Data / Rankings / Adult cigarette smoking rate, local model estimate / Counties in Iowa

Counties in Iowa by adult cigarette smoking rate, local model estimate

Clarke County had the highest adult cigarette smoking rate, local model estimate of 99 counties in 2021, at 20.5%. Story County had the lowest, at 11.6%. The median was 16.7%. Source: the Centers for Disease Control and Prevention.

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Highest20.5Clarke County
Lowest11.6Story County
Median16.799 counties

Map of counties, 2021

Adair County: 17.3 %Adams County: 16.5 %Allamakee County: 17.1 %Appanoose County: 19.8 %Audubon County: 16.1 %Benton County: 16.4 %Black Hawk County: 15.9 %Boone County: 16.1 %Bremer County: 13.6 %Buchanan County: 16.4 %Buena Vista County: 16.5 %Butler County: 16.6 %Calhoun County: 16.6 %Carroll County: 16.1 %Cass County: 18 %Cedar County: 16.1 %Cerro Gordo County: 15.6 %Cherokee County: 17.3 %Chickasaw County: 16.9 %Clarke County: 20.5 %Clay County: 16.6 %Clayton County: 18.3 %Clinton County: 17.8 %Crawford County: 18.4 %Dallas County: 11.6 %Davis County: 18.8 %Decatur County: 16.7 %Delaware County: 16.4 %Des Moines County: 17.6 %Dickinson County: 14.3 %Dubuque County: 14.7 %Emmet County: 17.5 %Fayette County: 17.9 %Floyd County: 16.7 %Franklin County: 17.2 %Fremont County: 17.1 %Greene County: 16.9 %Grundy County: 14.6 %Guthrie County: 16.2 %Hamilton County: 15.5 %Hancock County: 16.6 %Hardin County: 16.7 %Harrison County: 17.5 %Henry County: 16.8 %Howard County: 17.3 %Humboldt County: 17.8 %Ida County: 17 %Iowa County: 15.7 %Jackson County: 17.8 %Jasper County: 17.7 %Jefferson County: 15.5 %Johnson County: 12.7 %Jones County: 16.9 %Keokuk County: 18.4 %Kossuth County: 16.7 %Lee County: 18.1 %Linn County: 15.1 %Louisa County: 17.6 %Lucas County: 19.4 %Lyon County: 16 %Madison County: 14.9 %Mahaska County: 18.1 %Marion County: 14.7 %Marshall County: 17.5 %Mills County: 15.3 %Mitchell County: 15.8 %Monona County: 17.8 %Monroe County: 16.8 %Montgomery County: 18.7 %Muscatine County: 16.4 %O'Brien County: 17.5 %Osceola County: 16.9 %Page County: 18.8 %Palo Alto County: 15.4 %Plymouth County: 15.3 %Pocahontas County: 17.9 %Polk County: 15.4 %Pottawattamie County: 17.1 %Poweshiek County: 15.2 %Ringgold County: 17.5 %Sac County: 16.2 %Scott County: 16.2 %Shelby County: 15.9 %Sioux County: 12.7 %Story County: 11.6 %Tama County: 18 %Taylor County: 16.5 %Union County: 17.2 %Van Buren County: 20.1 %Wapello County: 20 %Warren County: 14 %Washington County: 15.6 %Wayne County: 18.6 %Webster County: 17.6 %Winnebago County: 15.6 %Winneshiek County: 13.3 %Woodbury County: 18.3 %Worth County: 15.9 %Wright County: 16.8 %
  • Under 15
  • 15 to 16
  • 16 to 17
  • 17 to 18
  • 18 and over
%, 2021. Source: CDC, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2021

Clarke County: 20.5 %Clarke County20.5Van Buren County: 20.1 %Van Buren County20.1Wapello County: 20 %Wapello County20Appanoose County: 19.8 %Appanoose County19.8Lucas County: 19.4 %Lucas County19.4Davis County: 18.8 %Davis County18.8Page County: 18.8 %Page County18.8Montgomery County: 18.7 %Montgomery County18.7Wayne County: 18.6 %Wayne County18.6Crawford County: 18.4 %Crawford County18.4Keokuk County: 18.4 %Keokuk County18.4Clayton County: 18.3 %Clayton County18.3Woodbury County: 18.3 %Woodbury County18.3Lee County: 18.1 %Lee County18.1Mahaska County: 18.1 %Mahaska County18.1Cass County: 18 %Cass County18Tama County: 18 %Tama County18Fayette County: 17.9 %Fayette County17.9Pocahontas County: 17.9 %Pocahontas County17.9Clinton County: 17.8 %Clinton County17.8Humboldt County: 17.8 %Humboldt County17.8Jackson County: 17.8 %Jackson County17.8Monona County: 17.8 %Monona County17.8Jasper County: 17.7 %Jasper County17.7Des Moines County: 17.6 %Des Moines County17.6Louisa County: 17.6 %Louisa County17.6Webster County: 17.6 %Webster County17.6Emmet County: 17.5 %Emmet County17.5Harrison County: 17.5 %Harrison County17.5Marshall County: 17.5 %Marshall County17.5O'Brien County: 17.5 %O'Brien County17.5Ringgold County: 17.5 %Ringgold County17.5Adair County: 17.3 %Adair County17.3Cherokee County: 17.3 %Cherokee County17.3Howard County: 17.3 %Howard County17.3Franklin County: 17.2 %Franklin County17.2Union County: 17.2 %Union County17.2Allamakee County: 17.1 %Allamakee County17.1Fremont County: 17.1 %Fremont County17.1Pottawattamie County: 17.1 %Pottawattamie County17.1Clarke County: 20.5 %Clarke County20.5Van Buren County: 20.1 %Van Buren County20.1Wapello County: 20 %Wapello County20Appanoose County: 19.8 %Appanoose County19.8Lucas County: 19.4 %Lucas County19.4Davis County: 18.8 %Davis County18.8Page County: 18.8 %Page County18.8Montgomery County: 18.7 %Montgomery County18.7Wayne County: 18.6 %Wayne County18.6Crawford County: 18.4 %Crawford County18.4Keokuk County: 18.4 %Keokuk County18.4Clayton County: 18.3 %Clayton County18.3Woodbury County: 18.3 %Woodbury County18.3Lee County: 18.1 %Lee County18.1Mahaska County: 18.1 %Mahaska County18.1Cass County: 18 %Cass County18Tama County: 18 %Tama County18Fayette County: 17.9 %Fayette County17.9Pocahontas County: 17.9 %Pocahontas County17.9Clinton County: 17.8 %Clinton County17.8Humboldt County: 17.8 %Humboldt County17.8Jackson County: 17.8 %Jackson County17.8Monona County: 17.8 %Monona County17.8Jasper County: 17.7 %Jasper County17.7Des Moines County: 17.6 %Des Moines County17.6Louisa County: 17.6 %Louisa County17.6Webster County: 17.6 %Webster County17.6Emmet County: 17.5 %Emmet County17.5Harrison County: 17.5 %Harrison County17.5Marshall County: 17.5 %Marshall County17.5O'Brien County: 17.5 %O'Brien County17.5Ringgold County: 17.5 %Ringgold County17.5Adair County: 17.3 %Adair County17.3Cherokee County: 17.3 %Cherokee County17.3Howard County: 17.3 %Howard County17.3Franklin County: 17.2 %Franklin County17.2Union County: 17.2 %Union County17.2Allamakee County: 17.1 %Allamakee County17.1Fremont County: 17.1 %Fremont County17.1Pottawattamie County: 17.1 %Pottawattamie County17.1
%. Source: CDC, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Retrieved 2026-10-12.

Full ranking

RankCounties2021 (%)
1Clarke County20.5
2Van Buren County20.1
3Wapello County20
4Appanoose County19.8
5Lucas County19.4
6Davis County18.8
6Page County18.8
8Montgomery County18.7
9Wayne County18.6
10Crawford County18.4
10Keokuk County18.4
12Clayton County18.3
12Woodbury County18.3
14Lee County18.1
14Mahaska County18.1
16Cass County18
16Tama County18
18Fayette County17.9
18Pocahontas County17.9
20Clinton County17.8
20Humboldt County17.8
20Jackson County17.8
20Monona County17.8
24Jasper County17.7
25Des Moines County17.6
25Louisa County17.6
25Webster County17.6
28Emmet County17.5
28Harrison County17.5
28Marshall County17.5
28O'Brien County17.5
28Ringgold County17.5
33Adair County17.3
33Cherokee County17.3
33Howard County17.3
36Franklin County17.2
36Union County17.2
38Allamakee County17.1
38Fremont County17.1
38Pottawattamie County17.1
41Ida County17
42Chickasaw County16.9
42Greene County16.9
42Jones County16.9
42Osceola County16.9
46Henry County16.8
46Monroe County16.8
46Wright County16.8
49Decatur County16.7
49Floyd County16.7
49Hardin County16.7
49Kossuth County16.7
53Butler County16.6
53Calhoun County16.6
53Clay County16.6
53Hancock County16.6
57Adams County16.5
57Buena Vista County16.5
57Taylor County16.5
60Benton County16.4
60Buchanan County16.4
60Delaware County16.4
60Muscatine County16.4
64Guthrie County16.2
64Sac County16.2
64Scott County16.2
67Audubon County16.1
67Boone County16.1
67Carroll County16.1
67Cedar County16.1
71Lyon County16
72Black Hawk County15.9
72Shelby County15.9
72Worth County15.9
75Mitchell County15.8
76Iowa County15.7
77Cerro Gordo County15.6
77Washington County15.6
77Winnebago County15.6
80Hamilton County15.5
80Jefferson County15.5
82Palo Alto County15.4
82Polk County15.4
84Mills County15.3
84Plymouth County15.3
86Poweshiek County15.2
87Linn County15.1
88Madison County14.9
89Dubuque County14.7
89Marion County14.7
91Grundy County14.6
92Dickinson County14.3
93Warren County14
94Bremer County13.6
95Winneshiek County13.3
96Johnson County12.7
96Sioux County12.7
98Dallas County11.6
98Story County11.6

Other periods

About this ranking

Percentage of adults who have smoked at least 100 cigarettes in their lifetime and now smoke every day or on some days. Model-based estimate for adults aged 18 and over from CDC PLACES. Crude prevalence, not age-adjusted.

US counties and cities (incorporated places of 10,000 or more). CDC PLACES combines Behavioral Risk Factor Surveillance System (BRFSS) answers with local population data through multilevel regression and poststratification, so a county or city value is a model estimate, not a survey count. The year is the BRFSS survey year, not the release year. CDC says the method does not support tracking change in a place over time, and each annual release can change the model, so values for different years are not strictly comparable. A state is missing in a year when its BRFSS data did not meet standards (Kentucky and Pennsylvania in 2023, Florida in 2021). Connecticut counties appear as its nine planning regions from 2022; its eight former counties are not served. City values for 2021 come from the 2023 release, built on 2010 Census place boundaries; later years use 2020 boundaries. State and national values come from direct BRFSS estimates under adult_smoking_rate.

Every value in the ranking comes from the same publisher and the same period, so the counties are compared on one definition. Equal values share a rank.

How to cite

Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.

Citation styles

The publisher is the author. Invokely is named only as the place the figures were read, where a style asks for it.

APA 7

Centers for Disease Control and Prevention. (2025). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence (Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021) [Data set]. Retrieved October 12, 2026, from https://www.cdc.gov/places/

MLA 9

PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence, Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021. Centers for Disease Control and Prevention, 4 Dec. 2025, https://www.cdc.gov/places/. Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021. Accessed 12 Oct. 2026.

Chicago (author-date)

Centers for Disease Control and Prevention. 2025. PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021. Dataset. Accessed October 12, 2026. https://www.cdc.gov/places/. Also distributed by Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021.

Harvard

Centers for Disease Control and Prevention (2025) PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence, Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021 [Dataset]. Available at: https://www.cdc.gov/places/, via Invokely: https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{centers_counties_in_iowa_by_2021,
  author = {{Centers for Disease Control and Prevention}},
  title = {{PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence: Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021}},
  year = {2025},
  howpublished = {Data set},
  url = {https://www.cdc.gov/places/},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021. Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.},
}
RIS
TY  - DATA
AU  - Centers for Disease Control and Prevention
TI  - PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence: Counties in Iowa by adult cigarette smoking rate, local model estimate, 2021
PY  - 2025
DA  - 2025/12/04
PB  - Centers for Disease Control and Prevention
DB  - Invokely
UR  - https://www.cdc.gov/places/
L2  - https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/iowa-counties?period=2021.
N1  - Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.
ER  -
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Rank Counties in Iowa by adult cigarette smoking rate, local model estimate using official data, and cite the source.
rank_places {"indicator":"adult_smoking_rate_modelled","level":"province","within":"Iowa","limit":10}
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Questions

Which county has the highest adult cigarette smoking rate, local model estimate?

Clarke County, with 20.5% in 2021, according to the Centers for Disease Control and Prevention.

Which county has the lowest adult cigarette smoking rate, local model estimate?

Story County, with 11.6% in 2021.

Where does this ranking come from?

Every value comes from one source and one period, so the places are comparable: Centers for Disease Control and Prevention, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Retrieved 2026-10-12.

Adult cigarette smoking rate, local model estimate: other rankings

Counties in Iowa: more rankings