.7 76.1
4 Indiana 21.7 77.1
5 Ohio 21.4 77.0
6 Louisiana 21.1 76.1
7 Mississippi 21.0 74.9
8 Tennessee 20.8 76.0
9 South Dakota 20.2 78.9
10 Missouri 20.1 77.3
11 Michigan 20.1 78.1
12 Alabama 20.0 75.6
13 Oklahoma 19.9 76.1
14 North Dakota 19.7 79.7
15 Maine 19.4 78.7
16 Wyoming 19.2 78.9
17 Montana 18.9 78.9
18 South Carolina 18.7 77.1
19 Alaska 18.5 79.0
20 Pennsylvania 17.9 78.5
21 North Carolina 17.9 78.1
22 Kansas 17.9 78.5
23 Iowa 17.4 79.4
24 Delaware 17.4 78.5
25 Wisconsin 17.2 79.5
26 Nebraska 16.6 79.6
27 New Hampshire 16.6 79.7
28 Georgia 16.3 77.9
29 New Mexico 15.9 78.0
30 Illinois 15.9 79.4
31 Nevada 15.7 78.7
32 Oregon 15.7 79.9
33 Minnesota 15.5 80.9
34 Rhode Island 15.2 79.8
35 Virginia 15.1 79.6
36 Idaho 15.0 79.4
37 Florida 14.9 80.2
38 Colorado 14.7 80.6
39 Vermont 14.7 79.8
40 Arizona 14.5 80.0
41 Hawaii 14.4 82.3
42 Texas 14.2 79.2
43 Massachusetts 13.7 80.6
44 New Jersey 13.2 80.5
45 New York 13.0 81.4
46 Maryland 12.6 79.2
47 Connecticut 12.5 80.9
48 Washington 12.1 80.4
49 California 11.5 81.7
50 Utah 9.1 80.1

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