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

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

Mississippi County had the highest adult cigarette smoking rate, local model estimate of 115 counties in 2021, at 28%. St. Charles County had the lowest, at 13.3%. The median was 21.5%. Source: the Centers for Disease Control and Prevention.

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Highest28Mississippi County
Lowest13.3St. Charles County
Median21.5115 counties

Map of counties, 2021

Adair County: 16.7 %Andrew County: 17.8 %Atchison County: 20.9 %Audrain County: 23.6 %Barry County: 22.3 %Barton County: 24 %Bates County: 23.6 %Benton County: 21.1 %Bollinger County: 24.4 %Boone County: 14.6 %Buchanan County: 21.7 %Butler County: 26.9 %Caldwell County: 23.1 %Callaway County: 19.6 %Camden County: 19.1 %Cape Girardeau County: 17.7 %Carroll County: 20.5 %Carter County: 23.6 %Cass County: 17.8 %Cedar County: 23.5 %Chariton County: 19.5 %Christian County: 17.8 %Clark County: 23.6 %Clay County: 16.1 %Clinton County: 19.9 %Cole County: 17.4 %Cooper County: 19.7 %Crawford County: 24.5 %Dade County: 23.9 %Dallas County: 25 %Daviess County: 21 %DeKalb County: 21 %Dent County: 24.1 %Douglas County: 23.7 %Dunklin County: 25.8 %Franklin County: 19.4 %Gasconade County: 19.2 %Gentry County: 22.6 %Greene County: 17.2 %Grundy County: 21.1 %Harrison County: 21.8 %Henry County: 21.8 %Hickory County: 23.1 %Holt County: 19.1 %Howard County: 18.4 %Howell County: 25.3 %Iron County: 24.5 %Jackson County: 17.7 %Jasper County: 21.2 %Jefferson County: 19.5 %Johnson County: 17.6 %Knox County: 23.7 %Laclede County: 22.7 %Lafayette County: 20.3 %Lawrence County: 23 %Lewis County: 22.7 %Lincoln County: 19.9 %Linn County: 21 %Livingston County: 21 %McDonald County: 27.1 %Macon County: 20.3 %Madison County: 21.5 %Maries County: 21.7 %Marion County: 20.9 %Mercer County: 21.6 %Miller County: 21.8 %Mississippi County: 28 %Moniteau County: 20.6 %Monroe County: 20.9 %Montgomery County: 22.2 %Morgan County: 24 %New Madrid County: 25.5 %Newton County: 20.9 %Nodaway County: 15.9 %Oregon County: 27.7 %Osage County: 17.7 %Ozark County: 25.8 %Pemiscot County: 27.1 %Perry County: 20 %Pettis County: 21.4 %Phelps County: 18.6 %Pike County: 23.3 %Platte County: 14.8 %Polk County: 21.1 %Pulaski County: 18.5 %Putnam County: 18.9 %Ralls County: 21.6 %Randolph County: 21.6 %Ray County: 21.6 %Reynolds County: 24.2 %Ripley County: 27.6 %St. Charles County: 13.3 %St. Clair County: 23 %Ste. Genevieve County: 20.2 %St. Francois County: 24.8 %St. Louis County: 15.7 %Saline County: 18.9 %Schuyler County: 21 %Scotland County: 22 %Scott County: 21.6 %Shannon County: 24.5 %Shelby County: 22.4 %Stoddard County: 25.1 %Stone County: 19.9 %Sullivan County: 21.5 %Taney County: 19.9 %Texas County: 24.6 %Vernon County: 23.4 %Warren County: 20.1 %Washington County: 25.6 %Wayne County: 26.4 %Webster County: 22.6 %Worth County: 20.3 %Wright County: 25.9 %St. Louis city: 20.3 %
  • Under 19
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  • 25 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

Mississippi County: 28 %Mississippi County28Oregon County: 27.7 %Oregon County27.7Ripley County: 27.6 %Ripley County27.6McDonald County: 27.1 %McDonald County27.1Pemiscot County: 27.1 %Pemiscot County27.1Butler County: 26.9 %Butler County26.9Wayne County: 26.4 %Wayne County26.4Wright County: 25.9 %Wright County25.9Dunklin County: 25.8 %Dunklin County25.8Ozark County: 25.8 %Ozark County25.8Washington County: 25.6 %Washington County25.6New Madrid County: 25.5 %New Madrid County25.5Howell County: 25.3 %Howell County25.3Stoddard County: 25.1 %Stoddard County25.1Dallas County: 25 %Dallas County25St. Francois County: 24.8 %St. Francois County24.8Texas County: 24.6 %Texas County24.6Crawford County: 24.5 %Crawford County24.5Iron County: 24.5 %Iron County24.5Shannon County: 24.5 %Shannon County24.5Bollinger County: 24.4 %Bollinger County24.4Reynolds County: 24.2 %Reynolds County24.2Dent County: 24.1 %Dent County24.1Barton County: 24 %Barton County24Morgan County: 24 %Morgan County24Dade County: 23.9 %Dade County23.9Douglas County: 23.7 %Douglas County23.7Knox County: 23.7 %Knox County23.7Audrain County: 23.6 %Audrain County23.6Bates County: 23.6 %Bates County23.6Carter County: 23.6 %Carter County23.6Clark County: 23.6 %Clark County23.6Cedar County: 23.5 %Cedar County23.5Vernon County: 23.4 %Vernon County23.4Pike County: 23.3 %Pike County23.3Caldwell County: 23.1 %Caldwell County23.1Hickory County: 23.1 %Hickory County23.1Lawrence County: 23 %Lawrence County23St. Clair County: 23 %St. Clair County23Laclede County: 22.7 %Laclede County22.7Mississippi County: 28 %Mississippi County28Oregon County: 27.7 %Oregon County27.7Ripley County: 27.6 %Ripley County27.6McDonald County: 27.1 %McDonald County27.1Pemiscot County: 27.1 %Pemiscot County27.1Butler County: 26.9 %Butler County26.9Wayne County: 26.4 %Wayne County26.4Wright County: 25.9 %Wright County25.9Dunklin County: 25.8 %Dunklin County25.8Ozark County: 25.8 %Ozark County25.8Washington County: 25.6 %Washington County25.6New Madrid County: 25.5 %New Madrid County25.5Howell County: 25.3 %Howell County25.3Stoddard County: 25.1 %Stoddard County25.1Dallas County: 25 %Dallas County25St. Francois County: 24.8 %St. Francois County24.8Texas County: 24.6 %Texas County24.6Crawford County: 24.5 %Crawford County24.5Iron County: 24.5 %Iron County24.5Shannon County: 24.5 %Shannon County24.5Bollinger County: 24.4 %Bollinger County24.4Reynolds County: 24.2 %Reynolds County24.2Dent County: 24.1 %Dent County24.1Barton County: 24 %Barton County24Morgan County: 24 %Morgan County24Dade County: 23.9 %Dade County23.9Douglas County: 23.7 %Douglas County23.7Knox County: 23.7 %Knox County23.7Audrain County: 23.6 %Audrain County23.6Bates County: 23.6 %Bates County23.6Carter County: 23.6 %Carter County23.6Clark County: 23.6 %Clark County23.6Cedar County: 23.5 %Cedar County23.5Vernon County: 23.4 %Vernon County23.4Pike County: 23.3 %Pike County23.3Caldwell County: 23.1 %Caldwell County23.1Hickory County: 23.1 %Hickory County23.1Lawrence County: 23 %Lawrence County23St. Clair County: 23 %St. Clair County23Laclede County: 22.7 %Laclede County22.7
%. 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 (%)
1Mississippi County28
2Oregon County27.7
3Ripley County27.6
4McDonald County27.1
4Pemiscot County27.1
6Butler County26.9
7Wayne County26.4
8Wright County25.9
9Dunklin County25.8
9Ozark County25.8
11Washington County25.6
12New Madrid County25.5
13Howell County25.3
14Stoddard County25.1
15Dallas County25
16St. Francois County24.8
17Texas County24.6
18Crawford County24.5
18Iron County24.5
18Shannon County24.5
21Bollinger County24.4
22Reynolds County24.2
23Dent County24.1
24Barton County24
24Morgan County24
26Dade County23.9
27Douglas County23.7
27Knox County23.7
29Audrain County23.6
29Bates County23.6
29Carter County23.6
29Clark County23.6
33Cedar County23.5
34Vernon County23.4
35Pike County23.3
36Caldwell County23.1
36Hickory County23.1
38Lawrence County23
38St. Clair County23
40Laclede County22.7
40Lewis County22.7
42Gentry County22.6
42Webster County22.6
44Shelby County22.4
45Barry County22.3
46Montgomery County22.2
47Scotland County22
48Harrison County21.8
48Henry County21.8
48Miller County21.8
51Buchanan County21.7
51Maries County21.7
53Mercer County21.6
53Ralls County21.6
53Randolph County21.6
53Ray County21.6
53Scott County21.6
58Madison County21.5
58Sullivan County21.5
60Pettis County21.4
61Jasper County21.2
62Benton County21.1
62Grundy County21.1
62Polk County21.1
65Daviess County21
65DeKalb County21
65Linn County21
65Livingston County21
65Schuyler County21
70Atchison County20.9
70Marion County20.9
70Monroe County20.9
70Newton County20.9
74Moniteau County20.6
75Carroll County20.5
76Lafayette County20.3
76Macon County20.3
76St. Louis city20.3
76Worth County20.3
80Ste. Genevieve County20.2
81Warren County20.1
82Perry County20
83Clinton County19.9
83Lincoln County19.9
83Stone County19.9
83Taney County19.9
87Cooper County19.7
88Callaway County19.6
89Chariton County19.5
89Jefferson County19.5
91Franklin County19.4
92Gasconade County19.2
93Camden County19.1
93Holt County19.1
95Putnam County18.9
95Saline County18.9
97Phelps County18.6
98Pulaski County18.5
99Howard County18.4
100Andrew County17.8
100Cass County17.8
100Christian County17.8
103Cape Girardeau County17.7
103Jackson County17.7
103Osage County17.7
106Johnson County17.6
107Cole County17.4
108Greene County17.2
109Adair County16.7
110Clay County16.1
111Nodaway County15.9
112St. Louis County15.7
113Platte County14.8
114Boone County14.6
115St. Charles County13.3

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 Missouri 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 Missouri 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/missouri-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 Missouri 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/missouri-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 Missouri 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/missouri-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{centers_counties_in_missouri_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 Missouri 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/missouri-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 Missouri 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/missouri-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/missouri-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 Missouri 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":"Missouri","limit":10}
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Questions

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

Mississippi County, with 28% in 2021, according to the Centers for Disease Control and Prevention.

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

St. Charles County, with 13.3% 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 Missouri: more rankings