These 13 States Have The Highest Smoking Rates In The Nation

By Maggie Ethridge 06/13/19
The Truth Initiative refers to a cluster of about a dozen U.S. states with higher-than-average smoking rates as "Tobacco Nation."
woman smoking a cigarette

A new report reveals a block of 13 states in the U.S. whose residents have higher rates of smoking and smoking-related diseases than the rest of the country.

Using data between the years of 2011 and 2018, Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee and West Virginia were found by The Truth Initiative to have a 6% higher rate of smokers.

As reported by US News, The Truth Initiative (whose tagline is "inspiring tobacco free lives") dubbed these 13 states—whose smoking rates rival even the highest smoking populations in the world—"Tobacco Nation."

Characteristics of these states as outlined by The Truth Initiative are: 21% of the residents smoke (versus 15% in all other U.S. states); the residents are notably poorer and spend more money on tobacco; residents report more than 20% more bad physical and mental health days; and local governments in these states have significantly less anti-tobacco programs and laws in place.

In addition, the life expectancy of these residents is three years fewer than the rest of the country, at 76 years of age.

"This part of the country, which is significant in size—22% of the U.S.—has been suffering from these disparities for many years," Robin Koval, Truth Initiative's CEO, told US News. "At the same time, so many advances have been made elsewhere in the United States. I think that makes it particularly egregious."

Truth Initiative reported that in these 13 states, there are fewer laws aimed at preventing smoking (such as indoor or public smoking bans) and fewer taxes on tobacco products. While the rest of the country has made significant progress in lowering smoking and smoking-related disease rates, Truth Initiative found no notable progress in Tobacco Nation since 2017, the year of its first report.

People residing in the Tobacco Nation are just as likely to attempt quitting a tobacco addiction, but are much less likely to succeed, according to the CDC. It is most likely the lack of resources and state-sponsored programs that contribute significantly to this problem, as well as the higher rate of mental and physical distress reported by the residents of these states.

Koval noted of the residents of Tobacco Nation, “The reality isn’t that these people have the tobacco gene. The problem is that they are living in a part of the country where the system is basically rigged to keep them smoking.”

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.